How do nonsteroidal anti-inflammatory drugs (NSAIDs) for RA work?

Nonsteroidal anti-inflammatory drugs (NSAIDs) are highly effective at relieving the symptoms of rheumatoid arthritis -- joint pain, swelling, and inflammation -- but they do not affect the course of the disease.

Traditional NSAIDs, such as aspirin, ibuprofen, and naproxen, work by blocking two enzymes in the body -- COX-1 and COX-2 -- that help produce prostaglandins, the chemical messengers involved in inflammation and pain. But COX-1 also helps protect the lining of your stomach and other tissues, so blocking it can cause side effects such as ulcers and gastrointestinal bleeding.

A relatively new type of NSAID, called a COX-2 inhibitor, was designed to be easier on the stomach by blocking, as the name suggests, only the COX-2 enzyme. But these newer NSAIDs have not been problem-free. Some were taken off the market due to concerns about an increased risk of stroke and heart attack.

Short-term use of NSAIDs -- for 1 to 2 weeks -- is generally considered safe, but when taken long-term at the doses needed to control the symptoms of rheumatoid arthritis, side effects may include high blood pressure, impaired kidney function, and increased risk of heart attack and stroke.

But because people with rheumatoid arthritis already have an increased risk for heart problems, the cardiovascular side effects of NSAIDs should be taken into consideration when weighing the pros and cons of treatment options. Work with your healthcare provider to find the safest and most effective treatment for your pain.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.