With at least 30 billion over-the-counter medications and 70 million prescription drugs sold yearly, nonsteroidal anti-inflammatory drugs (NSAIDs) belong to a class of drugs used to treat pain, inflammation, and fever. This entry focuses on the background, uses, adverse effects, and a clinical update on NSAIDs with an emphasis on lifestyle medicine.


NSAIDs exert their effects by inhibiting the cyclooxygenase (COX) enzymes COX-1 and COX-2, which are responsible for the formation of prostaglandins. This inhibition accounts for the activity of NSAIDs in relieving pain, inflammation, and fever. To date, close to 20 different NSAIDs are classified as either nonspecific COX inhibitors or COX-2–specific inhibitors.


Dating back to over a century ago, aspirin was the first NSAID developed and sold over the counter, but its use was limited ...

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