Anti-inflammatory drugs for joints (NSAIDs): a review of drugs. NSAIDs (NSAIDs) – what is it? list of new generation NSAIDs list

Nonsteroidal anti-inflammatory drugs, which are briefly called NSAIDs or NSAIDs (drugs), are widely used throughout the world. In the United States, where statistics cover all sectors of life, it was estimated that every year American doctors write more than 70 million prescriptions for NSAIDs. Americans drink, shoot and smear skin more than 30 billion doses of non-steroidal anti-inflammatory drugs per year. It is unlikely that our compatriots are lagging behind them.

Despite their popularity, most NSAIDs are characterized by high safety and extremely low toxicity. Even when used in large dosages, complications are extremely unlikely. What kind of miracle cures are these?

Nonsteroidal anti-inflammatory drugs are a large group of drugs that have three effects:

• painkillers;
• antipyretic;
• anti-inflammatory.

The term “non-steroidal” distinguishes these drugs from steroids, that is, hormonal drugs that also have an anti-inflammatory effect.

The property that sets NSAIDs apart from other analgesics is their lack of addiction with long-term use.

Excursion into history

The “roots” of non-steroidal anti-inflammatory drugs go back to the distant past. Hippocrates, who lived 460–377 BC, reported the use of willow bark for pain relief. A little later, in the 30s BC. Celsius confirmed his words and stated that willow bark is excellent at alleviating the signs of inflammation.

The next mention of analgesic bark occurs only in 1763. And only in 1827 chemists were able to isolate from willow extract the very substance that became famous in the time of Hippocrates. The active ingredient in willow bark turned out to be the glycoside salicin, a precursor to non-steroidal anti-inflammatory drugs. From 1.5 kg of bark, scientists obtained 30 g of purified salicin.

In 1869, a more effective salicin derivative, salicylic acid, was first obtained. It soon became clear that it damages the gastric mucosa, and scientists began an active search for new substances. In 1897, German chemist Felix Hoffmann and the Bayer company opened a new era in pharmacology by converting toxic salicylic acid into acetylsalicylic acid, which was named Aspirin.

For a long time, aspirin remained the first and only representative of the NSAID group. Since 1950, pharmacologists began to synthesize new drugs, each of which was more effective and safer than the previous one.

How do NSAIDs work?

Nonsteroidal anti-inflammatory drugs block the production of substances called prostaglandins. They are directly involved in the development of pain, inflammation, fever, and muscle cramps. Most NSAIDs nonselectively (non-selectively) block two different enzymes that are needed to produce prostaglandin. They are called cyclooxygenase - COX-1 and COX-2.

The anti-inflammatory effect of non-steroidal anti-inflammatory drugs is largely due to:

• reducing vascular permeability and improving microcirculation in them;
• decreased release from cells of special substances that stimulate inflammation - inflammatory mediators.

In addition, NSAIDs block energy processes at the site of inflammation, thereby depriving it of “fuel”. The analgesic (pain-relieving) effect develops as a result of a decrease in inflammatory process.

Serious drawback

It's time to talk about one of the most serious disadvantages of non-steroidal anti-inflammatory drugs. The fact is that COX-1, in addition to participating in the production of harmful prostaglandins, also plays a positive role. It is involved in the synthesis of prostaglandin, which prevents the destruction of the gastric mucosa under the influence of its own of hydrochloric acid. When non-selective COX-1 and COX-2 inhibitors start working, they completely block prostaglandins - both the “harmful” ones that cause inflammation and the “good” ones that protect the stomach. Thus, non-steroidal anti-inflammatory drugs provoke the development of gastric ulcers and duodenum, as well as internal bleeding.

But there are also special drugs among the NSAID family. These are the most modern tablets that can selectively block COX-2. Cyclooxygenase type 2 is an enzyme that is involved only in inflammation and does not carry any additional load. Therefore, blocking it is not fraught with unpleasant consequences. Selective COX-2 blockers do not cause gastrointestinal problems and are safer than their predecessors.

Nonsteroidal anti-inflammatory drugs and fever

NSAIDs have a completely unique property that sets them apart from other drugs. They have an antipyretic effect and can be used to treat fever. To understand how they work in this capacity, you should remember why body temperature rises.

Fever develops due to increased levels of prostaglandin E2, which changes the so-called firing rate of neurons (activity) within the hypothalamus. Namely, the hypothalamus - a small area in the diencephalon - controls thermoregulation.

Antipyretic non-steroidal anti-inflammatory drugs, also called antipyretics, inhibit the COX enzyme. This leads to inhibition of prostaglandin production, which ultimately contributes to inhibition of neuronal activity in the hypothalamus.

By the way, it has been established that ibuprofen has the most pronounced antipyretic properties. It has surpassed its closest competitor, paracetamol, in this regard.

Classification of non-steroidal anti-inflammatory drugs

Now let's try to figure out what drugs belong to non-steroidal anti-inflammatory drugs.

Today, several dozen drugs from this group are known, but not all of them are registered and used in Russia. We will consider only those medications that can be bought in domestic pharmacies. NSAIDs are classified according to their chemical structure and mechanism of action. So as not to scare the reader complex terms, we present a simplified version of the classification, in which we present only the most famous names.

So, the entire list of non-steroidal anti-inflammatory drugs is divided into several subgroups.

Salicylates

The most experienced group with which the history of NSAIDs began. The only salicylate that is still used today is acetylsalicylic acid, or Aspirin.

Derivatives propionic acid

These include some of the most popular non-steroidal anti-inflammatory drugs, in particular drugs:

• ibuprofen;
• naproxen;
• ketoprofen and some other medications.

Derivatives acetic acid

No less famous are acetic acid derivatives: indomethacin, ketorolac, diclofenac, aceclofenac and others.

Selective COX-2 inhibitors

The safest non-steroidal anti-inflammatory drugs include seven new drugs of the latest generation, but only two of them are registered in Russia. Remember their international names - celecoxib and rofecoxib.

Other non-steroidal anti-inflammatory drugs

Separate subgroups include piroxicam, meloxicam, mefenamic acid, nimesulide.

Paracetamol has very weak anti-inflammatory activity. It mainly blocks COX-2 in the central nervous system and has an analgesic as well as a moderate antipyretic effect.

When are NSAIDs used?

Typically, NSAIDs are used to treat acute or chronic inflammation accompanied by pain.

We list the diseases for which non-steroidal anti-inflammatory drugs are used:

• arthrosis;
• moderate pain due to inflammation or soft tissue injury;
• osteochondrosis;
• lower back pain;
• headache;
• acute gout;
• dysmenorrhea (menstrual pain);
• bone pain caused by metastases;
• postoperative pain;
• pain in Parkinson's disease;
• fever (increased body temperature);
• intestinal obstruction;
• renal colic.

In addition, nonsteroidal anti-inflammatory drugs are used to treat babies whose ductus arteriosus does not close within 24 hours of birth.

This amazing aspirin!

Aspirin can safely be considered one of the drugs that surprised the whole world. The most common non-steroidal anti-inflammatory pills, which were used to reduce fever and treat migraines, showed an unusual side effect. It turned out that by blocking COX-1, aspirin also inhibits the synthesis of thromboxane A2, a substance that increases blood clotting. Some scientists suggest that there are other mechanisms by which aspirin affects blood viscosity. However, for millions of patients hypertension, angina pectoris, coronary heart disease and other cardiovascular diseases, this is not so significant. It is much more important for them that aspirin in low doses helps prevent cardiovascular disasters - heart attack and stroke.

Most experts recommend taking low-dose cardiac aspirin to prevent myocardial infarction and stroke in men aged 45–79 and women aged 55–79. The dose of aspirin is usually prescribed by a doctor: as a rule, it ranges from 100 to 300 mg per day.

Several years ago, scientists discovered that aspirin reduces the overall risk of developing oncological diseases and mortality from them. This effect is especially true for colorectal cancer. American doctors recommend that their patients take aspirin specifically to prevent the development of colorectal cancer. In their opinion, the risk of developing side effects due to long-term treatment with aspirin, it is still lower than oncological. By the way, let's take a closer look at the side effects of non-steroidal anti-inflammatory drugs.

Cardiac risks of non-steroidal anti-inflammatory drugs

Aspirin, with its antiplatelet effect, stands out from the orderly row of its group brethren. The vast majority of non-steroidal anti-inflammatory drugs, including modern COX-2 inhibitors, increase the risk of myocardial infarction and stroke. Cardiologists warn that patients who have recently had a heart attack should avoid NSAID treatment. According to statistics, the use of these drugs increases the likelihood of developing unstable angina by almost 10 times. According to research data, naproxen is considered the least dangerous from this point of view.

On July 9, 2015, the most authoritative American drug quality control organization, the FDA, published an official warning. It talks about an increased risk of stroke and heart attack in patients using non-steroidal anti-inflammatory drugs. Of course, aspirin is a happy exception to this axiom.

The effect of non-steroidal anti-inflammatory drugs on the stomach

Another known side effect of NSAIDs is gastrointestinal. We have already said that it is closely related to the pharmacological action of all non-selective inhibitors of COX-1 and COX-2. However, NSAIDs not only reduce the level of prostaglandins and thereby deprive the gastric mucosa of protection. Drug molecules themselves behave aggressively towards the mucous membranes of the gastrointestinal tract.

During treatment with nonsteroidal anti-inflammatory drugs, nausea, vomiting, dyspepsia, diarrhea, and gastric ulcers, including those accompanied by bleeding, may appear. Gastrointestinal side effects of NSAIDs develop regardless of how the drug enters the body: oral in the form of tablets, injectable in the form of injections, or rectal in the form of suppositories.

The longer the treatment lasts and the higher the dosage of NSAIDs, the higher the risk of developing peptic ulcers. To reduce the likelihood of its occurrence to a minimum, it makes sense to take the lowest effective dose within the shortest period.

Recent studies show that in more than 50% of people taking non-steroidal anti-inflammatory drugs, the lining of the small intestine is damaged.

Scientists note that drugs from the NSAID group affect the gastric mucosa in different ways. Thus, the most dangerous drugs for the stomach and intestines are indomethacin, ketoprofen and piroxicam. And among the most harmless in this regard are ibuprofen and diclofenac.

Separately, I would like to say about the enteric coatings that cover non-steroidal anti-inflammatory tablets. Manufacturers claim that this coating helps reduce or completely eliminate the risk of gastrointestinal complications of NSAIDs. However, research and clinical practice show that such protection does not actually work. The likelihood of damage to the gastric mucosa is much more effectively reduced by the simultaneous use of medications that block the production of hydrochloric acid. Proton pump inhibitors - omeprazole, lansoprazole, esomeprazole and others - can somewhat mitigate the damaging effects of drugs from the group of non-steroidal anti-inflammatory drugs.

Say a word about citramone...

Citramon is the product of the brainstorming of Soviet pharmacologists. In ancient times, when the range of our pharmacies did not amount to thousands of drugs, pharmacists came up with an excellent analgesic-antipyretic formula. They combined “in one bottle” a complex of a non-steroidal anti-inflammatory drug, an antipyretic and seasoned the combination with caffeine.

The invention turned out to be very successful. Each active substance enhanced the effect of each other. Modern pharmacists have somewhat modified the traditional prescription, replacing the antipyretic phenacetin with safer paracetamol. In addition, from old version citramona seized cocoa and citric acid- citric acid, which, in fact, gave the name to citramon. The 21st century drug contains aspirin 0.24 g, paracetamol 0.18 g and caffeine 0.03 g. And despite the slightly modified composition, it still helps with pain.

However, despite the extremely affordable price and very high efficiency, Citramon has its own huge skeleton in the closet. Doctors have long found out and fully proven that it seriously damages the gastrointestinal mucosa. So serious that the term “citramone ulcer” even appeared in the literature.

The reason for such obvious aggression is simple: the damaging effect of Aspirin is enhanced by the activity of caffeine, which stimulates the production of hydrochloric acid. As a result, the gastric mucosa, already left without the protection of prostaglandins, is exposed to an additional amount of hydrochloric acid. Moreover, it is produced not only in response to food intake, as it should be, but also immediately after Citramon is absorbed into the blood.

Let us add that “citramone”, or as they are sometimes called, “aspirin ulcers” are different large sizes. Sometimes they don’t “grow” into giant ones, but they grow in numbers, being located in whole groups in different parts of the stomach.

The moral of this digression is simple: do not overdo Citramon, despite all its benefits. The consequences could be too severe.

NSAIDs and... sex

In 2005, the unpleasant side effects of non-steroidal anti-inflammatory drugs arrived. Finnish scientists conducted a study that showed that long-term use of NSAIDs (over 3 months) increases the risk of erectile dysfunction. Let us remember that by this term doctors mean erectile dysfunction, popularly called impotence. Then urologists and andrologists were consoled by the not very high quality of this experiment: the effect of drugs on sexual function was assessed only on the basis of the man’s personal feelings and was not tested by specialists.

However, in 2011, the authoritative Journal of Urology published data from another study. It also showed a link between treatment with non-steroidal anti-inflammatory drugs and erectile dysfunction. However, doctors say that it is too early to draw final conclusions regarding the effect of NSAIDs on sexual function. In the meantime, scientists are looking for evidence, it is still better for men to refrain from long-term treatment with non-steroidal anti-inflammatory drugs.

Other side effects of NSAIDs

We have dealt with the serious problems that can arise from treatment with non-steroidal anti-inflammatory drugs. Let's move on to less common adverse events.

Renal dysfunction

NSAIDs are also associated with a relatively high level of renal side effects. Prostaglandins are involved in expansion blood vessels in the renal glomeruli, which allows maintaining normal filtration in the kidneys. When the level of prostaglandins falls - and it is on this effect that the action of non-steroidal anti-inflammatory drugs is based - kidney function may be impaired.

People at greatest risk for kidney side effects are, of course, people with kidney disease.

Photosensitivity

Often long-term treatment non-steroidal anti-inflammatory drugs are accompanied by increased photosensitivity. It is noted that piroxicam and diclofenac are most involved in this side effect.

People taking anti-inflammatory drugs may react to sun exposure with skin redness, rashes, or other skin reactions.

Hypersensitivity reactions

Non-steroidal anti-inflammatory drugs are also “famous” for allergic reactions. They can manifest as a rash, photosensitivity, itching, angioedema, and even anaphylactic shock. True, the latter effect is extremely rare and therefore should not frighten potential patients.

In addition, taking NSAIDs may be accompanied by headache, dizziness, drowsiness, and bronchospasm. Rarely, ibuprofen has been associated with irritable bowel syndrome.

Nonsteroidal anti-inflammatory drugs during pregnancy

Quite often, pregnant women are faced with the acute issue of pain relief. Can expectant mothers use NSAIDs? Unfortunately no.

Despite the fact that drugs from the non-steroidal anti-inflammatory group do not have a teratogenic effect, that is, they do not cause gross developmental defects in a child, they can still cause harm.

So, there is data that suggests a possible premature closure ductus arteriosus in the fetus if its mother took NSAIDs during pregnancy. Additionally, some studies show an association between NSAID use and preterm birth.

Nevertheless, selected drugs are still used during pregnancy. For example, Aspirin is often prescribed along with heparin to women who have developed antiphospholipid antibodies during pregnancy. IN Lately The old and rather rarely used Indomethacin has become particularly famous as a medicine for the treatment of pregnancy pathologies. It began to be used in obstetrics for polyhydramnios and the threat of premature birth. However, in France, the Ministry of Health has issued an official order prohibiting the use of non-steroidal anti-inflammatory drugs, including aspirin, after the sixth month of pregnancy.

NSAIDs: take it or leave it?

When do NSAIDs become a necessity, and when should they be completely abandoned? Let's look at everything possible situations.

NSAIDs are needed	NSAIDs should be taken with caution	It's best to avoid NSAIDs
If you have osteoarthritis, which is accompanied by pain, inflammation of the joints and impaired joint mobility, which is not relieved by other drugs or paracetamol If you have rheumatoid arthritis with severe pain and inflammation If you have a moderate headache, joint or muscle injury (NSAIDs are prescribed only for a short time. It is possible to start pain relief with paracetamol) If you have mild chronic pain other than osteoarthritis, such as in the back.	If you often suffer from indigestion If you are over 50 years old or have previously suffered from gastrointestinal diseases and/or have a family history of early heart disease If you smoke, have high level cholesterol or high arterial pressure or suffer from kidney disease If you are taking steroids or blood thinners (clopidogrel, warfarin) If you have to take NSAIDs to relieve the symptoms of osteoarthritis for many years, especially if you have had gastrointestinal diseases	If you have ever had a stomach ulcer or stomach bleeding If you have coronary artery disease or any other heart condition If you suffer from severe hypertension If you have chronic kidney disease If you have ever had a myocardial infarction If you are taking aspirin to prevent a heart attack or stroke If you are pregnant (especially in the third trimester)

NSAIDs in faces

We already know the strengths and weaknesses of NSAIDs. Now let's figure out which anti-inflammatory drugs are best to use for pain, which for inflammation, and which for fever and colds.

Acetylsalicylic acid

The first NSAID to see the light of day, acetylsalicylic acid is still widely used today. As a rule, it is used:

• to reduce body temperature.

  Please note that acetylsalicylic acid is not prescribed to children under 15 years of age. This is due to the fact that with childhood fever against the background viral diseases the drug significantly increases the risk of developing Reye's syndrome, a rare liver disease that is life-threatening.

  Adult dosage acetyl salicylic acid as an antipyretic agent is 500 mg. Tablets are taken only when the temperature rises.

• as an antiplatelet agent for the prevention of cardiovascular accidents. The dose of cardioaspirin can range from 75 mg to 300 mg per day.

In antipyretic dosage, acetylsalicylic acid can be bought under the name Aspirin (manufacturer and brand owner: German corporation Bayer). Domestic enterprises produce very inexpensive tablets, which are called Acetylsalicylic acid. In addition, the French company Bristol Myers produces effervescent tablets Upsarin Upsa.

Cardioaspirin has many names and forms of release, including Aspirin Cardio, Aspinat, Aspicor, CardiASK, Thrombo ACC and others.

Ibuprofen

Ibuprofen combines relative safety and the ability to effectively reduce fever and pain, so drugs based on it are sold without a prescription. Ibuprofen is also used as an antipyretic for newborns. It has been proven to reduce fever better than other non-steroidal anti-inflammatory drugs.

Additionally, ibuprofen is one of the most popular over-the-counter analgesics. It is not prescribed as often as an anti-inflammatory drug, however, the drug is quite popular in rheumatology: it is used to treat rheumatoid arthritis, osteoarthritis and other joint diseases.

The most popular brand names for ibuprofen include Ibuprom, Nurofen, MIG 200 and MIG 400.

Naproxen

Naproxen is prohibited for use in children and adolescents under 16 years of age, as well as in adults with severe heart failure. Most often, the non-steroidal anti-inflammatory drug naproxen is used as an anesthetic for headaches, dental, periodic, joint and other types of pain.

IN Russian pharmacies naproxen is sold under the names Nalgesin, Naprobene, Pronaxen, Sanaprox and others.

Ketoprofen

Ketoprofen preparations are distinguished by anti-inflammatory activity. It is widely used to relieve pain and reduce inflammation in rheumatic diseases. Ketoprofen is available in the form of tablets, ointments, suppositories and injections. Popular drugs include the Ketonal line produced by the Slovak company Lek. The German joint gel Fastum is also famous.

Indomethacin

One of the outdated non-steroidal anti-inflammatory drugs, Indomethacin is losing ground every day. It has modest analgesic properties and moderate anti-inflammatory activity. IN last years The name “indomethacin” is increasingly heard in obstetrics - its ability to relax the muscles of the uterus has been proven.

Ketorolac

A unique non-steroidal anti-inflammatory drug with a pronounced analgesic effect. The analgesic abilities of ketorolac are comparable to those of some weak narcotic analgesics. Negative side The drug is unsafe: it can cause gastric bleeding, provoke gastric ulcers, as well as liver failure. Therefore, ketorolac can be used for a limited period of time.

In pharmacies, ketorolac is sold under the names Ketanov, Ketalgin, Ketorol, Toradol and others.

Diclofenac

Diclofenac is the most popular non-steroidal anti inflammatory drug, the “gold standard” in the treatment of osteoarthritis, rheumatism and other joint pathologies. It has excellent anti-inflammatory and analgesic properties and is therefore widely used in rheumatology.

Diclofenac has many forms of release: tablets, capsules, ointments, gels, suppositories, ampoules. In addition, diclofenac patches have been developed to provide long-lasting action.

There are a lot of analogues of diclofenac, and we will list only the most famous of them:

• Voltaren - original drug Swiss company Novartis. It is distinguished by high quality and an equally high price;
• Diklak is a line of German drugs from the Hexal company, combining both reasonable cost and decent quality;
• Dicloberl made in Germany, Berlin Chemie company;
• Naklofen - Slovak drugs from KRKA.

In addition, the domestic industry produces many inexpensive non-steroidal anti-inflammatory drugs with diclofenac in the form of tablets, ointments and injections.

Celecoxib

A modern non-steroidal inflammatory drug that selectively blocks COX-2. It has a high safety profile and pronounced anti-inflammatory activity. Used for rheumatoid arthritis and other joint diseases.

The original celecoxib is sold under the name Celebrex (Pfizer). In addition, pharmacies have more affordable Dilaxa, Coxib and Celecoxib.

Meloxicam

A popular NSAID used in rheumatology. It has a fairly mild effect on the digestive tract, so it is often preferred for the treatment of patients with a history of stomach or intestinal diseases.

Meloxicam is prescribed in tablets or injections. Meloxicam preparations Melbek, Melox, Meloflam, Movalis, Exen-Sanovel and others.

Nimesulide

Most often, nimesulide is used as a moderate analgesic, and sometimes as an antipyretic. Until recently, pharmacies sold a children's form of nimesulide, which was used to reduce fever, but today it is strictly prohibited for children under 12 years of age.

Trade names of nimesulide: Aponil, Nise, Nimesil (German original drug in the form of a powder for preparing a solution for internal use) and others.

Finally, let’s devote a couple of lines to Mefenamic acid. It is sometimes used as an antipyretic, but it is significantly inferior in effectiveness to other non-steroidal anti-inflammatory drugs.

The world of NSAIDs is truly amazing in its diversity. And despite the side effects, these medications are rightfully among the most important and necessary, which cannot be replaced or bypassed. It remains only to praise the tireless pharmacists who continue to create new formulas and treat themselves with ever safer NSAIDs.

Content

It is difficult to find a person who does not have toothache or fever, and how many patients suffer from joint diseases, pain in the spine... Doctors in such cases prescribe anti-inflammatory non-steroidal drugs. Medicines in this group reduce pain, lower temperature, and relieve inflammation. They are used in many areas of medicine: therapy, orthopedics, gynecology. Among them are the familiar ones “Analgin” and “Aspirin”. Let's figure out what non-steroidal anti-inflammatory drugs are and how they act on the body.

Mechanism of action of NSAIDs

Anti-inflammatory non-steroidal drugs (NSAIDs) are used in the treatment of colds, spinal hernia, arthritis and arthrosis. The mechanism of action is based on the fact that their constituent components:

• inhibit any inflammatory processes;
• reduce swelling;
• reduce pain in any disease;
• are antipyretic;
• thin the blood.

It is worth noting that non-steroidal anti-inflammatory drugs have many contraindications. They severely irritate the mucous membrane of the stomach and duodenum, causing bleeding and ulcers. In addition, they help thin the blood. Therefore, they are not recommended to be taken:

• for diseases of the stomach, duodenum;
• in case of poor blood clotting;
• during pregnancy;
• if you are allergic to the components of the drug.
• during exacerbation of hypertension;
• for diseases of the kidneys and liver.

Classification of drugs

When getting to know non-steroidal anti-inflammatory drugs (NSAIDs), it is important to know:

1. In terms of pain relief, they are similar to narcotic drugs, but are not addictive.
2. They have a strong anti-inflammatory effect, but are not hormonal (steroid) drugs and do not lead to diseases associated with their use.
3. Based on their effect on the body, they are divided into two groups: selective, non-selective. Both are widely used in medicine, but require use strictly as prescribed by a doctor.

Selective

Selective NSAIDs differ in that they have a local selective effect on the inflamed area. They do not irritate or destroy the mucous membrane of the stomach and intestines; they are released into different types. These drugs include:

• "Nise." Tablets, ampoules, gel. Used for inflammation of ligaments, after operations in gynecology, for toothache in dentistry.
• "Movalis". Injections, tablets, suppositories for the treatment of arthritis, osteochondrosis.
• "Celecoxib" Capsules for inflammation of joints and bones.
• "Paracetamol". Tablets as an antipyretic for colds and fever.

Non-selective

The peculiarity of non-selective NSAIDs is that they inhibit inflammatory processes, while affecting the mucous membrane of the stomach and duodenum. They are among the most powerful drugs in the treatment of osteochondrosis and arthritis; their dosage and use must be agreed with the doctor. Among these drugs:

• "Diclofenac" in the form of tablets, ointments, injections.
• "Ibuprofen." Recommended for use by pregnant women.
• "Indomethacin". It works effectively, but affects the gastric mucosa.
• "Ketoprofen". Several times stronger than ibuprofen, has contraindications.

Main effects

What are non-steroidal anti-inflammatory drugs? These are medical drugs that greatly facilitate the life of a patient with diseases of the joints and spine. Helps with colds, fever, reducing temperature. They improve the condition after operations, change the quality of life in arthritis and arthrosis. The action is based on the fact that the substances in their composition have a strong analgesic effect. The most important thing is that NSAIDs actively inhibit inflammatory processes anywhere in the body. In addition, they are antipyretic and blood thinning.

Anti-inflammatory

The use of anti-inflammatory non-steroidal drugs has become widespread in the treatment of diseases of the musculoskeletal system. Here are osteochondrosis, arthritis, arthrosis, inflammation of connective tissues, radiculitis. At acute form Treatment begins with injections, then tablets are prescribed, and anti-inflammatory ointments and gels are used externally. Prescribed "Diclofenac" (trade name "Voltaren", "Ortofen"), "Viprosal", "Bystrumgel". The main point in using the products is the presence of a pronounced anti-inflammatory effect.

Antipyretic

Who hasn’t taken Aspirin at elevated temperatures? Together with Ibuprofen, Nise, Paracetamol, this is a group of anti-inflammatory non-steroidal drugs with an antipyretic effect. They have proven themselves in the treatment of colds and fever. Diclofenac, Ketanov, and Analgin give good results for reducing temperature. In case of influenza, they are prescribed together with antiviral drug"Azilthomirin." To alleviate the patient's condition, they are often taken in the form of tablets or suppositories.

Anesthetic

Severe back pain, migraine, neuralgia often do not give the patient rest either day or night. It's hard to sleep when your teeth hurt or acute attack gout. Renal colic, conditions after surgery, lumbago, sciatica, trauma - all require the use of NSAIDs for pain relief. They are used in the form of injections, tablets and ointments. Such drugs as “Nise”, “Naproxen”, “Ketonal”, “Ketanov” have excellent performance. They help with headaches, dental and joint pain.

Indications for use

Groups of non-steroidal anti-inflammatory drugs are recommended for various diseases. It is difficult to imagine an area of ​​medicine where they are not used. It is important not to self-medicate, but to use them only as prescribed by a doctor. In this case, it is necessary to follow the rules of admission:

• read the instructions;
• Take tablets and capsules with plenty of water.
• Avoid drinking alcohol and carbonated drinks;
• do not lie down after taking the capsule for better passage;
• Do not take several NSAIDs at the same time.

Orthopedists and traumatologists use non-steroidal anti-inflammatory drugs together with chondroprotectors to treat joints. They relieve swelling, reduce inflammation, relieve pain, allow movement, and improve quality of life. First, injections are prescribed, then tablets and non-steroidal anti-inflammatory ointments. "Indomethacin", "Flexen", "Nimesulide" showed good results in the treatment of:

• osteochondrosis;
• arthritis, arthrosis;
• coxarthrosis of the hip joints;
• spinal hernia;
• radiculitis;
• gout.

In gynecology, these medications are used to reduce monthly menstrual pain, alleviate the condition after operations, and reduce temperature during complications. In obstetrics, the use of a drug such as Indomethacin helps to relax the muscles of the uterus. The drugs are used as painkillers during procedures for removing the intrauterine device and endometrial biopsy. They help with diseases of the uterus and genital organs. It is important to remember that their use poses a danger to the intestines, causing ulcers and bleeding, and not to self-medicate.

Prescribed medications for colds with elevated temperature, for neuralgia, dental inflammation, pain. Sports injuries, renal colic - all are indications for the use of non-steroidal anti-inflammatory drugs. Due to the property of NSAIDs to thin the blood, they are used to prevent heart attacks and strokes, as antithrombosis drugs that reduce the likelihood of blockage of blood vessels. In ophthalmology, drugs are used for inflammation of the choroid, and as an antiallergic drug for conjunctivitis.

For adults

Adult patients should not self-medicate. It is necessary to undergo an examination so that the doctor can diagnose accurate diagnosis, appointed necessary funds. It is important to take into account the patient’s age and allergic reactions to medications. Many drugs have a huge number of contraindications for diseases. It is recommended that pregnant women and elderly people use non-steroidal anti-inflammatory drugs with caution. You should not take several medications at the same time. Only a doctor will prescribe the right remedy and will give a diagram of its application.

When treating adults with non-steroidal anti-inflammatory drugs, it must be taken into account that each drug has its own duration of action. Depending on your disease, condition, you will be prescribed the use medicines three times a day or once. There are 3 groups according to validity period:

1. A short. Lasts from two to eight hours. Medicines: Ibuprofen, Voltaren, Ortofen.
2. Average. Valid from ten to twenty hours. Medicines: Naproxen, Sulindac.
3. Long lasting. Duration: 24 hours. The drug "Celecoxib".

For children

Non-steroidal anti-inflammatory drugs should be used with caution in children. Many products have clear, strict contraindications. Some drugs are age-restricted. For example, Aspirin is not prescribed until the age of 16. Ibuprofen and Paracetamol are considered completely safe for children. Pediatricians prescribe them even to infants from 3 months. It is used when children have a cold, fever, or are teething. Because the small child It is difficult to take the medicine; it is prescribed in the form of suppositories.

List of new generation non-steroidal anti-inflammatory drugs

NSAIDs are not recommended for long-term use due to numerous side effects. Modern pharmacology has developed a group of drugs that are safe when taken regularly. New generation NSAIDs do not cause complications and have no dangerous contraindications. They act gently and selectively. These drugs include:

1. "Nimesulide". Reduces temperature, treats back pain.
2. "Celecoxib". Helps with osteochondrosis and arthrosis.
3. "Movalis". Prescribed against inflammation, for pain in the spine and joints.
4. "Xefocam." A potent pain reliever that is not addictive.

The peculiarity of the action of new generation non-steroidal anti-inflammatory drugs is that they do not irritate the gastrointestinal mucosa, do not cause bleeding or the appearance of ulcers. They act only on inflamed areas, sore spot. In addition, they do not destroy cartilage tissue. These drugs are used for outpatient treatment and in hospital settings. Side effects include:

• dizziness;
• drowsiness;
• increased blood pressure;
• shortness of breath;
• fatigue;
• indigestion;
• allergies.

Side effects

Anti-inflammatory non-steroidal drugs are used in many areas of medicine, but great care must be taken when using them. This should only be done on the recommendation of the doctor who examined you, because there are side effects:

1. The occurrence of ulcers and bleeding in the stomach and duodenum.
2. Renal dysfunction.
3. Problems with blood clotting.
4. Allergic reactions.
5. The appearance of tissue necrosis during injections.
6. Liver damage.
7. Problems with hearing and vision.
8. Dizziness, fainting.
9. Destruction of intra-articular cartilage.

Video about diseases for which NSAIDs are used

Watch the video and you will learn how to take non-steroidal anti-inflammatory drugs. You will clearly see how they act on the inflamed area. You will learn how to avoid severe complications from the use of these drugs. Why is it strictly forbidden to drink them with carbonated drinks, and what foods should be excluded from the diet during treatment.

Attention! The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only qualified doctor can make a diagnosis and make treatment recommendations based on individual characteristics specific patient.

Found an error in the text? Select it, press Ctrl + Enter and we will fix everything!

Non-steroidal anti-inflammatory drugs (NSAIDs, NSAIDs) are new generation medications that have anti-inflammatory, antipyretic and analgesic effects. Their mechanism of action is based on blocking certain enzymes (cyclooxygenase, COX), which are responsible for the formation of prostaglandins - chemical substances, contributing to pain, fever, inflammation.

• How NSAIDs work
  • When are NSAIDs used?
• • The main advantage of new generation NSAIDs
  • What are new generation NSAIDs?
  • Classification of NSAIDs
  • Dosage selection
  • Side effects
  • Use during pregnancy
• • Movalis
  • Celecoxib
  • Indomethacin
  • Ibuprofen
  • Diclofenac
  • Chondroprotectors - alternative drugs

The word “non-steroidal” in the name of these drugs indicates the fact that medications in this group are not artificial analogues of steroid hormones - powerful anti-inflammatory hormonal drugs. The most popular NSAIDs are diclofenac and ibuprofen.

How NSAIDs work

If analgesics are intended to combat pain, then NSAIDs reduce two unpleasant symptoms of the disease: inflammation and pain. Many drugs in this group are considered non-selective inhibitors of the cyclooxygenase enzyme, which suppress the effects of both of its isoforms (types) - COX-1 and COX-2.

Cyclooxygenase is responsible for the formation of thromboxane and prostaglandins from arachidonic acid, which, in turn, is obtained from phospholipids cell membrane using the enzyme phospholipase A2. Among other functions, prostaglandins are regulators and mediators in the formation of inflammation.

When are NSAIDs used?

Most often, NSAID drugs are used to treat chronic or acute inflammation that is accompanied by pain. Anti-inflammatory non-steroidal drugs have gained great popularity due to their effective treatment of joints.

We list the diseases for which these medications are prescribed:

NSAIDs should not be used during erosive and ulcerative lesions of the gastrointestinal tract, especially during the acute stage, cytopenias, severe renal and liver dysfunction, pregnancy, and individual intolerance. Should be prescribed with caution to patients with asthma, as well as to people who have previously had negative reactions while taking any other NSAIDs.

Non-steroidal anti-inflammatory drugs: list of NSAIDs for the treatment of joints

Let's consider the most effective and well-known NSAIDs, which are used to treat joints and other diseases when an antipyretic and anti-inflammatory effect is required:

Some medications are weaker, not so aggressive, some are designed for acute arthrosis, if emergency intervention is necessary to stop it in the body hazardous processes.

The main advantage of new generation NSAIDs

Side effects are observed during prolonged use of NSAIDs (for example, during treatment of osteochondrosis) and consist of damage to the intestinal and stomach mucosa with the formation of bleeding and ulcers. This disadvantage of non-selective NSAIDs was the reason for the creation of a new generation of drugs that block only COX-2 (an inflammatory enzyme) and do not affect the function of COX-1 (a defense enzyme).

That is, new generation drugs have almost no ulcerogenic side effects (damage to the mucous membrane of the digestive system) associated with prolonged use of non-selective NSAIDs, but they increase the chance of thrombotic complications.

The only disadvantage of the new generation of drugs is their high cost, which makes them inaccessible to most people.

What are new generation NSAIDs?

New generation anti-inflammatory nonsteroidal drugs act much more selectively; they inhibit COX-2 to a greater extent, while COX-1 remains almost unaffected. This is what can explain the rather high effectiveness of the drug in combination with a minimum of side effects.

List of effective and popular new generation anti-inflammatory non-steroidal drugs:

• Xefocam. A medicine that is based on Lornoxicam. His characteristic feature is the fact that the drug has an increased ability to relieve pain. In terms of this indicator, it is similar to morphine, but at the same time it does not create addiction and does not have an opiate-like effect on the central nervous system.
• Movalis. It has an antipyretic, well-defined anti-inflammatory and analgesic effect. The main advantage of this drug is that with constant medical supervision it can be used for quite a long time. Meloxicam is produced in the form of a solution for intramuscular injections, in ointments, suppositories and tablets. The tablets of the drug are quite convenient in that they have a long-lasting effect, and it is enough to use one tablet throughout the day.
• Nimesulide. Successfully used to treat arthritis, vertebrogenic back pain, etc. Normalizes temperature, relieves hyperemia and inflammation. Taking the drug quickly leads to improved mobility and reduced pain. It is also used in the form of an ointment for application to the problem area.
• Celecoxib. This drug significantly alleviates the patient’s condition with arthrosis, osteochondrosis and other diseases, effectively fights inflammation and perfectly relieves pain. Side effects on the digestive system from the drug are minimal or completely absent.

In cases where long-term use of anti-inflammatory non-steroidal drugs is not necessary, then older generation drugs are used. However, sometimes this is simply a necessary measure, since not all people can afford a course of treatment with these drugs.

Classification of NSAIDs

Based on their chemical origin, these drugs come in non-acidic and acidic derivatives.

Acidic preparations:

Non-acidic drugs:

• Sulfonamide derivatives;
• Alcanons.

At the same time, non-steroidal drugs differ in intensity and type of action - anti-inflammatory, analgesic, combined.

According to the strength of the anti-inflammatory effect of average doses, the drugs are arranged in the following sequence (the most powerful on top):

• Flurbiprofen;
• Indomethacin;
• Piroxicam;
• Diclofenac sodium;
• Naproxen;
• Aspirin;
• Amidopyrine;
• Ibuprofen.

According to the analgesic effect, the drugs are arranged in the following order:

Most often, the NSAID drugs listed above are used for chronic and acute diseases that are accompanied by inflammation and pain. As a rule, non-steroidal anti-inflammatory drugs are used to treat joints and relieve pain: injuries, arthrosis, arthritis, etc.

NSAIDs are often used for pain relief for migraines and headaches, renal colic, postoperative pain, dysmenorrhea, etc. Due to their inhibitory effect on prostaglandin synthesis, these drugs also have an antipyretic effect.

Dosage selection

Any medicine new to the patient should be prescribed at the beginning in a minimal dose. If tolerance is normal, the daily dose is increased after a few days.

Therapeutic dosages of NSAIDs are in a wide range, while recently there has been a tendency to increase single and daily doses of drugs that are well tolerated (ibuprofen, naproxen), while maintaining restrictions on maximum dosage indomethacin, aspirin, piroxicam, phenylbutazone. In some patients, the therapeutic effect is achieved only with the use of increased doses of NSAIDs.

Side effects

Long-term use of anti-inflammatory drugs in high dosages can cause:

Treatment with NSAIDs must be carried out for the shortest possible time and in minimal doses.

Use during pregnancy

It is undesirable to use NSAIDs during pregnancy, especially in the third trimester. Although no direct teratogenic effects are found, it is believed that NSAIDs can cause renal complications in the fetus and premature closure of the ductus arteriosus. There is also information about premature birth. Despite this, aspirin in combination with heparin has been used successfully in women with antiphospholipid syndrome.

Description of non-steroidal anti-inflammatory drugs

Movalis

It is a leader among non-steroidal anti-inflammatory drugs, has a long duration of action and is approved for long-term use.

It has a pronounced anti-inflammatory effect, which makes it possible to use it for rheumatoid arthritis, ankylosing spondylitis, and osteoarthritis. Protects cartilage tissue and is not without antipyretic and analgesic properties. Used for headaches and toothaches.

The determination of doses and administration options (suppositories, injections, tablets) depends on the type and severity of the disease.

Celecoxib

A COX-2 inhibitor that has a pronounced analgesic and anti-inflammatory effect. When used in therapeutic doses, it has almost no negative effect on the gastrointestinal mucosa, since it has a fairly low degree of affinity for COX-1 and, accordingly, does not cause disruption in the synthesis of constitutional prostaglandins.

Indomethacin

It is one of the most effective non-hormonal drugs. For arthritis, it reduces joint swelling, relieves pain and has a strong anti-inflammatory effect. Using medical product you need to be careful because it has a long list of side effects. In pharmacology, the drug is manufactured under the names Indovis EC, Indovazin, Indocollir, Indotard, Metindol.

Ibuprofen

It combines the ability to effectively reduce pain and temperature, and is relatively safe, which is why medications based on it can be purchased without a prescription. Ibuprofen is used as an antipyretic drug, including for newborns.

It is not used as often as an anti-inflammatory drug, but the medicine is very popular in rheumatology: it is used to treat osteoarthritis, rheumatoid arthritis and other joint diseases.

The most popular names include Nurofen, Ibuprom, MIG 400 and 200.

Diclofenac

Form of manufacture - capsules, tablets, gel, suppositories, injection solution. This drug for the treatment of joints perfectly combines both a high anti-inflammatory effect and high analgesic activity.

It is manufactured under the names Naklofen, Voltaren, Diklak, Ortofen, Vurdon, Diclonac P, Dolex, Olfen, Clodifen, Dikloberl, etc.

Chondroprotectors - alternative drugs

Very often, chondroprotectors are used to treat joints. People often do not understand the differences between chondroprotectors and NSAIDs. The latter quickly remove pain, but at the same time have many side effects. And chondroprotectors protect cartilage tissue, but they must be used in courses. The most effective chondroprotectors contain two substances - chondroitin and glucosamine.

Anti-inflammatory non-steroidal drugs are excellent assistants during the treatment of many diseases. But we must not forget that they only remove the negatively affecting symptoms on well-being; the treatment of diseases themselves is carried out by other methods and drugs.

Non-steroidal anti-inflammatory ointments (NSAIDs): list of drugs (creams, gels)

As a rule, anti-inflammatory ointments are used externally. But today you can buy products with a creamy texture that are taken orally, vaginally and rectally.

The cream, which has an anti-inflammatory effect, is used to treat joints, allergies and infections. But often such drugs are classified as adjuvant therapy methods.

In addition, almost all anti-inflammatory ointments have an analgesic and regenerating effect. Therefore, they are used to treat:

• diseases of the musculoskeletal system;
• bruises;
• injuries;
• local inflammation;
• pathologies of muscles and back.

The principle of action for the treatment of joint diseases and other diseases is to inhibit the production of inflammatory substances by cells - mediators (kinin, prostaglandins, lysosomal enzymes histamine).

Also, anti-inflammatory ointments are intended for cutaneous use. However, there are products that need to be inserted directly into the vagina or applied to the mucous membrane.

Nonsteroidal anti-inflammatory ointments are often used in a variety of fields of medicine. Today there are many ointments that are used:

1. for the treatment of joints;
2. in orthopedics;
3. gynecology;
4. infectology;
5. dermatology;
6. venereology.

The advantage of this form of release is that the gel or ointment does not spread along with the blood throughout the body, that is, their effect is local.

Anti-inflammatory drugs for diseases of the musculoskeletal system

Today there are a lot of pathologies in which damage and destruction of bones and joints occurs. The main component of the treatment of rheumatoid diseases are NSAIDs.

The pain syndrome in the case of the development of osteochondrosis, gouty arthritis or arthrosis is so severe that the patient immediately seeks medical help.

The first medications a doctor prescribes are NSAIDs. To achieve a more maximum effect, anti-inflammatory creams and anti-inflammatory ointments for joints are also prescribed, which are applied topically.

There are several groups of drugs, each of them is based on a specific component:

• indomethacin;
• diclofenac;
• nimesulide;
• ibuprofen;
• piroxicam;
• ketoprofen.

Anti-inflammatory drugs, the main active ingredient of which is diclofenac, are very effective after injury, for neurology and degenerative changes in the joints.

Diclofenac promotes rapid restoration of joint mobility, it reduces swelling, local temperature in the affected area and has an analgesic effect. The trade name of diclofenac-based NSAIDs is Ortofen ointment, Diclofenac gel, Diclak-gel, Diclovit and Voltaren.

Note! Diclofenac-based gel or ointment should not be used to treat children under 6 years of age or pregnant women.

It is also prohibited to apply it to damaged areas of the skin, and people suffering from stomach and duodenal ulcers can use such drugs only after the approval of a doctor.

Ibuprofen

Drugs that relieve inflammation, which contain ibuprofen (Nurofen, Dolgit), are indicated for the same symptoms as when using diclofenac-based products. That is, their main effect is pain relief and elimination of inflammation.

However, such funds cannot be used if you have:

• "aspirin" asthma;
• kidney and liver diseases;
• children under 2 years of age;
• gastrointestinal diseases;
• pregnancy;
• during lactation.

A cream that eliminates inflammatory processes with ketoprofen is used for various injuries and degenerative changes in the joints. Ketoprofen also prevents the formation of blood clots.

Products based on it should not be applied to damaged skin. Also, NSAIDs with ketoprofen are contraindicated in children under 12 years of age and pregnant women.

The most common products, the main component of which is ketoprofen:

1. Febrofeed;
2. Fastum-gel;
3. Artrosilene;
4. Ketonal;
5. Febrofeed.

Indomecin

The drugs based on indomethacin include: Indovazin, Sopharma, Indomethacin-Acri and Sofar. Their effect is similar to ketoprofan, but it is not so pronounced, and the indications and contraindications are similar to similar NSAIDs

Anti-inflammatory anesthetic cream Finalgel belongs to the group of piroxicam-containing medications. The gel restores joint health, relieves swelling and eliminates pain without drying out the skin.

This remedy is used for osteoarthrosis, periarthrosis and tendonitis. Pregnant women and children are prohibited from using the gel.

Indovazin cream, the main active ingredient of which is nimesulide. This is the only medicine from the entire group of NSAIDs intended for safe treatment joints.

Indovazin gel is not as toxic as other products, so it does not have a detrimental effect on the gastrointestinal tract. But despite this, like other drugs, Indovazin can be used only after a doctor’s prescription, because it also has side effects, although less significant.

Contraindications to the use of the product are as follows:

• age up to 3 years;
• joint and bone injuries;
• osteochondrosis;
• bursitis;
• arthritis.

It should be noted that the process by which anti-inflammatory drugs are rubbed into the skin helps to accelerate and improve the effect of the product. Local external preparations for the treatment of joint diseases, such as epicondylitis or arthritis, are more effective if combined with phonophoresis.

This treatment method improves the absorption of the active component. At the same time, the amount of product applied is reduced, which significantly saves its consumption, and most importantly, it is safer for the body.

Non-steroidal anti-inflammatory drugs (NSAIDs, NSAIDs) are new generation medications that have anti-inflammatory, antipyretic and analgesic effects. Their mechanism of action is based on blocking certain enzymes (cyclooxygenase, COX), which are responsible for the formation of prostaglandins - chemicals that promote pain, fever, and inflammation.

The word “non-steroidal” in the name of these drugs indicates the fact that medications in this group are not artificial analogues of steroid hormones - powerful anti-inflammatory hormonal drugs. The most popular representatives of NSAIDs are diclofenac, ibuprofen.

How NSAIDs work

If analgesics are intended to combat pain, then NSAIDs reduce two unpleasant symptoms of the disease: inflammation and pain. Many drugs in this group are considered non-selective inhibitors of the cyclooxygenase enzyme, which suppress the effects of both of its isoforms (types) - COX-1 and COX-2.

Cyclooxygenase is responsible for the formation of thromboxane and prostaglandins from arachidonic acid, which, in turn, is obtained from cell membrane phospholipids using the enzyme phospholipase A2. Among other functions, prostaglandins are regulators and mediators in the formation of inflammation.

When are NSAIDs used?

The most commonly used drugs are NSAIDs for the treatment of chronic or acute inflammation which are accompanied by pain. Anti-inflammatory non-steroidal drugs have gained great popularity due to their effective treatment of joints.

We list the diseases for which these medications are prescribed:

NSAIDs should not be used during erosive and ulcerative lesions of the gastrointestinal tract, especially at the stage of exacerbation, cytopenias, severe disorders of the kidneys and liver, pregnancy, individual intolerance. Should be prescribed with caution to patients with asthma, as well as to people who have previously had negative reactions while taking any other NSAIDs.

Non-steroidal anti-inflammatory drugs: list of NSAIDs for the treatment of joints

Let's look at the most effective and well-known NSAIDs, which are used to treat joints and other diseases when required. antipyretic and anti-inflammatory effect:

Some medications are weaker, not so aggressive, some are designed for acute arthrosis, if emergency intervention is necessary in order to stop dangerous processes in the body.

The main advantage of new generation NSAIDs

Side effects are observed during prolonged use of NSAIDs (for example, during the treatment of osteochondrosis) and consist of damage to the intestinal and gastric mucosa with the formation of bleeding and ulcers. This disadvantage of non-selective NSAIDs was the reason for the creation of a new generation of drugs that block only COX-2 (an inflammatory enzyme) and do not affect the function of COX-1 (a defense enzyme).

That is, new generation drugs have almost no ulcerogenic side effects (damage to the mucous membrane of the digestive system) associated with prolonged use of non-selective NSAIDs, but they increase the chance of thrombotic complications.

The only disadvantage of the new generation of drugs is their high cost, which makes them inaccessible to most people.

What are new generation NSAIDs?

The new generation of anti-inflammatory non-steroidal drugs act much more selectively, they are more inhibit COX-2, and COX-1 remains almost unaffected. This is what can explain the rather high effectiveness of the drug in combination with a minimum of side effects.

List of effective and popular anti-inflammatory non-steroidal drugs new generation:

• Xefocam. A medicine that is based on Lornoxicam. Its characteristic feature is the fact that the drug has an increased ability to relieve pain. In terms of this indicator, it is similar to morphine, but at the same time it does not create addiction and does not have an opiate-like effect on the central nervous system.
• Movalis. It has an antipyretic, well-defined anti-inflammatory and analgesic effect. The main advantage of this drug is that with constant medical supervision it can be used for quite a long time. Meloxicam is produced in the form of a solution for intramuscular injections, in ointments, suppositories and tablets. The tablets of the drug are quite convenient in that they have a long-lasting effect, and it is enough to use one tablet throughout the day.
• Nimesulide. Successfully used to treat arthritis, vertebrogenic back pain, etc. Normalizes temperature, relieves hyperemia and inflammation. Taking the drug quickly leads to improved mobility and reduced pain. It is also used in the form of an ointment for application to the problem area.
• Celecoxib. This drug significantly alleviates the patient’s condition with arthrosis, osteochondrosis and other diseases, effectively fights inflammation and perfectly relieves pain. Side effects on the digestive system from the drug are minimal or completely absent.

In cases where long-term use of anti-inflammatory non-steroidal drugs is not necessary, then older generation drugs are used. However, sometimes this is simply a necessary measure, since not all people can afford a course of treatment with these drugs.

Classification of NSAIDs

Based on their chemical origin, these drugs come in non-acidic and acidic derivatives.

Acidic preparations:

Non-acidic drugs:

• Sulfonamide derivatives;
• Alcanons.

At the same time, non-steroidal drugs differ in intensity and type of action - anti-inflammatory, analgesic, combined.

According to the strength of the anti-inflammatory effect Medium doses of drugs are arranged in the following order (strongest on top):

• Flurbiprofen;
• Indomethacin;
• Piroxicam;
• Diclofenac sodium;
• Naproxen;
• Ketoprofen;
• Aspirin;
• Amidopyrine;
• Ibuprofen.

According to analgesic effect The drugs are arranged in the following order:

Most often, the NSAIDs listed above are used for chronic and acute diseases which are accompanied by inflammation and pain. As a rule, non-steroidal anti-inflammatory drugs are used to treat joints and relieve pain: injuries, arthrosis, arthritis, etc.

NSAIDs are often used for pain relief for migraines and headaches, renal colic, postoperative pain, dysmenorrhea, etc. Due to their inhibitory effect on prostaglandin synthesis, these drugs also have an antipyretic effect.

Dosage selection

Any medicine new to the patient should be prescribed at the beginning in a minimal dose. If tolerated normally, after a few days daily dose is increased.

Therapeutic dosages of NSAIDs are in a wide range, while recently there has been a tendency to increase single and daily doses of drugs that are well tolerated (ibuprofen, naproxen), while maintaining restrictions on the maximum dosage of indomethacin, aspirin, piroxicam, phenylbutazone. In some patients, the therapeutic effect is achieved only with the use of increased doses of NSAIDs.

Side effects

Long-term use of anti-inflammatory drugs in higher dosages can cause:

Treatment with NSAIDs must be continued for the minimum possible time and minimum doses.

Use during pregnancy

It is undesirable to use NSAIDs during pregnancy, especially in the third trimester. Although no direct teratogenic effects are found, it is believed that NSAIDs can cause renal complications in the fetus and premature closure of the ductus arteriosus. There is also information about premature birth. Despite this, aspirin in combination with heparin has been used successfully in women with antiphospholipid syndrome.

Description of non-steroidal anti-inflammatory drugs

Movalis

Is a leader among non-steroidal anti-inflammatory drugs, which has a long duration of action and is approved for long-term use.

It has a pronounced anti-inflammatory effect, which makes it possible to use it for rheumatoid arthritis, ankylosing spondylitis, and osteoarthritis. Protects cartilage tissue and is not without antipyretic and analgesic properties. Used for headaches and toothaches.

The determination of doses and administration options (suppositories, injections, tablets) depends on the type and severity of the disease.

Celecoxib

A COX-2 inhibitor, which has a pronounced analgesic and anti-inflammatory effect. When used in therapeutic doses, it has almost no negative effect on the gastrointestinal mucosa, since it has a fairly low degree of affinity for COX-1 and, accordingly, does not cause disruption in the synthesis of constitutional prostaglandins.

Indomethacin

It is one of the most effective non-hormonal drugs. For arthritis, it reduces joint swelling, relieves pain and has a strong anti-inflammatory effect. When using a medication, you need to be careful, as it has a long list of side effects. In pharmacology, the drug is manufactured under the names Indovis EC, Indovazin, Indocollir, Indotard, Metindol.

Ibuprofen

It combines the ability to effectively reduce pain and temperature, and is relatively safe, which is why medications based on it can be purchased without a prescription. Ibuprofen is used as an antipyretic drug, including and for newborns.

It is not used as often as an anti-inflammatory drug, but the medicine is very popular in rheumatology: it is used to treat osteoarthritis, rheumatoid arthritis and other joint diseases.

The most popular names include Nurofen, Ibuprom, MIG 400 and 200.

Diclofenac

Form of manufacture - capsules, tablets, gel, suppositories, injection solution. This drug for the treatment of joints perfectly combines both a high anti-inflammatory effect and high analgesic activity.

It is manufactured under the names Naklofen, Voltaren, Diklak, Ortofen, Vurdon, Diclonac P, Dolex, Olfen, Clodifen, Dikloberl, etc.

Chondroprotectors - alternative drugs

Very common for treating joints use chondroprotectors. People often do not understand the differences between chondroprotectors and NSAIDs. The latter quickly remove pain, but at the same time have many side effects. And chondroprotectors protect cartilage tissue, but they must be used in courses. The most effective chondroprotectors contain two substances - chondroitin and glucosamine.

Anti-inflammatory non-steroidal drugs are excellent assistants during the treatment of many diseases. But we must not forget that they only remove the negatively affecting symptoms on well-being; the treatment of diseases themselves is carried out by other methods and drugs.

The mechanism of their action is based on blocking certain enzymes (COX, cyclooxygenase), they are responsible for the production of prostaglandins - chemicals that promote inflammation, fever, pain.

The word “non-steroidal”, which is contained in the name of the group of drugs, emphasizes the fact that the drugs in this group are not synthetic analogues of steroid hormones - powerful hormonal anti-inflammatory drugs.

The most famous representatives of NSAIDs: aspirin, ibuprofen, diclofenac.

How do NSAIDs work?

While analgesics directly combat pain, NSAIDs reduce both of the most unpleasant symptoms of the disease: pain and inflammation. Most drugs in this group are non-selective inhibitors of the cyclooxygenase enzyme, suppressing the action of both of its isoforms (varieties) - COX-1 and COX-2.

Cyclooxygenase is responsible for the production of prostaglandins and thromboxane from arachidonic acid, which in turn is obtained from cell membrane phospholipids by the enzyme phospholipase A2. Prostaglandins, among other functions, are mediators and regulators in the development of inflammation. This mechanism was discovered by John Wayne, who later received Nobel Prize for his discovery.

When are these drugs prescribed?

Typically, NSAIDs are used to treat acute or chronic inflammation accompanied by pain. Non-steroidal anti-inflammatory drugs have gained particular popularity for the treatment of joints.

We list the diseases for which these drugs are prescribed:

• acute gout;
• dysmenorrhea (menstrual pain);
• bone pain caused by metastases;
• postoperative pain;
• fever (increased body temperature);
• intestinal obstruction;
• renal colic;
• moderate pain due to inflammation or soft tissue injury;
• osteochondrosis;
• lower back pain;
• headache;
• migraine;
• arthrosis;
• rheumatoid arthritis;
• pain in Parkinson's disease.

NSAIDs are contraindicated for erosive and ulcerative lesions of the gastrointestinal tract, especially in the acute stage, severe liver and kidney dysfunction, cytopenias, individual intolerance, and pregnancy. Should be prescribed with caution to patients with bronchial asthma, as well as to persons who have previously experienced adverse reactions when taking any other NSAIDs.

List of common NSAIDs for treating joints

We list the most well-known and effective NSAIDs that are used to treat joints and other diseases when anti-inflammatory and antipyretic effects are necessary:

Some medications are weaker and not so aggressive, others are designed for acute arthrosis, when urgent intervention is required to stop dangerous processes in the body.

What are the advantages of new generation NSAIDs?

Adverse reactions are observed with long-term use of NSAIDs (for example, in the treatment of osteochondrosis) and consist of damage to the mucous membrane of the stomach and duodenum with the formation of ulcers and bleeding. This disadvantage of non-selective NSAIDs has led to the development of a new generation of drugs that block only COX-2 (an inflammatory enzyme) and do not affect the functioning of COX-1 (a defense enzyme).

Thus, new generation drugs are practically free of ulcerogenic side effects (damage to the mucous membrane of the digestive tract) associated with long-term use of non-selective NSAIDs, but they increase the risk of developing thrombotic complications

Among the disadvantages of the new generation of drugs, one can note only their high price, which makes it inaccessible to many people.

New generation NSAIDs: list and prices

What it is? New generation non-steroidal anti-inflammatory drugs act much more selectively; they inhibit COX-2 to a greater extent, while COX-1 remains practically untouched. This explains the fairly high effectiveness of the drug, which is combined with a minimal number of side effects.

List of popular and effective new generation non-steroidal anti-inflammatory drugs:

1. Movalis. It has antipyretic, pronounced analgesic and anti-inflammatory effects. The main advantage of this remedy is that with regular medical supervision it can be taken for a fairly long period of time. Meloxicam is available in the form of a solution for intramuscular injection, in tablets, suppositories and ointments. Meloxicam (Movalis) tablets are very convenient because they are long-acting and it is enough to take one tablet throughout the day. Movalis, which contains 20 tablets of 15 mg each, costs RUB.
2. Xefocam. A drug based on Lornoxicam. Its distinctive feature is the fact that it has a high ability to relieve pain. In this parameter, it corresponds to morphine, but is not addictive and does not have an opiate-like effect on the central nervous system. Xefocam, which contains 30 tablets of 4 mg, costs rubles.
3. Celecoxib. This drug significantly alleviates the patient’s condition with osteochondrosis, arthrosis and other diseases, relieves pain well and effectively fights inflammation. Side effects celecoxib has minimal or no effect on the digestive system. Price, rub.
4. Nimesulide. It is used with great success to treat vertebrogenic back pain, arthritis, etc. Removes inflammation, hyperemia, normalizes temperature. The use of nimesulide quickly reduces pain and improves mobility. It is also used as an ointment to apply to the problem area. Nimesulide, which contains 20 tablets of 100 mg, costs rub.

Therefore, in cases where long-term use of non-steroidal anti-inflammatory drugs is not required, older generation drugs are used. However, in some cases this is simply a forced situation, since few people can afford a course of treatment with such a drug.

Classification

How are NSAIDs classified and what are they? Based on their chemical origin, these drugs come in acidic and non-acidic derivatives.

1. Oxicams – piroxicam, meloxicam;
2. NSAIDs based on indoacetic acid - indomethacin, etodolac, sulindac;
3. Based on propionic acid – ketoprofen, ibuprofen;
4. Salicipates (based on salicylic acid) – aspirin, diflunisal;
5. Phenylacetic acid derivatives – diclofenac, aceclofenac;
6. Pyrazolidines (pyrazolonic acid) – analgin, metamizole sodium, phenylbutazone.

Also, non-steroidal drugs differ in type and intensity of effect - analgesic, anti-inflammatory, combined.

Effectiveness of average doses

Based on the strength of the anti-inflammatory effect of average doses of NSAIDs, they can be arranged in the following sequence (the strongest at the top):

According to the analgesic effect of average doses, NSAIDs can be arranged in the following sequence:

As a rule, the above medications are used for acute and chronic diseases accompanied by pain and inflammation. Most often, non-steroidal anti-inflammatory drugs are prescribed to relieve pain and treat joints: arthritis, arthrosis, injuries, etc.

NSAIDs are often used for pain relief for headaches and migraines, dysmenorrhea, postoperative pain, renal colic, etc. Due to their inhibitory effect on the synthesis of prostaglandins, these drugs also have an antipyretic effect.

What dosage to choose?

Any drug new to a given patient must be prescribed first lowest dose. If well tolerated, the daily dose is increased after 2-3 days.

Therapeutic doses of NSAIDs are in a wide range, and in recent years there has been a tendency to increase single and daily doses of drugs characterized by the best tolerance (naproxen, ibuprofen), while maintaining restrictions on the maximum doses of aspirin, indomethacin, phenylbutazone, piroxicam. In some patients healing effect achieved only when using very high doses of NSAIDs.

Side effects

Long-term use of anti-inflammatory drugs in high doses can cause:

1. Disruption nervous system– mood changes, disorientation, dizziness, apathy, tinnitus, headache, blurred vision;
2. Changes in the functioning of the heart and blood vessels - palpitations, increased blood pressure, swelling.
3. Gastritis, ulcer, perforation, gastrointestinal bleeding, dyspeptic disorders, changes in liver function with an increase in the activity of liver enzymes;
4. Allergic reactions – angioedema, erythema, urticaria, bullous dermatitis, bronchial asthma, anaphylactic shock;
5. Kidney failure, urinary disorders.

Treatment with NSAIDs should be carried out for the minimum permissible time and in the minimum effective doses.

Use during pregnancy

It is not recommended to use NSAIDs during pregnancy, especially in the third trimester. Although no direct teratogenic effects have been identified, NSAIDs are thought to cause premature closure of the ductus arteriosus and renal complications in the fetus. There is also information about premature births. Despite this, aspirin in combination with heparin has been successfully used in pregnant women with antiphospholipid syndrome.

According to the latest data from Canadian researchers, the use of NSAIDs before 20 weeks of pregnancy was associated with increased risk miscarriage (miscarriage). According to the results of the study, the risk of miscarriage increased by 2.4 times, regardless of the dose of the drug taken.

Movalis

The leader among non-steroidal anti-inflammatory drugs can be called Movalis, which has an extended period of action and is approved for long-term use.

It has a pronounced anti-inflammatory effect, which makes it possible to take it for osteoarthritis, ankylosing spondylitis, and rheumatoid arthritis. It has analgesic and antipyretic properties, and protects cartilage tissue. Used for toothache and headache.

Determining the dosage and method of administration (tablets, injections, suppositories) depends on the severity and type of disease.

Celecoxib

A specific inhibitor of COX-2, which has a pronounced anti-inflammatory and analgesic effect. When used in therapeutic doses, it has virtually no negative effect on the mucous membrane of the gastrointestinal tract, since it has a very low degree of affinity for COX-1, therefore, it does not cause disruption in the synthesis of constitutional prostaglandins.

As a rule, celecoxib is taken in a dosage of mg per day in 1-2 doses. The maximum daily dose is 400 mg.

Indomethacin

Refers to the most effective means non-hormonal action. For arthritis, indomethacin relieves pain, reduces joint swelling and has a strong anti-inflammatory effect.

The price of the drug, regardless of the form of release (tablets, ointments, gels, rectal suppositories) is quite low, the maximum cost of tablets is 50 rubles per package. When using the drug you must be careful, as it has a considerable list of side effects.

In pharmacology, indomethacin is produced under the names Indovazin, Indovis EC, Metindol, Indotard, Indocollir.

Ibuprofen

Ibuprofen combines relative safety and the ability to effectively reduce fever and pain, so drugs based on it are sold without a prescription. Ibuprofen is also used as an antipyretic for newborns. It has been proven to reduce fever better than other non-steroidal anti-inflammatory drugs.

Additionally, ibuprofen is one of the most popular over-the-counter analgesics. It is not often prescribed as an anti-inflammatory drug, however, the drug is quite popular in rheumatology: it is used to treat rheumatoid arthritis, osteoarthritis and other joint diseases.

The most popular brand names for ibuprofen include Ibuprom, Nurofen, MIG 200 and MIG 400.

Diclofenac

Perhaps one of the most popular NSAIDs, created back in the 60s. Release form: tablets, capsules, injection solution, suppositories, gel. This joint treatment product combines both high anti-pain activity and high anti-inflammatory properties.

It is produced under the names Voltaren, Naklofen, Ortofen, Diclak, Diclonac P, Vurdon, Olfen, Dolex, Dikloberl, Clodifen and others.

Ketoprofen

In addition to the drugs listed above, the group of drugs of the first type, non-selective NSAIDs, i.e. COX-1, includes a drug such as ketoprofen. In terms of the strength of its action, it is close to ibuprofen, and is available in the form of tablets, gel, aerosol, cream, solutions for external use and for injection, rectal suppositories(suppositories).

You can buy this product under the trade names Artrum, Febrofid, Ketonal, OKI, Artrosilen, Fastum, Bystrum, Flamax, Flexen and others.

Aspirin

Acetylsalicylic acid reduces the ability of blood cells to stick together and form blood clots. When taking Aspirin, the blood thins and the blood vessels dilate, which leads to relief from headaches and intracranial pressure. The action of the drug reduces the energy supply at the site of inflammation and leads to the attenuation of this process.4

Aspirin is contraindicated for children under 15 years of age, as a possible complication in the form of extremely severe Reye's syndrome, in which 80% of patients die. The remaining 20% ​​of surviving babies may be susceptible to epilepsy and mental retardation.

Alternative drugs: chondroprotectors

Quite often, chondroprotectors are prescribed for the treatment of joints. People often do not understand the difference between NSAIDs and chondroprotectors. NSAIDs quickly relieve pain, but they also have a lot of side effects. And chondroprotectors protect cartilage tissue, but they need to be taken in courses.

The most effective chondroprotectors include 2 substances - glucosamine and chondroitin.

The best anti-inflammatory agent for the respiratory system

With most infectious inflammatory diseases respiratory system and ENT organs, non-steroidal anti-inflammatory drugs are widely used as symptomatic therapy. They are prescribed to reduce fever, suppress inflammation and reduce pain.

Types of NSAIDs

Today, there are more than 25 different drugs belonging to the group of non-steroidal anti-inflammatory drugs. Classification by chemical structure is considered to be of little use for comparative assessment of the effectiveness and safety of a drug. Of greatest interest are drugs that have a pronounced antipyretic and anti-inflammatory effect and have a low adverse reactions.

List of anti-inflammatory drugs that can be prescribed for diseases of the respiratory system and ENT organs:

Only the attending physician knows which anti-inflammatory tablets, capsules, powder, mixture or syrup will be effective in each specific case.

Features of application

All non-steroidal anti-inflammatory drugs have similar principles of action, the use of which leads to the elimination of the inflammatory process, fever and pain. In pulmonology and otolaryngology, preference is given to NSAIDs, which have more pronounced antipyretic and anti-inflammatory properties. I would like to note that due to the high risk of adverse reactions, the combined use of several NSAIDs at once is highly undesirable. At the same time, their therapeutic effect does not increase, but the negative impact on the body, in particular on the digestive system, increases sharply.

At serious problems with the gastrointestinal tract (for example, peptic ulcer), it is better to use modern selective NSAID drugs of the new generation, which have a significantly lower likelihood of side effects. Despite the possibility of purchasing these medications without a prescription, the dosage and duration of the therapeutic course must be agreed with your doctor. During treatment, the consumption of alcoholic beverages should be avoided.

Paracetamol

With the main clinical symptoms Colds are effectively treated with Paracetamol. Taking it in the appropriate dosage makes it possible to quickly bring down a high fever, relieve malaise and fatigue, relieve pain, etc. The main advantages of the drug:

• Recommended for use by the World Health Organization.
• Fast antipyretic effect.
• Quite well tolerated by most patients.
• Low risk of adverse reactions.
• Compared to other similar anti-inflammatory drugs, the cost is relatively low, which makes it accessible to all segments of the population.

Paracetamol has its own characteristics of use. It can be used in the form of tablets, powder, rectal suppositories, injections, etc. Taking the drug orally or administering it rectally allows you to achieve more effective results. The interval between use should be at least 4 hours. Average duration treatment 5-7 days. A longer therapeutic course with this antipyretic drug is not recommended. Usually clinical manifestations Colds begin to subside on the 2-3rd day. If your condition worsens significantly, you should immediately consult a doctor.

If the patient has an allergy to the components of the drug or severe problems with the kidneys and liver, Paracetamol should not be prescribed. The development of the following pathological conditions is classified as side effects:

• Anemia.
• Decreased platelet count.
• Renal colic.
• Glomerulonephritis.
• Allergic manifestations (itching, redness of the skin, various rashes, etc.).

In an attempt to achieve a quick result, some patients ignore the instructions outlined in the official instructions for use and take a dosage of an anti-inflammatory drug that exceeds the maximum recommended. In case of an overdose of Paracetamol, the following symptoms are possible:

• The appearance of pallor, nausea, vomiting and pain in the abdominal area.
• If timely assistance is not provided and too large a dose of medication is taken, the kidneys and liver are affected. Arrhythmia, pancreatitis, and serious disorders of the central nervous system may develop.

If severe clinical manifestations of overdose are observed, it is necessary to prescribe Methionine or N-acetylcysteine, which are effective antidotes (antidote). In addition, when using Paracetamol, drug interactions with other drugs should be taken into account. For example, simultaneous use with indirect anticoagulants (coumarin derivatives) increases the effect of the latter. The antipyretic effect is significantly reduced when combined with barbiturates.

A qualified specialist (pharmacist or doctor) will help you choose the best non-steroidal anti-inflammatory drug.

Panadol Extra

Panadol Extra is considered a combined NSAID drug, which contains not only paracetamol, but also caffeine as active substances. Both components enhance each other's effect. Paracetamol relieves pain and relieves fever. Caffeine has a stimulating effect on the central nervous system. In addition, by increasing the concentration of paracetamol in the brain by increasing the permeability of the blood-brain barrier, caffeine increases the analgesic effect of the drug.

Panadol Extra helps alleviate the condition of colds, acute tonsillitis, laryngopharyngitis and other infectious and inflammatory pathologies of the respiratory system and ENT organs. Most adults and children tolerate this anti-inflammatory drug quite well. As a rule, there are no special problems with the absorption and excretion of the medicine. Panadol Extra is not prescribed to patients who have increased sensitivity to active ingredients. In rare cases, side effects occur, which may include:

• Blood pressure surges.
• Functional disorders of the liver.
• Allergic reactions (redness, rashes, itching, etc.).

For details of use and recommended dosage, please read the official instructions. It should only be noted that 8 tablets is the maximum that an adult patient can take per day. Considering pharmacological properties drug, the interval between doses should be at least 4 hours. Anti-inflammatory tablets Panadol Extra cost approximately 45 rubles per pack.

Coldrex

For acute infectious diseases the upper respiratory tract can be treated with Coldrex. This is a complex anti-inflammatory drug consisting of:

Considering its multicomponent composition, Coldrex has a very diverse pharmachologic effect:

1. The presence of paracetamol normalizes the temperature, relieves pain and eliminates the inflammatory process.
2. Ascorbic acid strengthens the local immunity of the respiratory tract.
3. Phenylephrine is responsible for the narrowing of peripheral blood vessels and preventing the increase in edema of the affected tissues.
4. Terpin hydrate enhances bronchial secretion and facilitates expectoration of sputum.
5. Caffeine potentiates the analgesic effect of paracetamol.

Coldrex has several varieties, each of which is selected individually, taking into account the severity of the clinical signs of the disease. There are the following contraindications to its use:

• Allergy to the active ingredients of the medicine.
• Severe disorders of the liver and kidneys.
• Diseases of the circulatory system.
• High blood pressure.
• Diabetes.
• Cardiovascular pathology (for example, arrhythmias, heart attack, etc.).
• Increased hormonal activity of the thyroid gland.
• Children under 6 years of age.

The therapeutic course should be no more than 5 days. The dosage and frequency of use are specified in detail in the official instructions. During treatment, drug interactions with other drugs must be taken into account. It is strictly not recommended to combine antidepressants, beta-blockers, etc. with medications from the group. Adverse reactions are rarely recorded. In general, the medicine is well tolerated. When used to treat children, it is better to first consult with your doctor. The cost of a package of Coldrex tablets ranges from 160 rubles.

The list of NSAID drugs (tablets, capsules, etc.) is constantly updated and supplemented with new drugs that have more pronounced therapeutic effects and less toxic properties.

Fervex

Another representative of combined nonsteroidal anti-inflammatory drugs is Fervex, which today is successfully used for most colds of the upper respiratory tract. How the pharmacological effect of the drug is realized:

• The analgesic and antipyretic effect is characteristic of paracetamol.
• Strengthening local immunity and tissue restoration ensures ascorbic acid.
• Pheniramine has an antihistamine effect, which helps reduce mucus production in the nasal cavity, improve breathing through the nose, eliminate sneezing, watery eyes, etc.

Despite the fact that Fervex is considered quite safe medicine, not all patients can use it. This drug should not be used for the following pathological conditions and diseases:

Children can use Fervex starting from the age of 15. Use with extreme caution when:

• Functional liver failure.
• Angle-closure glaucoma.
• Congenital disorders of bilirubin metabolism (for example, Gilbert's syndrome).
• Viral hepatitis.
• In old age.

At the recommended dosage, the drug is well tolerated. However, nausea, pain in the abdomen, itching, redness of the skin, rashes and other allergic reactions may occur. Unjustified prolonged use or significantly exceeding the recommended dosage increases the risk of developing serious problems with the kidneys and liver. If side effects occur, stop taking the medicine and consult a specialist for professional medical help.

The anti-inflammatory drug has its own characteristics of use. The contents of the Fervex sachet are dissolved in warm water (200 ml) and drunk completely. The recommended dosage is up to three times a day. The next appointment should be no earlier than 4 hours later. In case of functional disorders of the kidneys and liver, increase the interval between applications to 8 hours. The therapeutic course is up to five days. Can be used for 3 days to reduce fever. The French company UPSA produces powder for oral administration of Fervex. You can purchase it at a price of 360 rubles per package, which contains 8 sachets.

A complete list of modern anti-inflammatory drugs can be found in the pharmaceutical reference book.

Aspirin-S

Today, one of the most popular medicines for symptomatic treatment Infectious and inflammatory diseases of the respiratory system are considered Aspirin-S. Containing acetylsalicylic and ascorbic acids, it is able to effectively eliminate the main clinical manifestations of colds (fever, headaches, malaise, etc.). The effectiveness of the medicine has been proven by numerous scientific studies.

Aspirin-S is available in the form effervescent tablets, which can be quickly dissolved in water. This form is very convenient for most patients with colds. Especially with severe sore throat, when the use of conventional tablets or hot drinks provokes very unpleasant feeling. In addition, it has long been established that ascorbic acid is destroyed at high temperatures. By dissolving it in cool water, we preserve all the pharmacological properties of vitamin C. The absorption of the medicine occurs quite quickly, which ensures the immediate onset of the therapeutic effect. It is also worth noting that acetylsalicylic acid is completely soluble in water without the formation of sediment, reducing the likelihood of various side effects.

However, uncontrolled long-term use of the drug can lead to the development of a number of undesirable effects:

• Dizziness.
• Headaches.
• Nausea.
• Vomiting.
• Breathing problems.
• Drowsiness.
• Lethargy.
• Increased bleeding.
• Allergies (itching, rashes, redness of the skin, etc.).

In case of an overdose of Aspirin-S, it is necessary to control the acid-base balance in the body. If necessary, special solutions are introduced to normalize the condition (for example, sodium bicarbonate or citrate). Therapeutic measures taken should be aimed at enhancing the excretion of acetylsalicylic acid and its metabolites.

It should be noted that in children with suspected viral infection do not use medications that contain acetylsalicylic acid, since the likelihood of developing a more severe pathology, such as Reye's syndrome, increases. It manifests itself with prolonged vomiting, damage to the central nervous system and enlarged liver.

Before surgical intervention It is better to refrain from taking Aspirin-C, which affects the blood coagulation system. Also, acetylsalicylic acid slows down the process of removing uric acid from the body. Patients suffering from gout may experience another attack while being treated with this drug. Aspirin-S is a prohibited drug during pregnancy. On early stages often provokes birth defects development in the fetus, in later stages it inhibits labor.

The Swiss pharmaceutical company Bayer Consumer Care AG is one of the main manufacturers of Aspirin-S effervescent tablets. The cost of a package of medicine (10 pieces) is approximately 250 rubles.

Ibuprofen

Complex therapy for infectious and inflammatory diseases of the respiratory system and ENT organs may include Ibuprofen. It is now considered one of the most commonly prescribed non-steroidal anti-inflammatory drugs for the management of fever and pain. Widely used not only in therapeutic but also pediatric practice. Being a very safe and effective antipyretic drug, it is approved for sale without a doctor's prescription.

If there are appropriate indications, it can be used to treat children from the first days of life both in inpatient and laboratory conditions. Children are recommended to use Ibuprofen in the form of rectal suppositories, which have a number of advantages compared to other forms of medication:

• Simplicity and painlessness of administration.
• There is no need for additional special tools.
• The integrity of the skin is not compromised.
• There is no danger of infection.
• Intestinal fullness does not affect the absorption and effectiveness of the drug.
• Low incidence of allergic reactions.

Most patients do not experience any side effects during treatment with Ibuprofen. However, in rare cases, undesirable effects are still possible, which manifest themselves in the form of:

• Decreased appetite.
• Nausea.
• Vomiting.
• Headache.
• Drowsiness.
• Nervousness.
• Hearing and vision impairments.
• Increased blood pressure.
• Increased heart rate.
• Difficulty breathing.
• Edema syndrome.
• Kidney disorders.
• Allergies (rashes, itching, redness of the skin, Quincke's edema, etc.).

It is worth noting that the list of contraindications for the use of Ibuprofen is quite long, so we recommend that you read it in the official instructions for the drug. During therapy, it is advisable to use the minimum effective dosage of a non-steroidal anti-inflammatory drug to reduce the risk of adverse reactions. It is also preferable to stick to short courses of treatment. If the drug is ineffective or the condition worsens, you should immediately visit your doctor. Particular attention should be paid to the state of the digestive system, which is very sensitive to therapy non-steroidal drugs. Today, Ibuprofen is available under various trade names:

These drugs are produced both foreign and domestic pharmaceutical companies. The cost of the medicine will depend not only on the form of release, but also on the amount of the active substance. For example, a package of Ibuprofen tablets from the Russian pharmaceutical company Sintez costs about 40 rubles.

Non-steroidal anti-inflammatory drugs are available without a prescription, but this does not mean that you should not consult a specialist before using them.

Some doctors may recommend the drug Nise for infectious and inflammatory diseases of the upper and lower respiratory tract, which are accompanied by fever and pain. This modern non-steroidal anti-inflammatory drug contains the active substance nimesulide. It must be taken when the symptoms of the disease are severe. For example, Nise is able to bring down the temperature in 10-12 hours. He can also relieve headaches, fatigue, weakness, malaise, aching muscles and joints. However, if there is no sufficient therapeutic effect within 3-4 days, you should visit your doctor and adjust the course of treatment.

During the period of bearing a baby, the drug should absolutely not be used. It has been established that nimesulide has a negative effect on the growth and development of the fetus. In addition, the active substance can pass into breast milk, so during treatment it is necessary to switch to artificial feeding. If all recommendations for the use of the medicine specified in the instructions are correctly followed, practically no adverse reactions are observed. In rare cases, the following may occur:

• Nausea, vomiting, diarrhea and other dyspeptic disorders.
• Headache, drowsiness, irritability.
• Increased blood pressure, breathing problems.
• Changes in basic blood parameters (for example, anemia, decreased platelet count, etc.).
• Reversible functional problems with the functioning of the kidneys and liver.
• Rash, itching, erythema, redness of the skin and other allergic reactions.

Nise should be taken with extreme caution by patients who have problems with the digestive system, in particular peptic ulcers. It is recommended to use short therapeutic courses, which in most cases successfully cope with the main symptoms of colds. Foreign pharmaceutical companies mainly specialize in the production of Nise, so the price will often be slightly higher compared to domestic analogues of the drug. A package of tablets (20 pcs.) made in India will cost approximately 180 rubles.

When choosing an effective non-steroidal anti-inflammatory drug, never neglect the opinion of a specialist.

Which non-steroidal anti-inflammatory drugs are best?

Anti-inflammatory drugs for joints are the main treatment for diseases of cartilage and connective tissue. They slow down the progression of the disease, help fight exacerbations, and relieve painful symptoms. The regimen for taking the drug can be different - they are taken in courses, or as needed to alleviate the condition. Nonsteroidal anti-inflammatory drugs (NSAIDs) are available in various dosage forms - ointments and gels for local application, tablets and capsules, as well as injectable preparations for intra-articular administration.

Anti-inflammatory drugs (NSAIDs) - principle of action

This group of drugs is very extensive, but they all share a common principle of action. The essence of this process is that non-steroidal anti-inflammatory drugs for the treatment of joints interfere with the mechanism of formation of the inflammatory process. The enzyme cyclooxygenase is responsible for the synthesis of so-called inflammatory mediators. It is this that is inhibited by drugs from the NSAID group, interrupting the chain of development inflammatory reaction. They prevent pain, fever and local swelling.

But there is another important feature effects of non-steroidal anti-inflammatory drugs. There are two types of cyclooxygenase enzyme. One of them (COX-1) is involved in the synthesis of inflammatory mediators, and the second (COX-2) is involved in the synthesis of the protective layer of the stomach wall. NSAIDs act on both types of this enzyme, causing inhibition of both. This explains the common side effect of these drugs, which is damage to the mucous membrane of the digestive organs.

Based on their effect on COX-2, drugs are divided into selective and non-selective. The development of new NSAIDs aims to increase the selectivity of their effect on COX-1 and eliminate the effect on COX-2. Currently, new generation NSAID drugs have been developed that have almost complete selectivity.

The three main therapeutic effects of drugs in this group are anti-inflammatory, antipyretic and analgesic. In case of joint diseases, it is the anti-inflammatory effect that comes to the fore, and the analgesic effect is no less significant. The antipyretic effect is less important and practically does not manifest itself in new generation anti-inflammatory non-steroidal drugs, which are used to treat joint diseases.

Classification of anti-inflammatory drugs

Taking into account the structural features of the active substance, all NSAIDs can be divided into several groups:

Non-selective NSAIDs (affect mainly COX-1)

These include the following:

Non-selective NSAIDs (equally affecting COX-1 and COX-2).

• Lornoxicam;
• Xefocam;
• Lorakam.

Selective NSAIDs (inhibit COX-2)

• Celecoxib;
• Meloxicam;
• Nimesulide;
• Rofecoxib.

Some of these drugs have a strong anti-inflammatory effect, others are more antipyretic (Aspirin, Ibuprofen) or analgesic (Ketorolac) effect.

Indications for use of NSAIDs

knee arthritis is one of the reasons

For joint diseases, nonsteroidal drugs are prescribed according to several regimens, depending on the dosage form and stage of the disease. The list of diseases for which NSAIDs are prescribed is quite long - these include arthritis of various etiologies, including autoimmune, most arthrosis, the recovery period after injuries to the joints and muscles.

During exacerbation chronic diseases joints, non-steroidal anti-inflammatory drugs are used in combination. They are prescribed in the form of a course of tablets and ointments; in severe cases, treatment is supplemented with intra-articular injections. Outside of exacerbation and during acute conditions they are used as needed if symptoms of joint inflammation occur.

Side effects

Non-steroidal anti-inflammatory drugs have many side effects, so be sure to read the instructions before taking them. The most common side effects are:

• provocation of a stomach or duodenal ulcer,
• dyspepsia,
• dysfunction of the nervous system,
• allergic reactions

They are especially pronounced in medications in tablets, suppositories and solutions for intramuscular injections. Local agents (ointments and intra-articular injections) do not have this effect.

Another common group of side effects is the effect on the hematopoietic system. NSAIDs have a blood-thinning effect, and this effect must be taken into account when taking these drugs so as not to harm your health. A more dangerous effect on the blood system is expressed in the inhibition of hematopoietic processes. It manifests itself as a gradual decrease in the amount of formed elements in the blood - first anemia develops, then thrombocytopenia, and subsequently pancytopenia.

In addition, there are other side effects caused by chemical features drugs, they are indicated in the instructions for use. Due to the large number of side effects, you should consult your doctor before taking NSAIDs to treat joints.

Contraindications

Contraindications to the use of NSAIDs for joint diseases stem from their side effects and primarily concern tablet forms. They are not prescribed to patients during exacerbation of diseases of the gastrointestinal tract, as well as to patients with diseases of the blood system - anemia of various origins, coagulation disorders, leukemia and leukemia.

NSAIDs should not be prescribed simultaneously with drugs that reduce blood clotting (heparin), and it is also not recommended to take the same drug in different dosage forms - this leads to increased side effects. This primarily applies to drugs containing ibuprofen and diclofenac.

In addition, it is possible to develop an allergic reaction to NSAIDs. Its intensity is not related to the dosage form, and appears with the same frequency when taking tablets, using ointments and giving injections into the joints. Sometimes allergies can take very severe forms, for example, aspirin asthma - an asthmatic attack when using the drug. Allergic reaction there may be cross-reaction on NSAIDs, so caution should be exercised when taking medications.

Ointments with NSAIDs for joint diseases

Ointments are the most common dosage form used for joint pain. Their popularity is due to the fact that the effect of the ointment occurs quickly enough, and side effects are minimal. The ointment can be used to relieve acute pain and during the recovery period after injuries. But if a course of injections is prescribed, then the ointments are usually canceled.

The most popular drugs in the form of ointments are Diclofenac and drugs based on it (Voltaren), Dolobene, and others. Most of them can be bought at a pharmacy without a doctor's prescription. You can use such products for a long time without harm to health.

Non-steroidal anti-inflammatory drugs in tablets for joint diseases

NSAIDs in tablets are prescribed for joint damage, osteochondrosis, systemic connective tissue diseases with articular syndrome. They are used in courses, several times a year, prescribed in acute period. But the main task of tableted NSAIDs is to prevent exacerbation of diseases.

This dosage form is most effective for treating diseases of the joints and spine, but has the greatest number of contraindications. In addition to the conditions listed above, tablets containing NSAIDs cannot be used for liver diseases - fibrosis, cirrhosis, hepatitis, liver failure. For kidney diseases accompanied by a decrease in filtration rate, a reduction in dosage or frequency of administration is required.

A complete list of anti-inflammatory drugs can be found on Wikipedia. Among the most famous of them is Diclofenac tablets. Among the more modern drugs of the new generation are Xefocam, Celecoxib and Movalis. New drugs are safer, but have another negative point - high cost. It is necessary to take tablets after meals or with meals.

NSAIDs in solutions for intra-articular injections

This dosage form is prescribed for severe disease and to relieve severe exacerbations. Used in courses that are conducted only in a medical institution. Intra-articular injections make it possible to most effectively deliver the active substance to the site of inflammation. But they require high qualifications from the doctor who performs them, since they are associated with the risk of damage to the joint ligament.

IN injection form Diclofenac, Movalis, Xefocam and other drugs are produced. They are used to treat lesions of large joints, most often the knee, less often the elbow. Intra-articular injections are not prescribed for damage to the joints of the hands and feet, as well as for diseases of the spine. This is due to the fact that the technical difficulties of administering the drug make this method of treatment almost impossible.

Intra-articular injections are considered quite complex medical manipulation, and must be carried out in a treatment room, since they require sterility to avoid infection and highly qualified medical staff.

List of the best anti-inflammatory drugs

Let's take a closer look at the features of using the most popular drugs from the NSAID group.

Diclofenac (Voltaren, Naklofen, Olfen, Diclak, etc.)

Diclofenac and drugs based on it are produced in the form of tablets, capsules, ointments, gels, suppositories, and injection solutions. These drugs exhibit a powerful anti-inflammatory effect, quickly relieve pain, reduce fever and alleviate the patient’s condition. A high concentration of the active ingredient in the blood is observed within 20 minutes after taking the drug.

Like most drugs from the NSAID group, they have a negative effect on the gastrointestinal tract, I have a fairly extensive list of contraindications and side effects, so they should be used only as prescribed by a doctor, in short courses. The standard daily dose of Diclofenac tablets for adult patients is 150 mg, divided into 2-3 doses. Local forms(ointments, gels) are applied to the affected area in a thin layer up to 3 times a day.

Indomethacin (Metindol)

Has the same therapeutic effect as Diclofenac. Available in the form of tablets, capsules, ointments, gels, and rectal suppositories. But this drug has numerous side effects that are more pronounced, so at present it is rarely used, giving preference to more modern drugs.

Piroxicam

A drug from the oxicam group with pronounced analgesic, anti-inflammatory and antipyretic effects. Available in the form of capsules, tablets, ointments, creams, suppositories. It is used to treat gout, arthritis, joint and muscle pain, as well as in preparation for the IVF procedure.

Like other NSAIDs, it has an extensive list of side effects associated with damage to the digestive tract, disruption of hematopoietic processes, and reactions from the nervous system. Therefore, the drug should be used only as prescribed by a doctor. The analgesic effect of taking Piroxicam tablets lasts throughout the day. The standard dose of the drug for an adult is up to 40 mg per day.

Lornoxicam (Xefocam, Lorakam, Larfix)

The drug has a pronounced anti-inflammatory effect and quickly copes with painful pain. Does not exhibit antipyretic effects. The drug is used for the treatment of postoperative pain, algodismenorrhea, and in the treatment of osteoarthritis and rheumatoid arthritis.

Available in the form of tablets and powder intended for the preparation of solution for injection. The recommended dose for oral administration is up to 4 tablets per day in 2 divided doses. For injection into a muscle or vein, a single dose of the drug is 8 mg, the solution is prepared immediately before administration.

When using the drug, the likelihood of complications in persons with gastroenterological pathologies increases, therefore, the drug is not used for diseases of the gastrointestinal tract, as well as during pregnancy, lactation, pathologies of the heart, liver and in childhood.

Meloxicam (Movalix, Revmoxicam, Melox)

Preparations based on enolic acid belong to the class of selective COX-2 inhibitors. In this regard, they cause fewer side effects from the digestive system and do not provoke toxic damage to the kidneys and liver. Meloxicam tablets, rectal suppositories and injections in ampoules are available.

Indications for the use of the drug are diseases of the joints of an inflammatory and degenerative nature with severe pain - spondyloarthritis, osteoarthritis and arthritis. As a rule, in the first days of treatment, the drug is used in the form of intramuscular injections; after the acute inflammatory process subsides, they switch to taking Meloxicam in tablet form (1 tablet twice a day).

Nimesulide (Nimesil, Nimesin, Remesulide)

The drug belongs to the group of highly selective COX-2 inhibitors, has a powerful anti-inflammatory effect, which is complemented by antipyretic and analgesic properties. Nimesulide is produced in the form of tablets, granules for preparing a suspension, and in the form of a gel for topical use. A single dose of the drug in tablets is 100 mg, taken twice a day.

The gel is applied to the affected area several times a day (3-4), lightly rubbing. The suspension with a pleasant orange flavor can be prescribed to children from 12 years of age. The drug is intended for the treatment of post-traumatic and postoperative pain, degenerative joint lesions (accompanied by inflammation), bursitis, tendinitis.

In addition, Nimesulide is prescribed for atralgia, myalgia, painful periods, as well as to relieve headaches and toothaches. The drug can have a toxic effect on the liver and kidneys, so in case of diseases of these organs, the dose of the drug must be reduced.

Celecoxib (Revmroxib, Celebrex)

A drug from the coxib group, used in the treatment of inflammatory joint diseases, acute pain syndrome, and menstrual pain. Available in the form of capsules, which may contain 100 or 200 mg of active substance. Shows a pronounced analgesic and anti-inflammatory effect, while, if you do not exceed the therapeutic dose, it has practically no effect negative influence on the gastrointestinal mucosa.

The maximum permissible daily dose of the drug is 400 mg, divided into 2 doses. With long-term use of Celecoxib in high doses, side effects develop - ulceration of the mucous membrane, disorders of the hematopoietic system and other undesirable reactions from the nervous, cardiovascular and genitourinary system.

Aceclofenac (Zerodol)

The effect of the drug is similar to Diclofenac and is available in the form of tablets containing 100 mg of the active substance. Adults are recommended to take 1 tablet twice a day. The drug is intended for the treatment of gout, arthritis of various etiologies, osteoarthritis and spondylitis.

This medication is much less likely than other NSAIDs to provoke erosive lesions of the gastrointestinal tract, but its use may be accompanied by a number of side effects from the digestive, nervous, hematopoietic, and respiratory systems. The drug is prescribed with extreme caution for pathologies of the liver, kidneys, diabetes mellitus, ischemia, arterial hypertension and other conditions, a list of which is given in the instructions for the drug.

Rofecoxib

This is a modern remedy from the category of highly selective COX-2 inhibitors, which have virtually no negative effect on the gastrointestinal mucosa and kidneys. It is used as a strong analgesic and anti-inflammatory agent for most inflammatory and degenerative lesions of the musculoskeletal system. In addition, the medication is prescribed for migraine, neuralgia, lumbago, osteochondrosis, pain syndrome due to injury to muscles and ligaments.

This universal remedy is often included in the scheme complex treatment thrombophlebitis, diseases of the genitourinary system, used in ophthalmology, for diseases of ENT organs or for dental problems(stomatitis, pulpitis). In case of severe pain, you can take up to 4 tablets at a time. The drug is prescribed with caution when bronchial asthma, in early pregnancy, during lactation. This medication has much fewer contraindications and side effects than other anti-inflammatory drugs.

Combined NSAIDs

New generation drugs with anti-inflammatory effects combine a combination of the active substance with vitamins or other active ingredients, enhancing their therapeutic effect. We present to your attention a list of the most popular combination drugs:

• Flamidez (diclofenac + paracetamol);
• Neurodiclovit (diclofenac + vitamins B1, B6, B12);
• Olfen-75 (diclofenac + lidocaine);
• Dilocaine (lidocaine + diclofenac in low dosage);
• Dolaren gel (diclofenac + flax oil + menthol + methyl salicylate);
• Nimid Forte (nimesulide + tizanidine);
• Alite (soluble tablets containing nimesulide and the muscle relaxant dicycloverine);

This is not a complete list of combined anti-inflammatory drugs that are used to treat joints and degenerative lesions of the musculoskeletal system. For each patient, the doctor selects a treatment regimen individually, taking into account many factors. Drugs from the NSAID group have many contraindications and can cause a number of undesirable side reactions from various organs and systems.

Therefore, you cannot self-medicate! Only a specialist can recommend the optimal remedy, taking into account the clinical picture of the disease, the severity of symptoms, concomitant pathologies and determine the required dosage of the drug and the duration of the course of treatment. This will help avoid unwanted complications, alleviate the patient’s condition and speed up recovery.

Who should I contact?

Depending on the nature of the pathology, the following specialists can treat a patient with joint diseases: a neurologist, a therapist, an orthopedist or a rheumatologist. It is these doctors who have the right to prescribe drugs from the NSAID group for the treatment of specialized diseases.

If taking anti-inflammatory drugs leads to adverse reactions, specialists such as a gastroenterologist, cardiologist, allergist, nephrologist can join the patient’s treatment. If the patient is forced to take NSAIDs for a long time, be sure to consult with a nutritionist and choose the optimal diet that will protect the gastric mucosa from damage.