What otc is for inflammation?

Aspirin | Ibuprofen | Naproxen | Diclofenac | Best OTC anti-inflammatories | Side effects | Prescription vs. OTC anti-inflammatories

If you experience minor aches and pains, an anti-inflammatory medicine may be the first thing you look for at the pharmacy. There are many different over-the-counter (OTC) drugs that can help relieve inflammation and pain, and they typically fall under the same class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). Ibuprofen and aspirin are just a couple of the most popular NSAIDs.

It’s important to note that not all OTC anti-inflammatory drugs are the same. They may differ in effectiveness, cost, and side effects. If an OTC anti-inflammatory isn’t enough to treat your pain or inflammation, you may need a stronger prescription drug. It’s best to consult a healthcare provider for medical advice on the best treatment option, especially if you have underlying medical conditions or take other medications.

Continue reading to learn more about the best OTC anti-inflammatory drugs.

NSAIDs are the most common OTC anti-inflammatory medications, and they work by blocking the body’s production of certain chemicals called prostaglandins. These chemicals are involved with pain, inflammation, and fever.

NSAIDs are often used to treat aches and pains caused by toothaches, headaches, muscle aches, and menstrual cramps, among other types of pain. Unlike other pain relievers like Tylenol (acetaminophen), NSAIDs are effective for treating pain and discomfort caused by inflammatory conditions like arthritis. Acetaminophen is not an anti-inflammatory drug.

Aspirin is a widely available NSAID used to treat minor aches and pain, as well as fever. Brand names include Bayer and Ecotrin. Aspirin, also known as acetylsalicylic acid, can usually be found over the counter as a generic drug. It is not recommended for use in children under 12 or people with bleeding disorders.

The dosage of aspirin will vary depending on the symptoms being treated. Higher doses are typically needed for pain and inflammation. On the other hand, low-dose aspirin is often taken as a blood thinner to prevent blood clots and reduce the risk of strokes and heart attacks in people at high risk.

Ibuprofen is a common NSAID used for pain and fever in adults and children. It is available in different formulations, including tablets, capsules, and liquids, and in brand-name and generic forms. The brand names of ibuprofen include Advil and Motrin.

Ibuprofen is usually dosed every four to six hours as needed for pain relief. It is one of the most common NSAIDs used in younger children, as there are different forms of ibuprofen made specifically for children.

Naproxen is another common NSAID found over the counter, and it is available in generic and brand-name forms. The brand name of OTC naproxen is Aleve. Unlike other NSAIDs, naproxen is only available as an oral tablet or capsule.

Naproxen lasts longer than other NSAIDs, as it is usually dosed every eight to 12 hours. It is only approved for adults and children over the age of 12. There are two different types of naproxen: regular naproxen and naproxen sodium. The most common form of naproxen is naproxen sodium because it is absorbed more quickly than the regular form.

Diclofenac is an NSAID known under the brand name Voltaren. It is applied as a topical gel to the joints of the hands, feet, or knees as needed for pain due to arthritis.

The topical gel was initially approved as a prescription drug in 2007. However, in 2020, the FDA approved Voltaren as an OTC drug. As a result, it is now more accessible for treating joint pain and swelling caused by arthritis. It is also available as a delayed-release oral tablet with a prescription.

The best OTC anti-inflammatory drug will depend on your overall health condition, the type of pain being experienced, and other factors. In addition, some OTC drugs may be cheaper than others. However, with a prescription from a healthcare provider, coupons and discount cards may help lower retail prices.

The following table lists the most common OTC pain relievers.

Despite their popularity, NSAIDs can cause a range of side effects, some of which can be serious or even life-threatening in some cases. However, the side effects of NSAIDs are generally mild and temporary with short-term use and in the recommended doses. Some people won’t experience any adverse effects.

Common side effects of NSAIDs include:

High doses and long-term use of NSAIDs can increase the risk of side effects that can be serious. Some NSAIDs may cause fewer side effects than others, depending on the dosage and form. For example, a topical NSAID will cause fewer systemic side effects like heartburn and nausea than an oral NSAID.

​​NSAIDs can irritate the stomach lining and cause problems in the gastrointestinal tract. That’s because most NSAIDs are nonselective. They block the COX-1 enzyme, responsible for protecting the stomach lining, in addition to the COX-2 enzyme, responsible for making prostaglandins that cause pain and inflammation. In severe cases, the use of NSAIDs can cause stomach ulcers or bleeding.

Risk factors for stomach ulcers and bleeding include:

People with risk factors for gastrointestinal problems should avoid or use NSAIDs with caution. A healthcare provider can recommend alternatives to reduce the risk of stomach ulcers.

All NSAIDs, except aspirin, are known to increase the risk of cardiovascular or heart problems. Studies have shown that long-term use and high doses of NSAIDs can increase the risk of heart attack, strokes, heart failure, and other heart problems.

NSAIDs should only be used short-term in the lowest effective doses. It’s important to tell your healthcare provider if you have heart disease, high blood pressure, or other heart complications before using an NSAID.

NSAIDs can cause liver and kidney problems over time. However, the risk of kidney problems is higher than that of liver problems. NSAIDs can affect blood flow to the kidneys, disrupting kidney function and leading to kidney damage. People with liver disease or kidney disease should use NSAIDs with caution.

Allergic reactions are possible while taking NSAIDs. Seek immediate medical attention if you experience signs or symptoms of an allergic reaction, such as hives, swelling of the throat or face, or trouble breathing.

Prescription NSAIDs are more potent than OTC NSAIDs and are used for more serious types of pain. A healthcare provider will want to monitor pain and side effects if they prescribe an NSAID for long-term use.

OTC pain relievers are generally taken in lower doses than prescription medications. However, higher doses of OTC NSAIDs are available with a doctor’s prescription. For example, ibuprofen and naproxen are available in higher strengths with a prescription.

Several different types of NSAIDs are available, but not all are available over the counter. Some NSAIDs can only be purchased with a prescription. Examples of prescription-only NSAIDs include:

It’s a good idea to consult with a healthcare provider for the best pain medicine. One drug may be a better choice than another based on your overall health condition and other drugs you may be taking.

The best OTC anti-inflammatory drug will depend on a person’s health condition and symptoms. NSAIDs like ibuprofen and naproxen are the most common anti-inflammatory drugs available over the counter for treating pain and fever.

NSAIDs may cause side effects and drug interactions, so it’s important to seek advice from a healthcare provider. A doctor or pharmacist can provide more information about the benefits and risks of NSAID use. That way, you can make an informed decision about the right treatment option.

Cost can also be a concern when choosing an OTC drug. You can use a SingleCare discount card to save on all of your medications, including brand-name and generic drugs. However, a prescription from a healthcare provider is needed to save on OTC drugs with a discount card. You can browse various medications for the lowest prices at nearby pharmacies.

When your back hurts, head aches, arthritis acts up or you’re feeling feverish, chances are you’ll be reaching for an NSAID (nonsteroidal anti-inflammatory drug) for relief.

You take an NSAID every time you consume an aspirin, or an Advil®, or an Aleve®. These drugs are common pain and fever relievers. Every day millions of people choose an NSAID to help them relieve headache, body aches, swelling, stiffness and fever.

You know the most common NSAIDs:

You can get nonprescription strength, over-the-counter NSAIDs in drug stores and supermarkets, where you can also buy less expensive generic (not brand name) aspirin, ibuprofen and naproxen sodium.

Acetaminophen (Tylenol®) is not an NSAID. It’s a pain reliever and fever reducer but doesn’t have anti-inflammatory properties of NSAIDs. However, acetaminophen is sometimes combined with aspirin in over-the-counter products, such as some varieties of Excedrin®.

NSAIDs are used to treat:

They can also be used to reduce fever or relieve minor aches caused by the common cold.

NSAIDs block the production of certain body chemicals that cause inflammation. NSAIDs are good at treating pain caused by slow tissue damage, such as arthritis pain. NSAIDs also work well fighting back pain, menstrual cramps and headaches.

NSAIDs work like corticosteroids (also called steroids), without many of the side effects of steroids. Steroids are man-made drugs that are similar to cortisone, a naturally-occurring hormone. Like cortisone, NSAIDs reduce pain and inflammation that often come with joint and muscle diseases and injuries.

Don’t use an over-the-counter NSAID continuously for more than three days for fever, and 10 days for pain, unless your doctor says it’s okay. Over-the-counter NSAIDs work well in relieving pain, but they’re meant for short-term use.

If your doctor clears you to take NSAIDs for a long period of time, you and your doctor should watch for harmful side effects. If you notice bad side effects your treatment may need to be changed.

That depends on the NSAID and the condition being treated. Some NSAIDs may work within a few hours, while others may take a week or two.

Generally, for acute (sharp sudden pain) muscle injuries, we recommend NSAIDs that work quickly. However, these may need to be taken as often as every four to six hours because of their short action time.

For osteoarthritis and rheumatoid arthritis that need long-term treatment, doctors usually recommend NSAIDs that are taken only once or twice a day. However, it generally takes longer for these drugs to have a therapeutic (healing) effect.

NSAIDs are prescribed in different doses, depending on the condition. These drugs may need to be taken from one to four times a day. Don’t increase the dose without asking your doctor first.

You may be prescribed higher doses of NSAIDs if you have rheumatoid arthritis (RA), for example. RA often causes a significant degree of heat, swelling and redness and stiffness in the joints. Lower doses may be prescribed for osteoarthritis and acute muscle injuries since there is generally less swelling and frequently no warmth or redness in the joints.

No single NSAID is guaranteed to work. You and your doctor may need to try out several types of NSAIDs in order to find the right one for you.

Prescription-strength NSAIDs are often recommended for rheumatologic diseases, including rheumatoid arthritis and moderate-to-severe osteoarthritis. These NSAIDs are also prescribed for moderately painful musculoskeletal conditions such as back pain.

Here are a few examples of prescription NSAIDs. Some NSAIDs are only available as generic formulations (no brand names).

Generic names (no brands)

In planning your treatment, your doctor looks at the effectiveness and the risks of these drugs. Your medical history, physical exam, X-rays, blood tests and presence of other medical conditions all play a part in deciding which NSAIDs will work for you.

After you start your NSAID program meet with your doctor regularly to check for any harmful side effects and, if necessary, make any changes. Blood tests or other tests (including a kidney function test) may need to be done for this part of your treatment.

The Food and Drug Administration requires that the labeling of NSAIDs contain these specific warnings:

These warnings are for non-aspirin NSAIDs:

This warning is for all NSAIDs including aspirin:

NSAIDs may increase the chance of serious stomach and bowel side effects like ulcers and bleeding. These side effects can occur without warning signs. This risk may be greater in people who:

You may have side effects if you take large doses of NSAIDs, or if you take them for a long time. Some side effects are mild and go away, while others are more serious and need medical attention. Unless your doctor tells you to do so, don't take an over-the-counter NSAID with a prescription NSAID, multiple over-the-counter NSAIDs or more than the recommended dose of an NSAID. Doing so could increase your risk of side effects.

The side effects listed below are the most common, but there may be others. Ask your doctor if you have questions about your specific medication.

The most frequently reported side effects of NSAIDs are gastrointestinal (stomach and gut) symptoms, such as:

These gastrointestinal symptoms can generally be prevented by taking the drug with food, milk or antacids (such as Maalox® or Mylanta®).

Call your doctor if these symptoms continue for more than a few days even if you’re taking the NSAID with food, milk or antacid. The NSAID may need to be stopped and changed.

Other side effects of NSAIDs include:

If these symptoms go on for more than a few days, stop taking the NSAID and call your doctor.

If you have any of these side effects, it is important to call your doctor right away:

Gastrointestinal/urinary

Head (vision, hearing, etc.)

Possible allergic reactions and other problems

NSAIDs can cause high blood pressure (hypertension) in some people. You may have to stop taking NSAIDs if you notice your blood pressure increases even if you’re taking your blood pressure medications and following your diet. Ask your doctor about this before you start taking NSAIDs.

If you have any of the following conditions or circumstances please check with your doctor before you take NSAIDs:

Disease states

Heart and bleeding conditions

Allergic and drug interactions

Rarely, an NSAID can cause a generalized allergic reaction known as anaphylactic shock. If this happens, it usually occurs soon after the person starts taking the NSAID. The symptoms of this reaction include:

How they work: NSAIDs work by blocking cyclooxygenase enzymes—COX-1 and/or COX-2— from making chemicals called prostaglandins, which contribute to inflammation, pain, and fever.

Cautions: All non-aspirin NSAIDs carry an FDA warning that says these medicines increase the risk of heart attack or stroke, which can occur as early as the first weeks of using the medicine. Anyone taking these drugs should seek medical attention immediately if they experience symptoms such as chest pain, shortness of breath or trouble breathing, weakness in one part or side of their body, or slurred speech. In addition, if you have a chronic condition, such as kidney disease, or if you take a blood thinner medication, it’s important to talk to your doctor before taking the medicine.

Pregnant women should be aware that NSAID use should be limited and only taken under the supervision of a health care provider between 20 and 30 weeks of pregnancy due to potential harm to the fetus. NSAIDs should be avoided entirely at 30 weeks or longer into a pregnancy due to an increased risk of fetal harm. Low-dose aspirin is safe to take during pregnancy, but before doing so, women should consult their provider for guidance.

What else to know: Short-term NSAID use can cause an upset stomach.

What you should use them for: Pain, fever, and inflammation. Different NSAIDs (more on that below) may be used for other reasons or specific problems.

Aspirin

What it is: Aspirin is an NSAID that can reduce fever and inflammation and ease mild-to-moderate pain. In some cases, it also is used for the prevention and care of some cardiovascular conditions (ask your doctor if this is appropriate for you). Aspirin is a blood thinner that inhibits blood clot formation, which can cause heart attacks and strokes—although for some people, the benefits of using aspirin this way may not outweigh the risks.

Common brand names: Bayer® and Bufferin® are examples.

What else to know: Do not give aspirin to children under 18 unless instructed to do so by a health care provider. Aspirin puts children under 18 at risk for Reye’s syndrome, which causes brain and liver damage. In addition, while aspirin helps many people, taking it can give rise to side effects, including stomach pain, heartburn, nausea, and/or vomiting.

For years, many adults have taken low-dose aspirin to help prevent cardiovascular disease (CVD). But in 2022, the U.S. Preventive Services Task Force (USPSTF) issued recommendations stating that adults 60 and older should not start an aspirin regimen for this purpose. It is recommended that people 40 to 59 with an estimated 10% or greater 10-year cardiovascular (CVD) risk talk to a medical provider for help in making an individual decision about an aspirin regimen. Your provider can estimate your 10-year CVD risk based on your age, blood pressure (and whether you take any medications to control it), cholesterol levels, and whether you smoke cigarettes or have diabetes, among other possible factors.)

The USPSTF recommendation is based on research suggesting the benefits of aspirin don’t always outweigh the potential harms, which can include a higher risk of bleeding in the brain, intestines, and stomach, especially as people get older.

What you should use it for: Fever and inflammation, as well as relief of mild-to-moderate pain from arthritis, headaches, muscle aches, backaches, menstrual periods, and toothaches. Aspirin may also be used to prevent heart attacks in people with angina or who have had a heart attack. It is also used to prevent the recurrence of ischemic strokes or mini-strokes. (However, it’s important to talk to your doctor about whether an aspirin regimen is right for you for these issues.)

The National Library of Medicine (NLM) provides a fact sheet with more information, including important warnings, on aspirin.

Ibuprofen

What it is: Ibuprofen, another NSAID, can help with arthritis pain, tenderness, and stiffness, as well as fever.

Brand names: Advil® and Motrin® are some examples.

What else to know: Use caution if you have phenylketonuria (PKU), an inherited condition that requires avoiding the sweetener aspartame, among other food products, since some ibuprofen products contain aspartame.

What you should use it for: Arthritis, backache, common cold, fever, headache, menstrual periods, and other aches and pains.

The NLM provides a fact sheet with more information, including important warnings, on ibuprofen.

Naproxen

What it is: This NSAID medication’s effect is longer-lasting than other NSAIDs and acetaminophen—it is taken every 8 to 12 hours as needed, while the other OTC medicines are typically in the 4- to 6-hour range. Like other NSAIDs, naproxen brings down fevers, reduces inflammation, and relieves pain from ailments ranging from arthritis and muscle aches to the common cold.

Brand names: Aleve® is a common example.

What else to know: It’s recommended that adults 65 or older take naproxen at lower doses than younger people and for shorter periods due to an increased risk of severe side effects and because higher doses may not be more effective. If taken over long periods or in high doses, this medication may temporarily decrease fertility in women.

However, anti-inflammatory medicines also come with some side effects, especially for people who have underlying risk factors. This article discusses the pros and cons of prescription and over-the-counter NSAIDs and alternatives to anti-inflammatory drugs.

NSAIDs are available in both over-the-counter (OTC) and prescription formulations. Some of the OTC anti-inflammatories are also available in stronger, prescription formulations. A class of NSAIDs called COX-2 inhibitors is available by prescription only.

While both OTC and prescription NSAIDs help relieve pain, prescription NSAIDs are more likely to reduce inflammation.

Many people experience adequate symptom relief with OTC NSAIDs and do not need to take stronger, prescription-strength options. Sometimes prescription NSAIDs are used because they provide longer-lasting relief. COX-2 inhibitors may be an option for people who have gastrointestinal side effects, which are common with OTC NSAIDs.

Usually, different NSAIDs can have similar effects. For example, if you are experiencing discomfort from arthritis, you might get relief from either Aleve (naproxen) or Advil (ibuprofen). But sometimes, people have a different response to treatment with a different medication, and a few medications might help your symptoms, while others do not have a significant effect.

It's difficult to predict which medications will be the most beneficial. The best way to determine which NSAID is best for you is to try different options. Often a healthcare provider will recommend one NSAID, and if symptoms don't improve within several weeks of treatment, another NSAID can be tried.

One of the best reasons to consider some of the COX-2 inhibitors, such as Celebrex or Mobic, is that these may be taken as once-a-day doses rather than three or four times daily. In addition, the COX-2 inhibitors are thought to have fewer side effects on the stomach.

Healthcare professionals often use generic and brand names interchangeably, especially when recommending or prescribing NSAIDs.

The most commonly prescribed or recommended NSAID medications are:

Medicine isn't the only way to control inflammation and discomfort. Due to the possible side effects of medication, many patients and healthcare providers are interested in non-pharmacologic methods to control inflammation, especially chronic inflammation.

There are many ways to manage inflammation. Some have better scientific support than others, but almost all are safe to try.

A good place to start is with the R.I.C.E. treatment, which stands for:

Other treatments that may be helpful include certain foods and supplements, topical treatments, and physical activities.

An often-neglected method to control inflammation is rest. Getting enough overall rest and sleep, as well as taking it easy on the injured part of your body allows the inflammation to subside and the recovery process to unfold.

Not only does this mean resting from athletics, but often this means allowing an injured body part to rest from normal activities that may prolong inflammation. If you have a busy life, rest might not be built into your routine, but ignoring the signs of inflammation may prolong the problem.

NSAID medications have potential side effects, even those that can be obtained over-the-counter. Some of the side effects are minor, and others are potentially dangerous.

Some people may be more prone to side effects. However, it is important to understand that even for healthy people without underlying medical conditions, there is an associated risk. The benefits of taking an anti-inflammatory medication need to be balanced with the possible risks of taking the medication.

Some of the more common side effects of NSAID medications include:

These are not the only risks associated with NSAIDs, but they are the most common. It is always safest to have a discussion with your healthcare provider if you have any concerns about the risk of taking these medications.

Taking pain medicines before exercising is OK. But do not overdo the exercise just because you have taken the medicine.

Read labels to learn how much medicine you or your child can take at one time and during the whole day. This is known as the dosage. Talk to your pharmacist or your child's health care provider if you are not sure about the correct amount. Do not give children medicine that is meant for adults.

Other tips for taking pain medicines:

ACETAMINOPHEN

Acetaminophen (Tylenol) is a non-aspirin pain reliever. It is NOT an NSAID, which is described below.

PRECAUTIONS

ASPIRIN and NSAIDS

• Aspirin (available as a single ingredient known by various brand names such as Bayer® or St. Joseph® or combined with other ingredients known by brand names such as Anacin®, Ascriptin®, Bufferin®, or Excedrin®).
• Ibuprofen (known by brand names such as Motrin® and Advil®).