How it worked NSAIDs reduce inflammation and relieve fever and pain by blocking enzymes and proteins made by the body. NSAIDs such as ibuprofen and naproxen block a protein (called prostaglandin) that makes heavy menstrual bleeding worse. Aspirin does not block this protein.

How it is Used - as an analgesic, anti-inflammatory and anti-pyretic - may be used alone or in combination with paracetamol and/or weak/strong Opioids.

Why it work - NSAIDs produce a range of effects in the body by inhibiting the enzyme cyclo-oxygenase (COX). COX is the main enzyme which converts arachidonic acid to prostaglandins, thromboxane and prostacyclins. It is found in many central and peripheral tissues in the body, and this explains why NSAIDs have such a wide range of effects.

What effects it has:

• analgesia - acting on peripheral tissues, the dorsal horn of the spinal cord, and the brain
• anti-inflammatory - via the prostaglandin effect
• anti-pyretic - temperature control in the brain
• gastric ulceration - impaired gastric lining protection
• anti-platelet - anti-thromboxane effect prevents platelets sticking together with increased bleeding tendency
• renal impairment - altered kidney blood flow control worse with dehydration
• increased wheezing in susceptible asthmatics increasing the muscle tone in the bronchi of the lungs

Side Effects

The most common side effects of NSAIDs are stomach upset, heartburn, ulcers, and skin rashes. Taking NSAIDs with food may help prevent some of these problems. Your chances of having these side effects are greater if you take large doses of NSAIDs or take them for a long time.

Less common side effects include confusion; swelling of the face, feet, or lower legs; or a sudden decrease in the amount of urine. These side effects are more likely to occur in older adults and people with other serious health problems.

Aspirin, unlike other NSAIDs, has been shown to reduce the risk of heart attack and stroke. If you use other NSAIDs regularly, aspirin may not work as well to prevent a heart attack and stroke. Do not give aspirin to anyone younger than 20 unless your doctor tells you to. It has been linked to Reye's syndrome, a rare but serious illness.

If you are pregnant, trying to become pregnant, or breast-feeding, talk to your doctor before you use NSAIDs. Do not use NSAIDs during pregnancy unless your doctor tells you to. They can cause problems with your baby or with delivery.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)