NSAIDs
Are you a clinician? See the clinical version of this page.
Anti-inflammatory painkillers, taken as tablets (some available over the counter). They ease pain and stiffness but do not change the course of the disease. Take the lowest dose that helps, for the shortest time, and with food to protect your stomach. For osteoarthritis of the knee or hand, a rub-on (topical) NSAID is often tried first because much less gets into the body.
- Ibuprofen: 400 to 800 mg up to three or four times a day.
- Naproxen: 250 to 500 mg twice a day.
- Celecoxib (COX-2 selective): 100 to 200 mg once or twice a day.
- Diclofenac: 50 to 75 mg two to three times a day.
- Meloxicam: 7.5 to 15 mg once a day.
- Topical diclofenac (Voltaren gel, Pennsaid): A gel or solution rubbed onto the sore joint, three to four times a day. Often the first choice for knee or hand osteoarthritis because much less gets into the bloodstream than tablets.
Tests while you take it
Tell your team about stomach pain, black stools, swelling, or shortness of breath. Long-term use may need blood pressure and kidney checks.
What to know
Common side effects
The most common effects are stomach upset or irritation. Used regularly or at higher doses, NSAIDs can affect the kidneys and raise blood pressure, and over time can carry stomach and heart risks.
Tests and monitoring
With regular use your team may check your blood pressure and kidney function, and may add a medicine to protect your stomach.
Important cautions
NSAIDs are used with care if you have a history of stomach ulcers, kidney disease, or heart disease, or if you take blood thinners, and extra care is needed in older people. Tell your team what else you take.
What to watch for
- Black or bloody stools, vomiting blood, or severe stomach pain.
- Swelling of the legs, breathlessness, or a sudden drop in how much urine you pass.
- New or poorly controlled high blood pressure.