N SAIDs are among the most widely used medications world wide to reduce pain and inflammation (i.e. swelling, redness, warmth and pain) associated with arthritis and musculoskeletal pain.

e.g. Diclofenac (Voltaren®) , Ibuprofen (Brufen®)

 Choosing a NSAID

This is difficult as a wide variety is available. Response to NSAIDs can vary between two people. Effectiveness, side effects and price determine which one to use. The best person to decide is your doctor aided by you.

 How do NSAIDs work?

NSAIDs reduce pain and inflammation by inhibiting enzymes called cyclo-oxygenases. These enzymes are also involved in protecting the lining of the stomach and regulating the blood flow to kidneys which account for some of the important side effects seen with NSAIDs.

 Dose of NSAID

Lower doses are adequate for most people to relieve pain. These can be taken on a regular basis or when the pain occurs. Higher doses are needed to fully treat inflammation and must be taken on a regular basis for 2 to 4 weeks before full benefit is seen.

If the initial dose is inadequate your doctor may increase the dose of the same drug or change over to another NSAID. Patients taking one NSAID should never take a second NSAID at the same time.

 Taking NSAIDs

NSAIDs should always be taken after meals and never on an empty stomach. The risk of causing irritation to the stomach and bleeding from it are reduced when NSAIDs are taken with meals.

NSAIDs should not be taken more frequently or for a longer period than they have been prescribed.

 Side effects

Most people tolerate NSAIDs without any difficulty. The most common side effects include:

*  Gastrointestinal – short term may cause upper abdominal discomfort, long term use especially with higher doses can lead to ulcers and bleeding from the stomach

*  Kidneys – even short term use of NSAIDs can harm kidneys especially if there is existing kidney disease and/or when  taken together with other drugs that can be harmful to the kidneys

*  Allergies – skin rashes, difficulty in breathing (bronchospasms) in susceptible people

 If you had any problems previously with NSAID use inform your doctor. This will ensure adequate protection.