Topic Overview

Non-steroidal anti-inflammatory drugs (NSAIDs) reduce fever and inflammation and relieve pain. Examples of NSAIDs include aspirin, ibuprofen, and naproxen.

Be sure to follow the non-prescription medicine precautions.

Ibuprofen (such as Motrin or Advil)

• Adults: The initial dose is 400 mg. Follow-up doses are 200 mg to 400 mg every 4 hours as needed, up to a maximum of 4 doses in a 24-hour period.
• Children: Your child's over-the-counter medicine will have a "Drug Facts" label. On the label, you'll find directions for your child's age or weight, the dose to give, and how often to give the dose. For children younger than 6 months of age, follow what your doctor has told you about the amount to give.
  • Be extra careful with liquid medicines. Infants usually need a different dose than older children do. And some liquid forms are stronger (more concentrated) than others. Always read the label so that you give the right dose.
  • When you give medicine, use the tool that comes with the medicine, such as a dropper or a dosing cup. Don't use a spoon instead of the tool. Spoons can be different sizes. If the medicine doesn't come with a tool to give doses, ask your pharmacist for one.

Naproxen (such as Aleve)

• Adults: Initial dose is 440 mg. Follow-up doses are 220 mg every 8 to 12 hours as needed. Drink a full glass of water with each dose. Do not take more than 440 mg in any 8-hour to 12-hour period or 660 mg in a 24-hour period.
• Adults older than 65: Do not take more than 220 mg every 12 hours unless your doctor tells you to.
• Children: Do not give naproxen to children younger than 12 unless your doctor tells you to. Your doctor may prescribe naproxen for your child.

Side effects

The most common side effects of NSAIDs are stomach upset, heartburn, and nausea. If the medicine upsets your stomach, you can try taking it with food. But if that doesn't help, talk with your doctor to make sure it's not a more serious problem.

• NSAIDs can cause a severe allergic reaction. Symptoms may include hives, swelling of the face, wheezing, and shock. If you have any of these symptoms, call 911 or other emergency services immediately.
• For safety, read the label carefully and do not take more than prescribed. Taking a larger dose or taking the medicine longer than recommended can increase your risk of dangerous side effects.
• Do not use a nonprescription NSAID for longer than 10 days without talking to your doctor.

Reasons to stop taking NSAIDs

NSAIDs may delay healing. If you develop any of the following signs of infection, stop taking the medication:

• An increase in pain
• Skin that is hot to the touch around the injury or wound
• Redness or red streaks extending from the injury or wound
• Pus that continues to form in the wound
• Fever with no other cause
• Swollen glands above the injury or wound

NSAID risks

• NSAIDs have the potential to increase your risk of heart attack, stroke, skin reactions, and serious stomach and intestinal bleeding. These risks are greater if you take NSAIDs at higher doses or for longer periods than recommended.
• Aspirin, unlike other NSAIDs, can help certain people lower their risk of a heart attack or stroke. But taking aspirin isn't right for everyone, because it can cause serious bleeding. Talk to your doctor before you start taking aspirin every day.

Talk to your doctor about whether NSAIDs are right for you. People who are older than 65 or who have existing heart, stomach, kidney, liver, or intestinal disease are at higher risk for problems. For other people, the benefits may outweigh the risks.

Do not take NSAIDS if you have ever had an allergic reaction to any type of pain medicine.

If you are pregnant, trying to become pregnant, or breastfeeding, talk to your doctor before you use NSAIDs. It is especially important to avoid using NSAIDs during the last 3 months of pregnancy unless your doctor tells you to. They can cause problems with the baby or the delivery.

Talk to your doctor before taking NSAIDs if you have:

• Ulcers or a history of stomach or intestinal bleeding.
• Stomach pain, upset stomach, or heartburn that lasts or comes back.
• Anemia.
• Bleeding problems.
• A habit of drinking more than 3 alcoholic drinks a day. This increases your risk of stomach bleeding.
• High blood pressure.
• Kidney, liver, or heart disease.
• Any serious health condition.

Talk to your doctor before using NSAIDs if you take:

• Blood thinners (anticoagulants).
• Lithium.
• Diuretics (water pills).
• Medicine for arthritis or diabetes.
• Aspirin to protect your heart.
• Any other drugs.

Do not give aspirin to anyone younger than 18 because of the risk of Reye syndrome, a rare but serious disease.