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NSAIDs for Rheumatoid Arthritis Treatment Option in Dhakuria

NSAIDs

NSAIDs for Rheumatoid Arthritis Treatment Option in Dhakuria

Non-steroidal anti-inflammatory drugs, abbreviated as NSAIDs, are medications that help reduce pain, inflammation, or fever. They are commonly prescribed for a variety of conditions due to their antipyretic, anti-inflammatory, and analgesic properties. This includes arthritic conditions, gout, and opioid-sparing agents for patients with trauma injuries or surgery. NSAIDs are generally of two types, categorised as non-selective NSAIDs and COX-2 selective NSAIDs, based on how they inhibit cyclooxygenase (COX) enzymes involved in the inflammatory process. NSAIDs are available in several dosage forms, including tablets or capsules, gels, creams, liquids, and suppositories.

Some examples of NSAIDs involve over-counter medications, such as ibuprofen, aspirin, and naproxen sodium, or prescription NSAIDs, which include oxaprozin, etodolac, Naproxen, nabumetone, and diclofenac. At Manipal Hospitals in Dhakuria, West Bengal, specialists in the Department of Rheumatology review every individual case when prescribing NSAIDs to patients suffering from various inflammatory conditions to ensure the most appropriate and effective treatment.

FAQ's

Common symptoms that may necessitate specialists prescribing NSAIDs include:

  • Headaches

  • Painful menstruation (dysmenorrhea)

  • Strains and sprains

  • High-temperature fever (pyrexia), cold or flu

  • Severe pain or inflammation, especially due to arthritis or tendonitis

  • Toothaches and muscle aches

NSAIDs involve the process of blocking cyclooxygenase (COX) enzymes, which convert arachidonic acid into thromboxanes, prostacyclins, and prostaglandins, contributing to inflammation, fever, or pain by raising body temperature and dilating blood vessels. This can manifest in redness or swelling in regions where the chemicals are released. By blocking these hormone-like chemicals that act on pain nerves, it desensitises and reduces symptoms and discomfort that may arise.

Several risk factors are considered when prescribing NSAIDs, some of which include the following: 

  • Those with gastrointestinal or heart problems, such as stomach ulcers, Crohn’s disease, liver disease, heart failure, stroke, or heart attacks, are usually refrained from taking NSAIDs

  • Consuming alcohol or taking high doses of NSAIDs

  • Previous allergies induced by NSAIDs

Additionally, our specialists will discuss if you require NSAIDs in some cases. This includes if you are aged 65 and over, are pregnant, planning for pregnancy or breastfeeding, have co-morbidities such as high blood pressure or cholesterol levels, or are taking other medications.

Our specialists will discuss with you if you can take NSAIDs with other medications. Possible complications that may occur when interacting with other medications include:

  • Kidney failure when combined with angiotensin-converting enzyme (ACE) inhibitors or diuretics

  • Reduced effectiveness in treating heart failure or high blood pressure when combined with medications such as beta-blockers, diuretics, and ACE inhibitors

  • Gastrointestinal (GI) ulceration or bleeding when combined with other NSAIDs or corticosteroids

  • GI damage or bleeding when drinking high amounts of alcohol

  • Accidental overdose due to over-the-counter medications which have NSAIDs

Possible adverse events or risks that may arise when taking NSAIDs include:

  • Gastrointestinal conditions, such as damage to gastric mucosa or lining

  • Renal-related complications, which include acute renal dysfunction, renal papillary necrosis, fluid or electrolyte disorder, and nephrotic syndrome

  • Cardiovascular events or Hepatotoxicity, especially when taking diclofenac

  • Haematological adverse effects may occur if the patient has a medical history of GI ulcers that affect the activity of platelets, such as thrombocytopenia, and during the surgery.

  • Minor effects, such as aspirin-exacerbated respiratory disease or urticaria

The decision as to whether our specialist prescribes NSAIDs after surgery depends on the type of procedure. Common medications that are usually prescribed by specialists after surgery include ibuprofen, naproxen sodium, celecoxib, or ketorolac, which help mitigate any swelling or post-operative pain. However, NSAIDs are not usually prescribed for patients who have undergone procedures such as Coronary Artery Bypass Graft Surgery (CABG). Moreover, our specialists may prescribe a combination of medications with NSAIDs to enhance your recovery and lower any risks based on your condition.

Our specialists determine specific doses based on your condition. Specialists usually prescribe NSAIDs one to four times per day, although this is established based on the duration of the drug’s effects on the body. For conditions like rheumatoid arthritis, higher doses of NSAIDs are prescribed due to the significant inflammation or swelling associated with the condition. However, for conditions like osteoarthritis or muscle injuries, lower doses are sufficient. Our specialists may prescribe a variety of NSAIDs before finding the most effective one for you.

Our specialists may recommend the following if you are unable to take or manage the side effects of NSAIDs, which include:

  • Topical treatments, which include lidocaine or capsaicin creams

  • Acupuncture

  • Physical therapy or massage

  • Yoga

  • Medicines, such as non-acetylated salicylates

  • Anti-inflammatory diet

General precautions you should take after taking NSAIDs include:

  • Quitting NSAIDS if you notice symptoms such as swollen ankles, black-coloured stools, dark or coffee-coloured vomit, or irregular breathing

  • Adhering to doses and timing prescribed by our specialist

  • Having food before taking NSAIDs to protect the stomach lining

  • Paying attention to the labels of medicines you’re taking and being aware of their side effects

  • Informing our specialists or pharmacists if you are taking other medications.

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