Nonsteroidal anti-inflammatory drugs are medicines that relieve
, swelling, stiffness, and inflammation.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed for a variety
of painful conditions, including arthritis, bursitis, tendonitis, gout,
, and other injuries.
Although the NSAIDs are often discussed as a group, not all are approved
for use in children. As of 2004, the following drugs are approved for
Other NSAIDs have been used in pediatric therapy, but should not be
considered as first choice for treatment of children or adolescents.
A new class of NSAIDs, called COX-2 inhibitors, have a lower risk of
causing ulcers than do the traditional NSAIDs. These drugs may be
appropriate for use in older teenagers but have not been approved for use
in younger children, and there is some evidence that they are
inappropriate for infants.
Nonsteroidal anti-inflammatory drugs relieve pain, stiffness, swelling,
and inflammation, but they do not cure the diseases or injuries
responsible for these problems. Two drugs in this category, ibuprofen and
naproxen, also reduce
. Some nonsteroidal anti-inflammatory drugs can be bought without a
prescription; others are available only with a prescription from a
physician or dentist.
Children with certain medical conditions and those who are taking some
other medicines can have problems if they take nonsteroidal
anti-inflammatory drugs. Before giving children these drugs, parents need
to let the physician know about any of the following conditions.
The physician needs to know about any
to foods, dyes, preservatives, or other substances. For children who have
had reactions to nonsteroidal anti-inflammatory drugs in the past, parents
should check with a physician before having these drugs prescribed again.
Teens and young women who are pregnant or who plan to become pregnant
should check with their physicians before taking these medicines. Whether
nonsteroidal anti-inflammatory drugs cause birth defects in people is
unknown, but some do cause birth defects in laboratory animals. If taken
late in pregnancy, these drugs may prolong pregnancy, lengthen labor time,
cause problems during delivery, or affect the heart or blood flow of the
Some nonsteroidal anti-inflammatory drugs pass into breast milk. Women who
are breastfeeding their babies should check with their physicians before
taking these drugs.
A number of medical conditions may influence the effects of nonsteroidal
anti-inflammatory drugs. Parents of children and teens who have any of the
conditions listed below should tell their physician about the condition
before having nonsteroidal anti-inflammatory drugs prescribed.
The most common side effects are stomach pain or cramps,
or lightheadedness, and drowsiness. As the patient's body adjusts
to the medicine, these symptoms usually disappear. If they do not, the
physician who prescribed the medicine should be contacted.
Serious side effects are rare, but do sometimes occur. If any of the
following side effects occur, patients should stop taking the medicine and
get emergency medical care immediately:
Other side effects do not require emergency medical care, but should have
medical attention. If any of the following side effects occur, patients
should stop taking the medicine and the physician who prescribed the
medicine should be called as soon as possible:
A number of less common, temporary side effects are also possible. They
usually do not need medical attention and will disappear once the body
adjusts to the medicine. If they continue or interfere with normal
activity, the physician should be contacted. Among these side effects are:
Nonsteroidal anti-inflammatory drugs may interact with a variety of other
medicines. When interaction occurs, the effects of the drugs may change,
and the risk of side effects may be greater. Physicians prescribing this
drug should know all other medicines the patient is already taking. Among
the drugs that may interact with nonsteroidal anti-inflammatory drugs are:
NSAIDs may also interact with certain herbal preparations sold as dietary
supplements. Among the herbs known to interact with NSAIDs are bearberry (
), feverfew (
), evening primrose (
), and gossypol, a pigment obtained from cottonseed oil and used as a male
contraceptive. In most cases, the herb increases the tendency of NSAIDs to
irritate the digestive tract. It is just as important for doctors to know
which herbal remedies the patient is taking on a regular basis as it is
for doctors to know the other prescription medications which are being
Many serious digestive system effects of NSAIDs can be prevented by taking
mysoprostol (Cytotec), but this drug is only appropriate for patients with
a high risk of ulcers. It is not called for when the NSAID is being used
for a short period of time or in patients with other risk factors. Stomach
upset can often be prevented by taking NSAIDs with food or milk.
—A lack of hemoglobin, the compound in blood that carries oxygen
from the lungs throughout the body and brings waste carbon dioxide from
the cells to the lungs, where it is released.
—Inflammation of the tissue around a joint.
—Inflammation of the colon (large bowel).
—A class of newer NSAIDs that are less likely to cause side
effects in the digestive tract. COX-2 inhibitors work by inhibiting the
production of cyclooxygenase-2, an enzyme involved in inflammation.
—Pain, redness, swelling, and heat that usually develop in
response to injury or illness.
—A group of drugs that includes aspirin and related compounds.
Salicylates are used to relieve pain, reduce inflammation, and lower
—Inflammation of a tendon, which is a tough band of tissue that
connects muscle to bone.
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5600 Fishers Lane, Rockville, MD 20857. Web site:
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