Nonsteroidal anti-inflammatory drugs--NSAIDs--are a diverse group of medications that share the common therapeutic property of reducing inflammation. Acute inflammation is a complex natural response to injury or infection; the goal of the response is healing. Chronic inflammation is a persistent inflammatory response; it may occur unprovoked or continue beyond its usefulness, becoming destructive. NSAIDs are used to treat both acute and chronic inflammatory conditions.
Aspirin
Aspirin is one of the world's oldest pharmaceuticals. It reduces inflammation by inhibiting the formation of prostaglandins, chemicals that act as signalers and activators in the inflammatory process. Aspirin has anti-inflammatory, pain-relieving, and fever-reducing properties. In addition to being sold as a stand-alone product, aspirin is included in many combination over-the-counter and prescription drug formulations.
Celecoxib
Celecoxib's anti-inflammatory activity is related to its selective inhibition of the cyclooxygenase-2 (COX-2) enzyme, which plays a role in prostaglandin production. This prescription drug is used primarily to treat arthritic conditions such as rheumatoid arthritis and osteoarthritis. Celecoxib carries a black box warning mandated by the U.S. Food and Drug Administration, or FDA, noting the potential for increased risk of serious gastrointestinal bleeding and cardiovascular events such as heart attack, stroke or blood clots. All prescription NSAIDs have this black box warning.
Diclofenac
Diclofenac is a delayed-release NSAID. It inhibits prostaglandin synthetase, an enzyme in the prostaglandin production pathway. Diclofenac is used primarily for the treatment of chronic arthritic conditions. It carries the prescription NSAID black box warning.
Diflunisal
Diflunisal is a derivative of salicylic acid, the parent chemical of aspirin. Like aspirin, it has pain-relieving, anti-inflammatory and fever-reducing properties. It is a prostaglandin synthetase inhibitor. Diflunisal is used primarily to treat mild to moderate pain associated with arthritic conditions. It carries the prescription NSAID black box warning.
Ibuprofen
Ibuprofen was discovered in the 1960s and has been available in the U.S. since 1974. This widely used anti-inflammatory pain reliever inhibits cyclooxygenase-1 and 2. Available both over-the-counter and in prescription strengths, ibuprofen is used for a variety of mild to moderate pain conditions. Prescription-strength ibuprofen carries the NSAID black box warning required by the FDA.
Ketoprofen
Ketoprofen inhibits prostaglandin and leukotriene production. Like prostaglandins, leukotrienes are chemicals involved in the initiation and perpetuation of an inflammatory response. Immediate and extended-release formulations of this drug are marketed for arthritis-related symptoms and other pain indications. Ketoprofen is available over the counter and by prescription. Prescription strength ketoprofen carries the NSAID black box warning.
Meloxicam
Meloxicam is a prostaglandin synthetase inhibitor used primarily for the treatment of osteoarthritis pain. It is available only by prescription and carries the NSAID black box warning.
Nabumetone
Nabumetone inhibits prostaglandin production and is used to treat arthritis. This prescription drug is typically taken once daily. It carries the NSAID black box warning.
Naproxen
Naproxen is an over-the-counter and prescription NSAID. It is used to treat arthritic conditions, tendinitis, bursitis, gout and other pain conditions. Prescription strength forms of this prostaglandin synthetase inhibitor carry the NSAID black box warning.
Piroxicam
Piroxicam is a prescription NSAID used for the treatment of arthritic conditions. It is a prostaglandin synthetase inhibitor and carries the NSAID black box warning.
Sulindac
Sulindac is a prostaglandin synthetase inhibitor used for the treatment of arthritic conditions including osteoarthritis, rheumatoid arthritis, gouty arthritis, bursitis and tendinitis. Sulindac is available by prescription and carries the NSAID black box warning.
References
- "Physicians' Desk Reference"; Kathleen Engel, Project Editor; 2008
- Drugs.com: Aspirin
- Drugs.com: Celecoxib
- Drugs.com: Diclofenac
- Drugs.com: Diflunisal
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