NSAIDs: Ibuprofen, Naproxen & Similar Pain Relievers

NSAIDs block cyclooxygenase (COX) enzymes that make prostaglandins — local chemicals that promote inflammation, pain, and fever. Less prostaglandin means less swelling in a sprained ankle and less throbbing during period cramps.

Aspirin is technically an NSAID but is often used at low daily doses for heart protection rather than pain. Prescription NSAIDs like meloxicam or celecoxib are chosen when people need longer-term anti-inflammatory effect and cannot take standard OTC options.

Prostaglandins coat the stomach and help kidneys adapt when blood pressure drops. NSAIDs peel back that protection. Occasional use with food is fine for many healthy adults; daily use — or use during vomiting, fever, or little fluid intake — is when ER doctors see bleeding ulcers and acute kidney injury.

Older adults, people with heart failure, chronic kidney disease, or prior ulcers carry the highest risk. If you need regular pain relief and have any of those conditions, ask what alternative plan fits you rather than self-treating with the same OTC dose for months.

NSAIDs make platelets stickier and can irritate the GI tract — a bad combination with warfarin, Eliquis, or aspirin. Even “just ibuprofen for a few days” has landed people in the hospital with serious bleeds.

ACE inhibitors and ARBs (lisinopril, losartan) depend on healthy kidney blood flow. NSAIDs blunt that effect and can spike blood pressure or worsen kidney function — a problem that is worse when you are sick, hot, or not drinking enough fluids.