NSAIDs are a group of drugs that are widely used to treat rheumatic pain and fever. NSAIDs are available as tablets, suppositories and gel / cream. In many rheumatic diseases, Paracetamol is preferred as the first choice and NSAIDs as the next option if needed.
NSAIDs do not affect the course of the disease, but should reduce pain and discomfort. The drugs do not contain cortisone (steroids) or addictive substances. Among the most common NSAIDs in the Norwegian market are: ibuprofen (Ibux), naproxen (Napren-E), diclofenac (Volraren), piroksicam (Brexidol). Among the subgroup COX-II inhibitors etherocoxib (Arcoxia) is widely used. Some combinations between NSADs and one ulcer-protective agent is also used (Artrotec: diclofenac + misoprostol. Vivomo: naproxen + esomeprazole).
Before start of treatment
Before starting treatment, one should define a treatment goal.
Pregnancy and breast-feeding
NSAIDs may impair the ability to conceive as long as the drug is used. Not all NSAIDs can be used during pregnancy. Ibuprofen can be used, with the exception of the last two months of birth. Regardless, the doses should be as low as possible in pregnancy.
- Please read information about pregnancy in rheumatic diseases on a separate page here and about NSAID and pregnancy here
The dosage for children follows body weight and is different for the different NSAIDs.
Many NSAIDs are available at pharmacies without a prescription.
- For chronic rheumatic diseases, the doctor gives "Blue" prescription.
Side effects may occur and the risk must be compared with the indication for treatment. Common side effects:
- NSAID tablets and suppositories should not be used at risk ulcer. Concurrent use of Prednisone and other cortisone drugs increase the risk
- Take special care asthma and allergies that worsen in some cases
- General increased bleeding risk is seen with concomitant use of anticoagulants ("Blood Thinners" drugs) such as Marevan, Fragmin, Klexane, Albyl-E, Pradaxa, Xarelto, Eliquis and Lixiana
- NSAIDs can affect kidney and liver function
- Some suffer from visual disturbances and dizziness
- The drugs may increase the risk of heart attack, especially at high doses
Checks and follow-up
Medical examinations should rule out signs of side effects and whether the effect is as desired. To assess efficacy (after, for example, three months of treatment), assessment of symptoms at baseline and during treatment is important.
For more information is recommended Felleskatalogen.no