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Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Topic Overview

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

Be sure to follow the nonprescription medicine precautions. Always take these medicines exactly as prescribed or according to the label.

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: Check with your child's doctor if your child is less than 6 months old or less than 12 pounds. Dosages are based on the child's weight. Give follow-up doses every 6 hours as needed, up to a maximum of 4 doses in a 24-hour period.
    • Talk to your doctor before you give medicine to reduce a fever in a baby who is 3 months of age or younger. This is to make sure a young baby's fever is not a sign of a serious illness. The exception is if your baby has just had an immunization. Fevers sometimes occur as a reaction to immunizations. After immunizations, you can give your baby medicine to reduce a fever.
Ibuprofen dose for your child's weight
Child's weight in pounds (lb) Child's weight in kilograms (kg) Dose
Less than 12 lb Less than 6 kg Ask a doctor
12–17 lb 7–8 kg 50 mg
18–23 lb 9–10 kg 75 mg
24–35 lb 11–16 kg 100 mg
36–47 lb 17–21 kg 150 mg
48–59 lb 22–27 kg 200 mg
60–71 lb 28–32 kg 250 mg
72–95 lb 33–43 kg 300 mg
96 lb and above 44 kg and above Adult dose

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. To help prevent these side effects, take NSAIDs with food and a glass of water.

  • 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, has been shown to reduce the risk of heart attack and stroke. It does carry the risks of serious stomach and intestinal bleeding as well as skin reactions.

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 breast-feeding, 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 20 because of the risk of Reye syndrome, a rare but serious disease.

Credits

By Healthwise Staff
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
David Messenger, MD
Last Revised May 23, 2013

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