Guide to OTC Anti-Inflammatories


Over-the-counter (OTC) medications are drugs you can buy without a doctor’s prescription. Nonsteroidal anti-inflammatory drugs (NSAIDs) are drugs that help reduce inflammation, which often helps to relieve pain. In other words, they’re anti-inflammatory drugs.

Some of the more common OTC NSAIDs are:

  • aspirin
  • ibuprofen (Advil, Motrin, Midol)
  • naproxen (Aleve, Naprosyn)

NSAIDs can be very effective. They tend to work quickly and generally have fewer side effects than corticosteroids, which also help with inflammation. However, before you use an NSAID, you should know about the potential side effects and interactions with other drugs. Read on for this information, plus tips to help you use them safely and effectively.

What they do

NSAIDs work by blocking prostaglandins. Prostaglandin is a substance that sensitizes your nerve endings and enhances pain during inflammation. Prostaglandins also play a role in controlling your body temperature. By blocking these effects, NSAIDs help relieve your pain and bring down your fever.

In fact, NSAIDs can be helpful in reducing many types of discomfort, including:

  • headache
  • backache
  • muscle aches
  • inflammation and stiffness caused by arthritis and other inflammatory conditions
  • menstrual aches and pains
  • pain after a minor surgery
  • sprains or other injuries

If you’re at risk of heart attack or stroke, your doctor may recommend daily low-dose aspirin to help lower your risk.

Side effects

Just because you can buy NSAIDs without a prescription doesn’t mean they’re perfectly safe. There are some potential side effects and risks.

Some of the most commonly reported side effects include stomach upset, diarrhea, and gas. You can minimize these side effects by taking your medication with food, milk, or antacids. Less often, NSAIDs may cause lightheadedness, dizziness, or mild headache.

Serious side effects that require immediate medical attention include:

  • ringing in your ears
  • blurry vision
  • rash, hives, and itching
  • fluid retention
  • blood in your urine or stools
  • vomiting and blood in your vomit
  • severe stomach pain
  • chest pain
  • rapid heartbeat
  • jaundice (yellowing of the skin and eyes)

NSAIDs are intended for occasional and short-term use. Your risk of side effects increases the longer you use them.

Drug interactions

NSAIDs can interact with other medications. Sometimes, this interaction can make your drugs less effective. Two examples are blood pressure medications and low-dose aspirin when used as a blood thinner.

Other combinations can cause serious side effects, too. These include using an NSAID with:

  • Warfarin: NSAIDs can actually enhance the impact of warfarin (Coumadin), a medication used to prevent or treat blood clots. That combination can lead to excessive bleeding.
  • Cyclosporine: Cyclosporine is used to treat arthritis or ulcerative colitis. It is also prescribed for people who have had an organ transplant. Taking it with an NSAID can lead to kidney damage.
  • Lithium: Combining NSAIDs with the mood-stabilizing drug lithium can lead to a dangerous build up of lithium in your body.
  • Aspirin: Taking NSAIDs with low-dose aspirin can increase the risk of developing stomach ulcers.
  • SSRIs: Bleeding within the digestive system may also be a problem if you take NSAIDs with selective serotonin reuptake inhibitors (SSRIs).
  • Diuretics: It’s usually not a problem to take NSAIDs if you also take diuretics. However, your doctor should monitor you for high blood pressure and kidney damage while you take them both.

For children

Children younger than 18 years who may have chickenpox or influenza should avoid aspirin and products containing aspirin. Giving aspirin to children can increase their risk of Reye’s syndrome, which may result in liver and brain damage. Reye’s syndrome is potentially fatal.

Tips for using OTC NSAIDs

To get the best effects from your OTC treatment, follow these tips.

Assess your needs

Some OTC medications, like acetaminophen (Tylenol) are good for relieving pain, but they don’t help with inflammation. If you can tolerate them, NSAIDs are probably the better choice for arthritis and other inflammatory conditions.

Read the labels

Some OTC products combine acetaminophen and anti-inflammatory medicine. NSAIDs can be found in some cold and flu medications. Be sure to read the ingredients list on all OTC medications so you know how much of each drug you’re taking. Taking too much of an active ingredient in combination products increases your risk of side effects.

Store properly

OTC medications can lose their effectiveness before the expiration date if stored in a hot, humid place, like your bathroom medicine cabinet. To make them last, keep them in a cool, dry place.

Take the correct dose

When taking an OTC NSAIDs, be sure to read and follow the directions. Products vary in strength, so make sure you’re taking the right amount each time.

Ask your doctor

NSAIDs aren’t a good idea for everybody. Before taking these medications, check with your doctor if you have or had had:

  • an allergic reaction to aspirin or another pain reliever
  • a blood disease
  • stomach bleeding, stomach ulcers (peptic ulcers), or intestinal problems
  • high blood pressure or heart disease
  • liver or kidney disease

You should also talk to your doctor about the safety of using an NSAID if you consume three or more alcoholic beverages a day or if you take blood thinning medication.


NSAIDs can be great for relieving pain caused by inflammation. Many anti-inflammatory drugs are available over the counter. Talk to your doctor about how much of a drug is too much, and stick to that limit. NSAIDs may be ingredients in certain medications, so be sure to read the label of any OTC drug you take.