NSAIDs

Non-steroidal anti-inflammatory drugs (NSAIDs) are used to relieve pain, reduce inflammation and swelling, and bring down a high temperature

NSAIDs are commonly used, but they're not suitable for everyone and can cause side effects. Check with your GP or pharmacist before taking an NSAID.

NSAIDs are available as tablets, capsules, creams, gels, injections, and suppositories (capsules inserted into the bottom).

Some can be bought over the counter from pharmacies. But you need a prescription for certain NSAIDs.

Types of NSAIDs

The main types of NSAIDs used in Ireland include:

  • ibuprofen
  • naproxen
  • diclofenac
  • etofenamate

NSAIDs may be sold or prescribed under these names or a brand name. They're all similarly effective, but a particular one may work best for you.

Uses of NSAIDs

NSAIDs are often used to relieve symptoms of:

They provide relief by changing the body's response to pain.

Get emergency help

You might have to get emergency help if you:

  • take too much
  • have serious side effects
  • have an allergic reaction

If you take too much

You can overdose if you take too much of an NSAID. This can be dangerous.

Immediate action required: Call 999 or 112 or go to an emergency department (ED) if:

  • you have fits or seizures
  • you have breathing difficulties
  • you are losing consciousness

Serious side effects

NSAIDs can cause serious side effects and allergic reactions.

Immediate action required: Call 999 or 112 or go to an ED if you have:

  • severe chest or stomach pain
  • weakness on one side of the body
  • difficulty breathing

Urgent advice: Contact a GP immediately if you:

  • have black poo
  • vomit blood or dark particles
  • have yellow skin or eyes
  • have blood in the pee
  • are not peeing at all
  • have swollen ankles
  • feel weak, sick or tired
  • have ringing in your ears
  • have indigestion
  • have heartburn
  • feel sick

Serious allergic reaction

A serious allergic reaction (anaphylaxis) to NSAIDs is rare.

Immediate action required: Call 999 or 112 or go to an ED if:

  • you get a skin rash with redness, peeling, flaking or blistering
  • you have trouble breathing
  • your mouth, face, lips, tongue or throat start swelling

When you start taking NSAIDs

NSAIDs taken by mouth should start to work within 1 hour.

If you're using a gel or cream it should work within 1 to 2 days.

For arthritis, you may need to use a gel or cream for up to 7 days to feel the full effect.

When you stop taking NSAIDs, the effects wear off in about 15 hours.

If NSAIDs do not work

If NSAIDs do not work, talk to a pharmacist or GP about trying another painkiller such as paracetamol.

If alternatives do not work, your GP may prescribe a stronger painkiller or recommend treatment such as exercise or physiotherapy.

Check if you can take NSAIDs 

Talk to your pharmacist or GP before taking NSAIDs if you:

  • are over 65
  • have had an allergic reaction to NSAIDs or any medicine in the past
  • are taking other medicines
  • are trying to get pregnant, pregnant or breastfeeding
  • have high blood pressure, diabetes or high cholesterol
  • have ever had asthma
  • have liver, kidney or heart problems
  • have had stomach ulcers or intestinal problems

Chickenpox warning

Do not give ibuprofen to an adult or child with chickenpox. It can cause a serious skin reaction.

Pregnant and breastfeeding

If you are pregnant, trying to get pregnant, or breastfeeding, talk to your GP or pharmacist before taking an NSAID.

NSAIDs are not normally recommended in pregnancy unless prescribed by a GP or doctor.

Children

Ibuprofen is not suitable for some children. Check with your pharmacist or GP before giving ibuprofen to your child.

Children 3 months and older can usually take ibuprofen as a liquid syrup.

Children 7 years and older can usually take it as a tablet or capsule.

It's best to give ibuprofen with food or milk so they do not get an upset tummy. Follow the instructions on the package leaflet.

How and when to take NSAIDs

Always follow the instructions on the medicines label for your NSAID dose. It's best to take the lowest dose that works for the shortest possible time.

If you still need an NSAID after taking it for 10 days, check with your doctor before continuing.

Tablets and capsules

Always take NSAID tablets or capsules after a meal or snack. It will be less likely to upset your stomach.

Tablets or capsules should be swallowed whole and not chewed or crushed.

Gels and creams

Put the gel or creams on the painful area and slowly rub it in. It may feel cool on your skin. Wash your hands afterwards.

For prescription NSAIDs follow the instructions given by your GP or pharmacist.

Plasters and patches

Follow the instructions on the package leaflet. Treat only 1 painful area at a time. Do not use more than 2 medicated plasters in a 24-hour period.

Suppositories

Push suppositories gently into your back passage (anus). Follow the instructions on the package leaflet.

Food and alcohol

Generally you do not have to avoid specific foods while taking NSAIDs.

It's usually safe to drink alcohol while taking NSAIDs. But drinking more than the recommended amount per week (17 units for men, 11 for women) can irritate your stomach.

If you forget to take it

Take your missed dose as soon as you remember, unless it's nearly time for the next dose. In this case, skip the missed dose and take your next dose as normal.

Do not take a double dose to make up for a forgotten dose.

If you often forget doses, it may help to set a reminder alarm.

Side effects

Talk to your GP or pharmacist if side effects bother you or do not go away

Side effects can include:

  • headaches
  • feeling dizzy
  • feeling or being sick
  • tiredness or feeling sleepy
  • changes in vision
  • stomach pain, diarrhoea or indigestion
  • ringing in the ears

Interactions with other medicines 

NSAIDs do not mix well with some medicines. Tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.

It's important to get medical advice before taking an NSAID if you're already taking:

  • another NSAID
  • steroids or other anti-inflammatory medicines
  • low-dose aspirin or warfarin
  • ciclosporin
  • diuretics
  • lithium
  • methotrexate
  • selective serotonin reuptake inhibitors (SSRIs) medicines such as citalopram or fluoxetine (Prozac)
  • medicine for heart failure, such as digoxin
  • medicines to treat diabetes
  • zidovudine
  • quinolone antibiotics
  • medicines for blood pressure

If you're not sure if a medicine is safe to take at the same time as an NSAID, check the leaflet that comes with it or ask a GP or pharmacist.

Finding your patient information leaflet online

Your patient information leaflet (PIL) is the leaflet that comes in the package of your medicine. 

Information:

To find your PIL online, visit the Health Products Regulatory Authority (HPRA) website

  1. In the ‘Find a medicine’ search box, enter the brand name of your medicine. A list of matching medicines appears.
  2. To the right of your medicine, select ‘PIL’. A PDF of the PIL opens in a new window. 

You can also:

  1. Select the brand name of your medicine.
  2. Scroll down to the Documents section.
  3. From the Package Leaflet line, select PDF version. A PDF of the PIL opens in a new window. 

If your PIL is not on the HPRA website, the European Medicines Agency (EMA) website opens in a new window when you select ‘PIL’.

You can find your PIL on the EMA website.

Finding your PIL on the EMA website

If your PIL is not on the HPRA website, you will be sent to the European Medicines Agency (EMA) website.

To find your PIL on the EMA website:

  1. In the Medicines search box, enter the brand name of your medicine and the word ‘epar’. For example: ‘Zoely epar’. A list of matching medicines appears.
  2. Select the ‘Human medicine European public assessment report (EPAR)’ for your medicine
  3. From the table of contents, select Product information.
  4. Select the EPAR – Product Information link for your medicine. A PDF opens in a new window. The PIL information is in Annex III of the PDF under ‘labelling and package leaflet’

This content was fact checked by a pharmacist, a GP, the National Medication Safety Programme (Safermeds) and the Health Products Regulatory Authority (HPRA).

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This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.

Page last reviewed: 24 September 2021
Next review due: 24 September 2024

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