NSAIDs

Updated February 2023

What are NSAIDs?

Download button - information sheet

Non-steroidal anti-inflammatory drugs (NSAIDs) are medications commonly used to treat painful swollen joints. They are not steroids but are effective in reducing pain and stiffness. These medications are often used when your child is initially diagnosed with arthritis because they quickly control the pain and inflammation. However, usually other medications need to be added over time in order to further improve your child’s condition.
 

Important things to remember

  • You must see your rheumatologist regularly to make sure the treatment is working and check for possible side effects.
  • You should have regular blood tests as suggested by your rheumatologist.
  • If you are worried about any side effects, you should contact your rheumatologist as soon as possible.
  • If you stop NSAIDs for any reason, you must contact your rheumatologist.
     

How will it help?

NSAIDs stop cells making prostaglandins. Prostaglandins are chemicals released by cells. High levels may cause inflammation and swelling and increase pain. NSAIDs work very quickly and are often usually the first medication used to treat inflammation.

How are NSAIDs given?

They are usually given as a liquid or tablet. NSAIDs should always be taken with food. This can make it easier on the stomach.

 

NSAID generic name

Most common brand name

How it is given

Form of medication

Naproxen

Naprosyn, Inza, Naprogesic

By mouth, once or twice daily

Liquid or tablet

Ibuprofen

Nurofen, Advil

By mouth, three times daily

Liquid, tablet or capsule

Indomethacin

Indocid

 By mouth, three times daily

Tablet or capsule

Diclofenac

Voltaren, Difenac

By mouth, once or twice daily

Tablet or capsule

Piroxicam

Feldene, Mobilis

By mouth, once daily

Tablet or capsule (tablets can be dispersed in water)

Celecoxib

Celebrex

By mouth, twice daily

Tablet or capsule

Meloxicam

Mobic

By mouth, once daily

Tablet or capsule

What is the dose?

This depends on the weight of your child. 

How long will it be used for?

NSAIDs may be used while your child has ongoing pain.

Are there any side effects?

NSAIDs are usually effective, however as with all medications, side effects can occur. Some are common, and some are rare. Most people don’t have any problems when they take NSAIDs.

Most common side effects

Treatment

Stomach upset, stomach pain, nausea, decreased appetite and easy bruising

  • Take after food and notify your doctor

Stomach ulcers (beware of dark or bloody stools)

  • Stop medication and notify your doctor

Allergic and skin reactions (rash, hives, chest tightness, asthma)

  • Stop medication and notify your doctor

Sensitivity to sun

  • Sun protection (hat, sunblock)

Things you need to know when your child is taking this medication

These medications come in many forms. Please ask your doctor or pharmacist for more specific information.


What to do if your child is sick
If an additional medication is needed for pain or fever, give paracetamol (Panadol). Do not give another NSAID like ibuprofen (e.g. Nurofen), which may be included in cold and flu remedies. This would result in taking too much anti-inflammatory medication.


Interactions
Many medications used to control inflammation have a common side effect of stomach upset. Taking combinations of these medications (more than one NSAID) can increase the possibility of this happening.


Immunisations 
All immunisations can be safely given as per the normal immunisation schedule, when taking NSAIDs.


Infections
There is no added risk of infection.


Myths and misconceptions
You may hear a lot of different information about NSAIDs from friends, pharmacists or people that you know. If you are worried about anything, please talk to your child’s doctor or nurse for more information.
If your child is taking NSAIDs they should see their paediatric rheumatologist regularly to make sure the treatment is working and to minimise any possible side effects.