NSAIDs

Nonsteroidal anti-inflammatory drugs that produce analgesic, antipyretic, and anti-inflammatory effects primarily through inhibition of cyclooxygenase (COX) enzymes, resulting in reduced prostaglandin synthesis.

Examples

• Nonselective COX inhibitors

  • Ibuprofen

  • Naproxen

  • Diclofenac

  • Ketoprofen

  • Indomethacin

  • Ketorolac

  • Aspirin

• Preferential COX-2 inhibitors

  • Meloxicam

  • Etodolac

• Selective COX-2 inhibitors

  • Celecoxib

  • Etoricoxib

Indications

• Acute musculoskeletal pain

• Chronic inflammatory pain

• Osteoarthritis

• Rheumatoid arthritis

• Dysmenorrhea

• Acute gout attacks

• Postoperative pain

• Fever reduction

• Headache and migraine-related pain

Common adverse effects

• Gastrointestinal irritation, gastritis, peptic ulcer disease, and gastrointestinal bleeding

• Reduced renal perfusion and acute kidney injury, especially in volume depletion or chronic kidney disease

• Sodium and fluid retention

• Hypertension and worsening heart failure

• Increased cardiovascular thrombotic risk, particularly with selective COX-2 inhibitors

• Bronchospasm or hypersensitivity reactions in susceptible individuals

• Platelet dysfunction (especially with aspirin)