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Updated February 2023
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.
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.
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
Tablet or capsule
Diclofenac
Voltaren, Difenac
Piroxicam
Feldene, Mobilis
By mouth, once daily
Tablet or capsule (tablets can be dispersed in water)
Celecoxib
Celebrex
By mouth, twice daily
Meloxicam
Mobic
This depends on the weight of your child.
NSAIDs may be used while your child has ongoing pain.
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
Stomach ulcers (beware of dark or bloody stools)
Allergic and skin reactions (rash, hives, chest tightness, asthma)
Sensitivity to sun
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.