Non-steroidal Anti-Inflammatory Drugs (NSAIDS) and painkillers

Painkillers come in various strengths and are used specifically to relieve pain, whereas NSAIDs have a painkilling effect as well as an anti-inflammatory effect.

Some NSAIDs and painkillers are available to purchase over the counter from a pharmacy or supermarket, such as paracetamol (painkiller), ibuprofen (NSAID), and aspirin (NSAID). However, stronger painkillers and NSAIDs such as codeine and naproxen are only available on prescription.

Doctors may prescribe multiple painkillers and NSAIDs to help manage pain and inflammation. If you are taking painkillers or NSAIDs, you should read the patient information leaflet carefully and check with a Pharmacist or your doctor before taking any other medicines, including those which you may have bought over the counter.

What NSAIDs and painkillers are available?

As with painkillers, there are a number of different NSAIDs, and some have more than one brand name. Commonly prescribed NSAIDs include: -

  • Ibuprofen - Brufen / Nurofen/ Arthofen (and others)
  • Diclofenac - Voltarol / Dicloflex (and others)
  • Naproxen - Naprosyn/ Synflex (and others)

Differences in the anti-inflammatory features between the different NSAIDs are minor, but some people may find one type to be more effective, or have lesser side effects, than another. Pain relief starts soon after taking the first dose, but it can take two or more weeks to feel the full effect.

Like all other medications, NSAIDs do not come without potential side effects. These may include damage to the stomach lining, heartburn, indigestion and wheeziness. Great care is taken when prescribing NSAIDs to people with asthma or with a history of wheezing as they can aggravate these conditions. You can help minimise the unwanted gastro-intestinal side effects by taking the tablets with or after meals, or you might be prescribed something to take alongside it, to protect the stomach. Check the patient information leaflet for each individual medication for further information on potential side effects.

NSAIDs are usually taken in tablet form, but there are some in cream and gel form, which are rubbed onto the skin over the painful areas. However, if you have cracked or broken psoriasis in the painful area, topical NSAIDs should not be used. Topical NSAIDs that you may be prescribed include:

  • Ibuprofen - Ibugel Forte, Fenbid Forte (and others)
  • Ketoprofen - Oruvail, Powergel
  • Piroxicam - Feldene gel
  • Felbinac - Traxam
  • Diclofenac - Voltarol Emulgel/ gel patch

Cox-2 inhibitors are a newer type of NSAID designed to have lesser side effects on the stomach. Like traditional NSAIDs, Cox-2 inhibitors help reduce pain and inflammation. However, as with all medications, there are possible side effects, and some studies have shown that Cox-2 inhibitors may increase the risk of heart disease, especially in people with a history of heart disease or stroke. Cox-2s currently available on prescription include Celecoxib (Celebrex) and Etoricoxib (Arcoxia).

Resources

The information on this page is also available in our psoriatic arthritis - first line treatments information sheet.

December 2017 (Review: December 2020) 

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