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Nonsteroidal anti-inflammatory drugs (NSAIDs) are some of the most commonly used pain relievers in the world—because they work. But “NSAID” isn’t a single medication, of course. Ibuprofen, naproxen, diclofenac, and celecoxib all reduce pain and inflammation, yet they differ in how long they last, how hard they can be on your stomach, and how they may affect heart and kidney risk—especially at higher doses or with longer use. If you’re considering using an NSAID, read on to learn about the benefits, risks, and the best way to use it.
What Are NSAIDs?
Nonsteroidal anti-inflammatory drugs (NSAIDs) relieve pain and reduce inflammation by blocking certain enzymes (cyclooxygenase [COX]) involved in the production of chemicals that promote inflammation, pain, and fever (prostaglandin). Most NSAIDs block both COX-1 and COX-2 to varying degrees; when a medication is more COX-2 selective, it can mean fewer stomach or ulcer complications for some people when compared with nonselective NSAIDs (more on this below).
Many NSAIDs are available over the counter, while some are prescription-only. Whether you need a prescription or not depends on the pain you are trying to treat. Always consult your doctor about which option is right for you.
Common NSAIDs you’ll see by name include:
• Ibuprofen (e.g., Advil, Motrin)
• Naproxen/naproxen sodium (e.g., Naprosyn, Maxidol Liquid Gel)
• Diclofenac (e.g., Voltaren; topical Pennsaid)
• Celecoxib (Celebrex)
Some combination products also contain an NSAID, such as Vimovo (naproxen plus esomeprazole) or Suvexx (sumatriptan plus naproxen).
How Many People Use NSAIDs?
A 2018 study found that about 25% of the general population uses NSAIDs, with the vast majority of those being over-the-counter versions. This makes NSAIDs one of the most common medications people have in their bathroom cabinets. This does not mean they are without risk, however. Before you reach for that bottle, consider which NSAID you are using and what the risks might be.
When to Use Ibuprofen Vs. Other NSAIDs
Think of NSAID choice as matching the medication to the type of pain, how long you need relief, and your personal risk factors. What’s best for one person might not be good for someone else.
Ibuprofen (Advil, Motrin): Good for Short-Term Pain
Ibuprofen is widely used for temporary relief of headaches, minor injuries, dental pain, menstrual cramps, and fever—often when you want something shorter acting and flexible for “take when needed” dosing.
Naproxen (Naprosyn, Naproxen Sodium/Anaprox, Maxidol LIQGEL): Longer Lasting Relief
Naproxen generally lasts longer than ibuprofen, which can be helpful for pain that predictably lingers (for example, some arthritis flares or day-long musculoskeletal pain).
Some cardiovascular research suggests naproxen may have a comparatively lower cardiovascular risk than some other NSAIDs, but “lower” doesn’t mean “none;” dose and duration still matter.
Diclofenac (Voltaren; Pennsaid Topical): Targeted Arthritis Options
Diclofenac is used for inflammatory pain such as osteoarthritis and rheumatoid arthritis.
If pain is localized to a joint (like knee or hand osteoarthritis), topical diclofenac can be a smart first step because it delivers medication at the site with less whole-body exposure than tablets.
Celecoxib (Celebrex): An Option When Gastrointestinal Risk Is a Major Concern
Celecoxib is a COX-2 selective NSAID used for osteoarthritis, rheumatoid arthritis, and short-term acute pain. People at higher risk of NSAID-related ulcers or gastrointestinal bleeding may choose celecoxib first, as it can mitigate those risks, as can adding stomach protection (like a proton pump inhibitor such as omeprazole [Prilosec]), depending on individual risk.
How to Use NSAIDs Properly (Your Safety Basics)
1. Use the lowest effective dose for the shortest time—Heart attack and stroke risk can increase even early in treatment, and it rises with higher doses and longer use.
2. Don’t double up on NSAIDs—Avoid taking multiple NSAIDs at the same time. This may increase side effects without reliably improving pain control.
3. Protect your stomach if you’re at higher risk—Ulcers and gastrointestinal bleeding can be caused by NSAIDs; risk increases with age, prior ulcer/bleed history, higher doses, and longer duration. Gastrointestinal guidelines discuss preventive approaches for higher-risk patients (often involving proton pump inhibitors or NSAID selection).
4. Test for kidney health—In susceptible people, reduced kidney blood flow and worse fluid retention or heart failure risk can happen with NSAID use, especially those with chronic kidney disease or multiple comorbidities. Make sure your doctor tests your kidneys to ensure they can handle NSAID use.
When to Talk to a Doctor (Before Choosing an NSAID)
Check in with your doctor first if you have any of the noted risk factors, like a history of ulcers, gastrointestinal bleeding, heart disease or stroke, uncontrolled high blood pressure, chronic kidney disease, are on blood thinners or steroids, if you’re pregnant, or if you need pain control beyond a few days. When in doubt, always ask a healthcare professional which medication is best for you.
Key Takeaways
• NSAIDs are effective for pain with inflammation, but various risks rise with higher doses or longer use.
• Ibuprofen (Advil, Motrin) is a common short-acting option; naproxen (Naprosyn, naproxen sodium/Maxidol liquid gel) lasts longer; diclofenac (Voltaren, Pennsaid) can be oral or topical; celecoxib (Celebrex) is COX-2 selective and so may protect your stomach.
• For localized osteoarthritis pain, topical NSAIDs are often an appropriate first medication choice.
In Short
Nonsteroidal anti-inflammatory drugs (NSAIDs) can be a safe, effective way to calm pain and inflammation when you choose the right one for the right job and use it carefully. Match the medication to your symptoms (short-term pain vs. longer-lasting relief, localized joint pain vs. whole-body inflammation), and keep the basics in mind: the lowest effective dose, the shortest time, and never more than one NSAID at once. If you have risk factors like past ulcers or gastrointestinal bleeding, heart disease, high blood pressure, or chronic kidney disease, or if you need relief for more than a few days, talk with your doctor or pharmacist so you can get the benefit without unnecessary risk.
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