NSAID
A class of anti-inflammatory painkillers including ibuprofen and naproxen.
What it means
NSAIDs — non-steroidal anti-inflammatory drugs — reduce pain, inflammation and fever by blocking cyclo-oxygenase enzymes. Ibuprofen, naproxen and diclofenac are the familiar examples.
They are effective, and they are the class most often taken casually despite carrying genuine risks:
- Stomach — ulcers and bleeding, often without warning pain
- Kidneys — reduced blood flow, particularly if dehydrated
- Heart — a small increase in heart attack and stroke risk with regular use
- Asthma — worsened in a minority of people
In practice
A proton pump inhibitor such as omeprazole is co-prescribed to protect the stomach in people at higher risk.
Topical NSAID gels achieve useful joint relief with a fraction of the systemic exposure, and are underused.
Why it matters
The "triple whammy" — an NSAID together with an ACE inhibitor or sartan and a diuretic — is a well-recognised cause of acute kidney injury, and the combination is worth checking for.
NSAIDs should be avoided in diverticular disease, in significant kidney disease, and generally after 20 weeks of pregnancy. Paracetamol is the safer choice for most people with heart or kidney disease.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 30, 2026