What are anti-inflammatory medications? Non-steroidal anti-inflammatory drugs for the treatment of joints: classification, list. This can be explained by their actions

Classmates

Non-steroidal anti-inflammatory drugs (NSAIDs, NSAIDs) are new generation medications that have anti-inflammatory, antipyretic and analgesic effects. Their mechanism of action is based on blocking certain enzymes (cyclooxygenase, COX), which are responsible for the formation of prostaglandins - chemicals that promote pain, fever, and inflammation.

The word “non-steroidal” in the name of these drugs indicates the fact that medications in this group are not artificial analogues of steroid hormones - powerful anti-inflammatory hormonal drugs. The most popular representatives of NSAIDs are diclofenac, ibuprofen.

How NSAIDs work

If analgesics are intended to combat pain, then NSAIDs reduce two unpleasant symptoms of the disease: inflammation and pain. Many drugs in this group are considered non-selective inhibitors of the cyclooxygenase enzyme, which suppress the effects of both of its isoforms (types) - COX-1 and COX-2.

Cyclooxygenase is responsible for the formation of thromboxane and prostaglandins from arachidonic acid, which is obtained, in turn, from cell membrane phospholipids using the enzyme phospholipase A2. Among other functions, prostaglandins are regulators and mediators in the formation of inflammation.

When are NSAIDs used?

The most commonly used drugs are NSAIDs for the treatment of chronic or acute inflammation which are accompanied by pain. Anti-inflammatory non-steroidal drugs have gained great popularity due to their effective treatment of joints.

We list the diseases for which these medications are prescribed:

dysmenorrhea (pain during menstruation);
acute gout;
postoperative pain;
bone pain due to metastasis;
intestinal obstruction;
fever (high body temperature);
minor pain due to injury or inflammation of soft tissues;
renal colic;
lower back pain;
Parkinson's disease;
osteochondrosis;
migraine;
headaches;
rheumatoid arthritis;
arthrosis

NSAIDs should not be used during erosive and ulcerative lesions of the gastrointestinal tract, especially at the stage of exacerbation, cytopenias, severe disorders of the kidneys and liver, pregnancy, individual intolerance. Should be prescribed with caution to patients with asthma, as well as to people who have previously had negative reactions while taking any other NSAIDs.

Non-steroidal anti-inflammatory drugs: list of NSAIDs for the treatment of joints

Let's look at the most effective and well-known NSAIDs, which are used to treat joints and other diseases when required. antipyretic and anti-inflammatory effect:

Ibuprofen;
Indomethacin;
Meloxicam;
Naproxen;
Celecoxib;
Diclofenac;
Etodolac;
Ketoprofen.

Some medications are weaker, not so aggressive, some are designed for acute arthrosis, if emergency intervention is necessary in order to stop dangerous processes in the body.

The main advantage of new generation NSAIDs

Side effects are observed during prolonged use of NSAIDs (for example, during the treatment of osteochondrosis) and consist of damage to the intestinal and gastric mucosa with the formation of bleeding and ulcers. This disadvantage of non-selective NSAIDs was the reason for the creation of a new generation of drugs that block only COX-2 (an inflammatory enzyme) and do not affect the function of COX-1 (a defense enzyme).

That is, new generation drugs have almost no ulcerogenic side effects (damage to the mucous membrane of the digestive system) associated with prolonged use of non-selective NSAIDs, but they increase the chance of thrombotic complications.

The only disadvantage of the new generation of drugs is their high cost, which makes them inaccessible to most people.

What are new generation NSAIDs?

The new generation of anti-inflammatory non-steroidal drugs act much more selectively, they are more inhibit COX-2, and COX-1 remains almost unaffected. This is what can explain the rather high effectiveness of the drug in combination with a minimum of side effects.

List of effective and popular anti-inflammatory non-steroidal drugs new generation:

Xefocam. A medicine that is based on Lornoxicam. Its characteristic feature is the fact that the drug has an increased ability to relieve pain. In terms of this indicator, it is similar to morphine, but at the same time it does not create addiction and does not have an opiate-like effect on the central nervous system.
Movalis. It has an antipyretic, well-pronounced anti-inflammatory and analgesic effect. The main advantage of this drug is that with constant medical supervision it can be used for quite a long time. Meloxicam is produced in the form of a solution for intramuscular injections, in ointments, suppositories and tablets. The tablets of the drug are quite convenient in that they have a long-lasting effect, and it is enough to use one tablet throughout the day.
Nimesulide. Used successfully to treat arthritis, vertebrogenic back pain, etc. Normalizes temperature, relieves hyperemia and inflammation. Taking the drug quickly leads to improved mobility and reduced pain. It is also used in the form of an ointment for application to the problem area.
Celecoxib. This drug significantly alleviates the patient’s condition with arthrosis, osteochondrosis and other diseases, effectively fights inflammation and perfectly relieves pain. Side effects on the digestive system from the drug are minimal or completely absent.

In cases where long-term use of anti-inflammatory non-steroidal drugs is not necessary, then older generation drugs are used. However, sometimes this is simply a necessary measure, since not all people can afford a course of treatment with these drugs.

Based on their chemical origin, these drugs come in non-acidic and acidic derivatives.

Acidic preparations:

Preparations based on indoacetic acid - sulindac, etodolac, indomethacin;
Oxicams – meloxicam, piroxicam;
Salicipates – diflunisal, aspirin;
Based on propionic acid – ibuprofen, ketoprofen;
Pyrazolidines – phenylbutazone, metamizole sodium, analgin;
Phenylacetic acid preparations – aceclofenac, diclofenac.

Non-acidic drugs:

Sulfonamide derivatives;
Alcanons.

At the same time, non-steroidal drugs differ in intensity and type of action - anti-inflammatory, analgesic, combined.

According to the strength of the anti-inflammatory effect Medium doses of drugs are arranged in the following order (strongest on top):

Flurbiprofen;
Indomethacin;
Piroxicam;
Diclofenac sodium;
Naproxen;
Ketoprofen;
Aspirin;
Amidopyrine;
Ibuprofen.

According to analgesic effect The drugs are arranged in the following order:

Ketoprofen;
Ketorolac;
Indomethacin;
Diclofenac sodium;
Amidopyrine;
Flurbiprofen;
Naproxen;
Piroxicam;
Aspirin;
Ibuprofen.

Most often, the NSAIDs listed above are used for chronic and acute diseases which are accompanied by inflammation and pain. As a rule, non-steroidal anti-inflammatory drugs are used to treat joints and relieve pain: injuries, arthrosis, arthritis, etc.

NSAIDs are often used for pain relief for migraines and headaches, renal colic, postoperative pain, dysmenorrhea, etc. Due to their inhibitory effect on prostaglandin synthesis, these drugs also have an antipyretic effect.

Any medicine new to the patient should be prescribed initially in a minimal dose. If tolerated normally, after a few days daily dose is increased.

Therapeutic dosages of NSAIDs are in a wide range, while recently there has been a tendency to increase single and daily doses of drugs that are well tolerated (ibuprofen, naproxen), while maintaining restrictions on the maximum dosage of indomethacin, aspirin, piroxicam, phenylbutazone. In some patients, the therapeutic effect is achieved only with the use of increased doses of NSAIDs.

Long-term use of anti-inflammatory drugs in higher dosages can cause:

Changes in the functioning of blood vessels and the heart - swelling, increased blood pressure, palpitations;
Impaired urination, renal failure;
Disturbance of the central nervous system - disorientation, mood changes, apathy, dizziness, blurred vision, headache, tinnitus;
Allergic reactions - urticaria, angioedema, erythema, anaphylactic shock, bronchial asthma, bullous dermatitis;
Ulcer, gastritis, gastrointestinal bleeding, perforation, changes in liver function, dyspeptic disorders.

Treatment with NSAIDs must be continued for minimum possible time and minimum doses.

Use during pregnancy

It is undesirable to use NSAIDs during pregnancy, especially in the third trimester. Although no direct teratogenic effects are found, it is believed that NSAIDs can cause renal complications in the fetus and premature closure of the ductus arteriosus. There is also information about premature birth. Despite this, aspirin in combination with heparin has been used successfully in women with antiphospholipid syndrome.

Description of non-steroidal anti-inflammatory drugs Movalis

Is a leader among non-steroidal anti-inflammatory drugs, which has a long duration of action and is approved for long-term use.

It has a pronounced anti-inflammatory effect, which makes it possible to use it for rheumatoid arthritis, ankylosing spondylitis, and osteoarthritis. Protects cartilage tissue and is not without antipyretic and analgesic properties. Used for headaches and toothaches.

The determination of doses and administration options (suppositories, injections, tablets) depends on the type and severity of the disease.

A COX-2 inhibitor, which has a pronounced analgesic and anti-inflammatory effect. When used in therapeutic doses, it has almost no negative effect on the gastrointestinal mucosa, since it has a fairly low degree of affinity for COX-1 and, accordingly, does not cause disruption in the synthesis of constitutional prostaglandins.

It is one of the most effective non-hormonal drugs. For arthritis, it reduces joint swelling, relieves pain and has a strong anti-inflammatory effect. When using a medication, you need to be careful, as it has a long list of side effects. In pharmacology, the drug is manufactured under the names Indovis EC, Indovazin, Indocollir, Indotard, Metindol.

It combines the ability to effectively reduce pain and temperature, and is relatively safe, which is why medications based on it can be purchased without a prescription. Ibuprofen is used as an antipyretic drug, including and for newborns.

It is not used as often as an anti-inflammatory drug, but the medicine is also very popular in rheumatology: it is used to treat osteoarthritis, rheumatoid arthritis and other joint diseases.

The most popular names include Nurofen, Ibuprom, MIG 400 and 200.

Form of manufacture - capsules, tablets, gel, suppositories, injection solution. This drug for the treatment of joints perfectly combines both a high anti-inflammatory effect and high analgesic activity.

It is manufactured under the names Naklofen, Voltaren, Diklak, Ortofen, Vurdon, Diclonac P, Dolex, Olfen, Clodifen, Dikloberl, etc.

Chondroprotectors - alternative drugs

Very common for treating joints use chondroprotectors. People often do not understand the differences between chondroprotectors and NSAIDs. The latter quickly remove pain, but at the same time have many side effects. And chondroprotectors protect cartilage tissue, but they must be used in courses. The most effective chondroprotectors contain two substances - chondroitin and glucosamine.

Anti-inflammatory non-steroidal drugs are excellent assistants during the treatment of many diseases. But we must not forget that they only remove the negatively impacting symptoms on well-being; diseases are treated directly by other methods and drugs.

Nonsteroidal anti-inflammatory drugs (NSAIDs, NSAIDs) are a group of drugs whose action is aimed at symptomatic treatment (pain relief, inflammation relief and temperature reduction) in acute and chronic diseases. Their action is based on reducing the production of special enzymes called cyclooxygenase, which trigger a reaction mechanism to pathological processes in the body, such as pain, fever, inflammation.

Medicines in this group are widely used throughout the world. Their popularity is ensured by good efficiency against the background of sufficient safety and low toxicity.

The most well-known representatives of the NSAID group for most of us are aspirin (acetylsalicylic acid), ibuprofen, analgin and naproxen, available in pharmacies in most countries of the world. Paracetamol (acetaminophen) is not a NSAID, since it has relatively weak anti-inflammatory activity. It acts against pain and fever according to the same principle (blocking COX-2), but mainly only in the central nervous system, almost without affecting the rest of the body.

Soreness, inflammation and fever are common pathological conditions that accompany many diseases. If we consider the pathological course at the molecular level, we can see that the body “forces” the affected tissues to produce biologically active substances - prostaglandins, which, acting on blood vessels and nerve fibers, cause local swelling, redness and soreness.

In addition, these hormone-like substances, reaching the cerebral cortex, affect the center responsible for thermoregulation. Thus, impulses are sent about the presence of an inflammatory process in tissues or organs, so a corresponding reaction occurs in the form of fever.

A group of enzymes called cyclooxygenases (COX) are responsible for triggering the mechanism for the appearance of these prostaglandins. The main effect of non-steroidal drugs is to block these enzymes, which in turn leads to inhibition of the production of prostaglandins, which increase the sensitivity of nociceptive receptors responsible for pain. Consequently, painful sensations that bring a person suffering and unpleasant sensations are relieved.

Types by mechanism of action

NSAIDs are classified according to their chemical structure or mechanism of action. Long-known drugs of this group were divided into types according to their chemical structure or origin, since at that time their mechanism of action was still unknown. Modern NSAIDs, on the contrary, are usually classified according to the principle of action - depending on what type of enzymes they act on.

There are three types of cyclooxygenase enzymes – COX-1, COX-2 and the controversial COX-3. At the same time, non-steroidal anti-inflammatory drugs, depending on the type, affect the main two of them. Based on this, NSAIDs are divided into groups:

non-selective inhibitors (blockers) of COX-1 and COX-2– act on both types of enzymes at once. These drugs block COX-1 enzymes, which, unlike COX-2, are constantly present in our body, performing various important functions. Therefore, exposure to them may be accompanied by various side effects, and a particular negative effect is on the gastrointestinal tract. This includes most classic NSAIDs.
selective COX-2 inhibitors. This group affects only enzymes that appear in the presence of certain pathological processes, such as inflammation. Taking such drugs is considered safer and preferable. They do not have such a negative effect on the gastrointestinal tract, but at the same time the load on the cardiovascular system is greater (they can increase blood pressure).
selective NSAIDs COX-1 inhibitors. This group is small, since almost all drugs that affect COX-1 also affect COX-2 to varying degrees. An example is acetylsalicylic acid in a small dosage.

In addition, there are controversial COX-3 enzymes, the presence of which has only been confirmed in animals, and they are also sometimes classified as COX-1. It is believed that their production is slightly slowed down by paracetamol.

In addition to reducing fever and eliminating pain, NSAIDs are recommended for blood viscosity. The drugs increase the liquid part (plasma) and reduce the formed elements, including lipids that form cholesterol plaques. Due to these properties, NSAIDs are prescribed for many diseases of the heart and blood vessels.

Basic non-selective NSAIDs

acetylsalicylic acid (aspirin, diflunisal, salasate);
arylpropionic acid (ibuprofen, flurbiprofen, naproxen, ketoprofen, tiaprofenic acid);
arylacetic acid (diclofenac, fenclofenac, fentiazac);
heteroarylacetic (ketorolac, amtolmetin);
indole/indene acetic acid (indomethacin, sulindac);
anthranilic acid (flufenamic acid, mefenamic acid);
enolic acid, in particular oxicam (piroxicam, tenoxicam, meloxicam, lornoxicam);
methanesulfonic acid (analgin).

Acetylsalicylic acid (aspirin) is the first known NSAID, discovered back in 1897 (all others appeared after the 1950s). In addition, this is the only drug that can irreversibly inhibit COX-1 and is also indicated to stop platelet aggregation. Such properties make it useful in the treatment of arterial thrombosis and for the prevention of cardiovascular complications.

Selective COX-2 inhibitors

rofecoxib (Denebol, Vioxx discontinued in 2007)
lumiracoxib (Prexige)
parecoxib (Dynastat)
etoricoxib (Arcosia)
celecoxib (Celebrex).

Main indications, contraindications and side effects

Today, the list of NSAIDs is constantly expanding and new generation drugs are regularly arriving on pharmacy shelves that can simultaneously lower the temperature, relieve inflammation and pain in a short period of time. Thanks to its mild and gentle effect, the development of negative consequences in the form of allergic reactions, as well as damage to the gastrointestinal tract and urinary system is minimized.

Table. Non-steroidal anti-inflammatory drugs - indications

Non-steroidal anti-inflammatory drugs are considered the most used at this time.

This can be explained by their actions:

Anti-inflammatory;
Antipyretic;
Analgesic.

Suitable for symptomatic treatment, since most diseases are accompanied by the listed manifestations. Over the past few years, new drugs in this area have appeared, and most of them are effective, have a prolonged effect, and are well tolerated.

What is it?

NSAIDs are medications for symptomatic treatment. Many of the drugs sold in pharmacies without a prescription.

About 30 million people on Earth use it daily the medicines we describe, 45% users are over 62 years of age, 15% Patients in the hospital receive such drugs as a means of treatment. These drugs are popular due to their actions described above.

Now we will look at them in more detail.

The effect of such drugs

The main one is the inhibition of the synthesis of prostaglandins (PG) from arachidonic acid by inhibiting the enzyme cyclooxygenase (PG synthetase).

PGs have the following focus:

Local dilation of blood vessels, due to which there is a decrease in swelling, exudation, and rapid healing of the injury.
Reduce pain.
They help reduce fever due to their effect on the hypothalamic regulation centers.
Anti-inflammatory effect.

Indications for use

Medicines of this group, as a rule, prescribed for acute and chronic pathologies, in the clinic where pain and inflammation are observed.

Most often, drugs in this group are prescribed for:

Rheumatoid arthritis is a chronic inflammation of the joints.
Osteoarthritis is a non-inflammatory chronic joint disease of unknown etiology.
Inflammatory arthropathy: ankylosing spondylitis; psoriatic arthritis; Reiter's syndrome.
Gout is the deposition of urate in body tissues.
Dysmenorrhea - menstrual pain.
Bone cancer accompanied by pain.
Migraine pain. B
Pain observed after operations.
Minor pain due to injuries and inflammation.
High temperature.
Pain syndrome in diseases of the urinary system.

Release forms

NSAIDs are available in the following forms:

So you can choose according to your taste; some forms are suitable for treating children.

Classification of non-steroidal anti-inflammatory drugs

There are several classifications of the described group.

According to chemical structure:

Salicylic acid derivatives- Aspirin.
Pyrazolone derivatives- Analgin.
Anthranilic acid derivatives– Sodium mefenaminate.
Propionic acid derivatives– representative of the group – Ibuprofen. Read more here: ibuprofen instructions for use.
Acetic acid derivatives– in this group is Diclofenac sodium. Here, read the article Diclofenac instructions for use in more detail.
Oxicam derivatives– representatives of Piroxicam and Meloxicam.
Derivatives of isonicotinic acid– this includes Amizon.
Coxib derivatives– in this group are Celecoxib, Rofecoxib.
Derivatives of other chemical groups– Mesulide, Etodolac.
Combination drugs– Reopirin, Dilocaine.

All drugs in this group are divided into 2 types:

Cyclooxygenase type 1 inhibitors;
Cyclooxygenase type 2 inhibitors.

List of first generation drugs

List of second generation drugs

Movalis.
Nise.
Nimesil.
Arcoxia.
Celebrex.

Answer to the question: nise or nimesil - which is better? - read here.

List of the most effective NSAIDs

Now we will present you a list of the most effective NSAIDs:

Nimesulide. Very effective against pain in the spine, back muscles, arthritis, etc. Relieves inflammation, hyperemia, reduces temperature. The use of this drug reduces pain and normalizes mobility in the joints. Available in the form of ointments and tablets. Skin reactions are not considered a contraindication. It is not advisable to use during pregnancy, especially in the last trimester. Nimesulide tablets 100 mg 20 pieces cost from 87 to 152 rubles.
Celecoxib. It is used for osteochondrosis, arthrosis, etc. diseases. Excellent relieves pain and inflammation. Side effects on digestion are minimal or non-existent. The price of Celecoxib tablets varies between 500-800 rubles and depends on the number of capsules in the package. Read about doctors who treat arthrosis here.
Meloxicam. Another name is Movalis. It relieves fever very well, relieves pain, relieves inflammation. It is very important that under the supervision of a doctor you can take it for a long time. Forms of the drug: ampoules for intramuscular injection, dragees, suppositories, ointment. The tablets are effective for 24 hours, so one per day is enough. Meloxicam ampoules 15 mg, 1.5 ml, 3 pcs. Price 237 rub. Meloxicam-Tevatablets 15 mg 20 pcs. Price 292 rub. Meloxicam rectal suppositories 15 mg, 6 pcs. Price 209 rub. Meloxicam Avexima tablets 15 mg 20 pcs. Price 118 rub.
Xefocam. It is a powerful analgesic and acts like morphine. Effective for 12 hours. And fortunately, the drug is not addictive. Xefocam tablets are coated. captivity. about. 8 mg 10 pcs. Price 194 rub. Xefocam tablets are coated. captivity. about. 8 mg 30 pcs. Price 564 rub.

Many pathological changes occurring in the body accompany pain. To combat such symptoms, NSAIDs, or nonsteroidal anti-inflammatory drugs, have been developed. They provide excellent pain relief, relieve inflammation, and reduce swelling. However, the drugs have a large number of side effects. This limits their use in some patients. Modern pharmacology has developed the latest generation of NSAIDs. Such medications are much less likely to cause unpleasant reactions, but remain effective drugs against pain.

Impact principle

What causes the effect of NSAIDs on the body? They act on cyclooxygenase. COX has two isoforms. Each of them has its own functions. This enzyme (COX) causes a chemical reaction, as a result of which arachidonic acid is converted into prostaglandins, thromboxanes and leukotrienes.

COX-1 is responsible for the production of prostaglandins. They protect the gastric mucosa from unpleasant effects, influence the functioning of platelets, and also affect changes in renal blood flow.

COX-2 is normally absent and is a specific inflammatory enzyme synthesized due to cytotoxins, as well as other mediators.

The action of NSAIDs, such as inhibition of COX-1, carries many side effects.

New developments

It is no secret that first-generation NSAIDs had an adverse effect on the gastric mucosa. Therefore, scientists have set themselves the goal of reducing undesirable impacts. A new release form was developed. In such preparations, the active substance was in a special shell. The capsule was made from substances that did not dissolve in the acidic environment of the stomach. They began to break down only when they entered the intestines. This made it possible to reduce the irritant effect on the gastric mucosa. However, the unpleasant mechanism of damage to the walls of the digestive tract still remains.

This forced chemists to synthesize completely new substances. They differed fundamentally from previous drugs in their mechanism of action. New generation NSAIDs are characterized by a selective effect on COX-2, as well as inhibition of prostaglandin production. This allows you to achieve all the necessary effects - analgesic, antipyretic, anti-inflammatory. At the same time, NSAIDs of the latest generation make it possible to minimize the effect on blood clotting, platelet function, and gastric mucosa.

The anti-inflammatory effect is due to a decrease in the permeability of vascular walls, as well as a decrease in the production of various inflammatory mediators. Due to this effect, irritation of nerve pain receptors is minimized. The influence on certain thermoregulation centers located in the brain allows the latest generation of NSAIDs to effectively lower overall temperature.

Indications for use

The effects of NSAIDs are widely known. The effect of such drugs is aimed at preventing or reducing the inflammatory process. These medications provide an excellent antipyretic effect. Their effect on the body can be compared with the effect of narcotic analgesics. In addition, they provide analgesic and anti-inflammatory effects. The use of NSAIDs is widespread in clinical settings and in everyday life. Today these are one of the popular medical drugs.

A positive effect is noted under the following factors:

Diseases of the musculoskeletal system. For various sprains, bruises, and arthrosis, these medications are simply irreplaceable. NSAIDs are used for osteochondrosis, inflammatory arthropathy, and arthritis. The medicine has an anti-inflammatory effect in myositis, herniated intervertebral discs.
Severe pain. The drugs are quite successfully used for biliary colic and gynecological ailments. They eliminate headaches, even migraines, and kidney discomfort. NSAIDs are successfully used for patients in the postoperative period.
High temperature. The antipyretic effect allows the drugs to be used for a variety of ailments by both adults and children. Such medicines are effective even for fever.
Thrombosis. NSAIDs are antiplatelet drugs. This allows them to be used for ischemia. They are a preventative against heart attack and stroke.

Classification

About 25 years ago, only 8 groups of NSAIDs were developed. Today this number has increased to 15. However, even doctors cannot give an exact figure. Having appeared on the market, NSAIDs quickly gained widespread popularity. The drugs have replaced opioid analgesics. Since they, unlike the latter, did not provoke respiratory depression.

The classification of NSAIDs involves division into two groups:

Old drugs (first generation). This category includes well-known drugs: Citramon, Aspirin, Ibuprofen, Naproxen, Nurofen, Voltaren, Diklak, Diclofenac, Metindol, Movimed, Butadione .
New NSAIDs (second generation). Over the past 15-20 years, pharmacology has developed excellent drugs, such as Movalis, Nimesil, Nise, Celebrex, Arcoxia.

However, this is not the only classification of NSAIDs. New generation drugs are divided into non-acid derivatives and acids. Let's look at the last category first:

Salicylates. This group of NSAIDs contains the following drugs: Aspirin, Diflunisal, Lysine monoacetylsalicylate.
Pyrazolidines. Representatives of this category are the following drugs: “Phenylbutazone”, “Azapropazone”, “Oxyphenbutazone”.
Oxycams. These are the most innovative NSAIDs of the new generation. List of drugs: Piroxicam, Meloxicam, Lornoxicam, Tenoxicam. The drugs are not cheap, but their effect on the body lasts much longer than other NSAIDs.
Derivatives of phenylacetic acid. This group of NSAIDs contains the following drugs: Diclofenac, Tolmetin, Indomethacin, Etodolac, Sulindac, Aceclofenac.
Anthranilic acid preparations. The main representative is the drug Mefenaminat.
Propionic acid agents. This category contains many excellent NSAIDs. List of drugs: “Ibuprofen”, “Ketoprofen”, “Benoxaprofen”, “Fenbufen”, “Fenoprofen”, “Tiaprofenic acid”, “Naproxen”, “Flurbiprofen”, “Pirprofen”, “Nabumeton”.
Derivatives of isonicotinic acid. The main medicine is Amizon.
Pyrazolone preparations. The well-known remedy “Analgin” belongs to this category.

Non-acid derivatives include sulfonamides. This group includes the following drugs: Rofecoxib, Celecoxib, Nimesulide.

Side effects

New generation NSAIDs, the list of which is given above, have an effective effect on the body. However, they have virtually no effect on the functioning of the gastrointestinal tract. These drugs have one more positive aspect: new generation NSAIDs do not have a destructive effect on cartilage tissue.

However, even such effective means can provoke a number of undesirable effects. You should know them, especially if the drug is used for a long time.

The main side effects may be:

dizziness;
drowsiness;
headache;
fatigue;
increased heart rate;
increased blood pressure;
slight shortness of breath;
dry cough;
indigestion;
the appearance of protein in the urine;
increased activity of liver enzymes;
skin rash (spot);
fluid retention;
allergy.

However, damage to the gastric mucosa is not observed when taking new NSAIDs. The drugs do not cause exacerbation of the ulcer with bleeding.

The best anti-inflammatory properties are phenylacetic acid drugs, salicylates, pyrazolidones, oxicams, alkanones, propionic acid and sulfonamide drugs.

The medications that most effectively relieve joint pain are Indomethacin, Diclofenac, Ketoprofen, and Flurbiprofen. These are the best NSAIDs for osteochondrosis. The above medications, with the exception of Ketoprofen, have a pronounced anti-inflammatory effect. Piroxicam belongs to this category.

Effective analgesics are the drugs Ketorolac, Ketoprofen, Indomethacin, Diclofenac.

The leader among the latest generation of NSAIDs is the drug Movalis. This product can be used for a long period. Anti-inflammatory analogues of an effective drug are the drugs “Movasin”, “Mirlox”, “Lem”, “Artrosan”, “Melox”, “Melbek”, “Mesipol” and “Amelotex”.

The drug "Movalis"

This drug is available in the form of tablets, rectal suppositories and solution for intramuscular administration. The product belongs to enolic acid derivatives. The drug is distinguished by excellent analgesic and antipyretic properties. It has been established that this medicine has a beneficial effect in almost any inflammatory process.

Indications for use of the drug are osteoarthritis, ankylosing spondylitis, rheumatoid arthritis.

However, you should know that there are also contraindications to taking the drug:

hypersensitivity to any of the components of the drug;
peptic ulcer in the acute stage;
severe renal failure;
ulcerative bleeding;
severe liver failure;
pregnancy, breastfeeding;
severe heart failure.

The drug should not be taken by children under 12 years of age.

For adult patients diagnosed with osteoarthritis, it is recommended to take 7.5 mg per day. If necessary, this dose can be increased by 2 times.

For rheumatoid arthritis and ankylosing spondylitis, the daily dose is 15 mg.

Patients prone to side effects should take the drug with extreme caution. People who have severe renal failure and are on hemodialysis should take no more than 7.5 mg per day.

The cost of the drug "Movalis" in tablets of 7.5 mg, No. 20, is 502 rubles.

Consumer opinion about the medicine

Reviews from many people who are subject to severe pain indicate that Movalis is the most suitable remedy for long-term use. It is well tolerated by patients. In addition, its long-term presence in the body makes it possible to take the medicine once. A very important factor, according to most consumers, is the protection of cartilage tissue, since the drug does not have a negative effect on them. This is very important for patients who use the drug for osteochondrosis and arthrosis.

In addition, the medicine perfectly relieves various pains - toothache, headache. Patients pay special attention to the impressive list of side effects. While taking NSAIDs, treatment, despite the manufacturer's warning, was not complicated by unpleasant consequences.

The drug "Celecoxib"

The action of this remedy is aimed at alleviating the patient’s condition with osteochondrosis and arthrosis. The drug perfectly eliminates pain and effectively relieves the inflammatory process. No adverse effects on the digestive system were identified.

Indications for use given in the instructions are:

This drug has a number of contraindications. In addition, the medicine is not intended for children under 18 years of age. Particular caution should be exercised by people diagnosed with heart failure, as the drug increases the susceptibility to fluid retention.

The cost of the drug varies, depending on the packaging, in the region of 500-800 rubles.

Consumer Opinion

Reviews about this medicine are quite contradictory. Some patients, thanks to this remedy, were able to overcome joint pain. Other patients claim that the drug did not help. Thus, this remedy is not always effective.

In addition, you should not take the drug yourself. In some European countries, this medicine is banned because it has cardiotoxic effects, which is quite harmful to the heart.

The drug "Nimesulide"

This medicine has not only anti-inflammatory and anti-pain effects. The product also has antioxidant properties, thanks to which the drug inhibits substances that destroy cartilage tissue and collagen fibers.

The product is used for:

arthritis;
arthrosis;
osteoarthritis;
myalgia;
arthralgia;
bursitis;
fever;
various pain syndromes.

At the same time, the medicine has an analgesic effect very quickly. As a rule, the patient feels relief within 20 minutes after taking the drug. That is why this remedy is very effective for acute paroxysmal pain.

Almost always, the medicine is well tolerated by patients. But sometimes side effects may occur, such as dizziness, drowsiness, headache, nausea, heartburn, hematuria, oliguria, urticaria.

The product is not approved for use by pregnant women and children under 12 years of age. People who have arterial hypertension or impaired functioning of the kidneys, eyesight or heart should take the drug Nimesulide with extreme caution.

The average price of the medicine is 76.9 rubles.

Anti-inflammatory drugs for joints are the main treatment for diseases of cartilage and connective tissue. They slow down the progression of the disease, help fight exacerbations, and relieve painful symptoms. The regimen for taking the drug can be different - they are taken in courses, or as needed to alleviate the condition. Nonsteroidal anti-inflammatory drugs (NSAIDs) are produced in different dosage forms - ointments and gels for topical use, tablets and capsules, as well as injectable preparations for intra-articular administration.

Anti-inflammatory drugs (NSAIDs) - principle of action

This group of drugs is very extensive, but they all share a common principle of action. The essence of this process is that non-steroidal anti-inflammatory drugs for the treatment of joints interfere with the mechanism of formation of the inflammatory process. The enzyme cyclooxygenase is responsible for the synthesis of so-called inflammatory mediators. It is precisely this that is inhibited by drugs from the NSAID group, interrupting the chain of development of the inflammatory reaction. They prevent pain, high fever and local swelling.

But there is another important feature of the action of non-steroidal anti-inflammatory drugs. There are two types of cyclooxygenase enzyme. One of them (COX-1) is involved in the synthesis of inflammatory mediators, and the second (COX-2) is involved in the synthesis of the protective layer of the stomach wall. NSAIDs act on both types of this enzyme, causing inhibition of both. This explains the common side effect of these drugs, which is damage to the mucous membrane of the digestive organs.

Based on their effect on COX-2, drugs are divided into selective and non-selective. The development of new NSAIDs aims to increase the selectivity of their effect on COX-1 and eliminate the effect on COX-2. Currently, new generation NSAID drugs have been developed that have almost complete selectivity.

The three main therapeutic effects of drugs in this group are anti-inflammatory, antipyretic and analgesic. In case of joint diseases, it is the anti-inflammatory effect that comes to the fore, and the analgesic effect is no less significant. The antipyretic effect is less important and practically does not manifest itself in new generation anti-inflammatory non-steroidal drugs, which are used to treat joint diseases.

Classification of anti-inflammatory drugs

Taking into account the structural features of the active substance, all NSAIDs can be divided into several groups:

Non-selective NSAIDs (affect mainly COX-1)

These include the following:

Aspirin;
Ketoprofen;

Non-selective NSAIDs (equally affecting COX-1 and COX-2).

Lornoxicam;
Lorakam.

Selective NSAIDs (inhibit COX-2)

Celecoxib;
Meloxicam;
Nimesulide;
Rofecoxib.

Some of these drugs have a strong anti-inflammatory effect, others are more antipyretic (Aspirin, Ibuprofen) or analgesic (Ketorolac) effect.

Indications for use of NSAIDs

knee arthritis is one of the reasons

For joint diseases, nonsteroidal drugs are prescribed according to several regimens, depending on the dosage form and stage of the disease. The list of diseases for which NSAIDs are prescribed is quite long - these include arthritis of various etiologies, including autoimmune, most arthrosis, the recovery period after injuries to the joints and muscles.

When exacerbating chronic joint diseases, non-steroidal anti-inflammatory drugs are used in combination. They are prescribed in the form of a course of tablets and ointments; in severe cases, treatment is supplemented with intra-articular injections. Outside of exacerbation and in acute conditions, they are used as needed if symptoms of joint inflammation occur.

Side effects

Non-steroidal anti-inflammatory drugs have many side effects, so be sure to read the instructions before taking them. The most common side effects are:

provocation of a stomach or duodenal ulcer,
dyspepsia,
dysfunction of the nervous system,

They are especially pronounced in medications in tablets, suppositories and solutions for intramuscular injections. Local agents (ointments and intra-articular injections) do not have this effect.

Another common group of side effects is the effect on the hematopoietic system. NSAIDs have a blood-thinning effect, and this effect must be taken into account when taking these drugs so as not to harm your health. A more dangerous effect on the blood system is expressed in the inhibition of hematopoietic processes. It manifests itself as a gradual decrease in the amount of formed elements in the blood - first anemia develops, then thrombocytopenia, and subsequently pancytopenia.

In addition, there are other side effects caused by the chemical characteristics of the drugs; they are indicated in the instructions for use. Due to the large number of side effects, you should consult your doctor before taking NSAIDs to treat joints.

Contraindications

Contraindications to the use of NSAIDs for joint diseases stem from their side effects and primarily concern tablet forms. They are not prescribed to patients during exacerbation of diseases of the gastrointestinal tract, as well as to patients with diseases of the blood system - anemia of various origins, coagulation disorders, leukemia and leukemia.

NSAIDs should not be prescribed simultaneously with drugs that reduce blood clotting (heparin), and it is also not recommended to take the same drug in different dosage forms - this leads to increased side effects. This primarily applies to drugs containing ibuprofen and diclofenac.

In addition, it is possible to develop an allergic reaction to NSAIDs. Its intensity is not related to the dosage form, and appears with the same frequency when taking tablets, using ointments and giving injections into the joints. Sometimes allergies can take very severe forms, for example, aspirin asthma - an asthmatic attack when using the drug. An allergic reaction to NSAIDs can be cross-reactive, so caution should be exercised when taking the drugs.

Ointments with NSAIDs for joint diseases

Ointments are the most common dosage form used for joint pain. Their popularity is due to the fact that the effect of the ointment occurs quickly enough, and side effects are minimal. The ointment can be used to relieve acute pain and during the recovery period after injuries. But if a course of injections is prescribed, then the ointments are usually canceled.

The most popular drugs in the form of ointments are Diclofenac and drugs based on it (Voltaren), Dolobene, and others. Most of them can be bought at a pharmacy without a doctor's prescription. You can use such products for a long time without harm to health.

Non-steroidal anti-inflammatory drugs in tablets for joint diseases

NSAIDs in tablets are prescribed for joint damage, osteochondrosis, systemic connective tissue diseases with articular syndrome. They are used in courses, several times a year, and are prescribed in the acute period. But the main task of tableted NSAIDs is to prevent exacerbation of diseases.

This dosage form is most effective for treating diseases of the joints and spine, but has the greatest number of contraindications. In addition to the conditions listed above, tablets containing NSAIDs cannot be used for liver diseases - fibrosis, cirrhosis, hepatitis, liver failure. For kidney diseases accompanied by a decrease in filtration rate, a reduction in dosage or frequency of administration is required.

A complete list of anti-inflammatory drugs can be found on Wikipedia. Among the most famous of them is Diclofenac tablets. Among the more modern drugs of the new generation are Xefocam, Celecoxib and Movalis. New drugs are safer, but have another negative point - high cost. It is necessary to take tablets after meals or with meals.

NSAIDs in solutions for intra-articular injections

This dosage form is prescribed for severe disease and to relieve severe exacerbation. Used in courses that are conducted only in a medical institution. Intra-articular injections make it possible to most effectively deliver the active substance to the site of inflammation. But they require high qualifications from the doctor who performs them, since they are associated with the risk of damage to the joint ligament.

Diclofenac, Movalis, Xefocam and other drugs are available in injection form. They are used to treat lesions of large joints, most often the knee, less often the elbow. Intra-articular injections are not prescribed for damage to the joints of the hands and feet, as well as for diseases of the spine. This is due to the fact that the technical difficulties of administering the drug make this method of treatment almost impossible.

Intra-articular injections are considered a rather complex medical procedure, and must be carried out in a treatment room, since they require sterility to avoid infection and highly qualified medical staff.

List of the best anti-inflammatory drugs

Let's take a closer look at the features of using the most popular drugs from the NSAID group.

(Voltaren, Naklofen, Olfen, Diklak, etc.)

Diclofenac and drugs based on it are produced in the form of tablets, capsules, ointments, gels, suppositories, and injection solutions. These drugs exhibit a powerful anti-inflammatory effect, quickly relieve pain, reduce fever and alleviate the patient’s condition. A high concentration of the active ingredient in the blood is observed within 20 minutes after taking the drug.

Like most drugs from the NSAID group, they have a negative effect on the gastrointestinal tract, I have a fairly extensive list of contraindications and side effects, so they should be used only as prescribed by a doctor, in short courses. The standard daily dose of Diclofenac tablets for adult patients is 150 mg, divided into 2-3 doses. Local forms (ointments, gels) are applied to the affected area in a thin layer up to 3 times a day.

Indomethacin (Metindol)

Has the same therapeutic effect as Diclofenac. Available in the form of tablets, capsules, ointments, gels, and rectal suppositories. But this drug has numerous side effects that are more pronounced, so at present it is rarely used, giving preference to more modern drugs.

A drug from the oxicam group with pronounced analgesic, anti-inflammatory and antipyretic effects. Available in the form of capsules, tablets, ointments, creams, suppositories. It is used to treat gout, arthritis, joint and muscle pain, as well as in preparation for the IVF procedure.

Like other NSAIDs, it has an extensive list of side effects associated with damage to the digestive tract, disruption of hematopoietic processes, and reactions from the nervous system. Therefore, the drug should be used only as prescribed by a doctor. The analgesic effect of taking Piroxicam tablets lasts throughout the day. The standard dose of the drug for an adult is up to 40 mg per day.

Lornoxicam (Xefocam, Lorakam, Larfix)

The drug has a pronounced anti-inflammatory effect and quickly copes with painful pain. Does not exhibit antipyretic effects. The drug is used for the treatment of postoperative pain, algodismenorrhea, and in the treatment of osteoarthritis and rheumatoid arthritis.

Available in the form of tablets and powder intended for the preparation of solution for injection. The recommended dose for oral administration is up to 4 tablets per day in 2 divided doses. For injection into a muscle or vein, a single dose of the drug is 8 mg, the solution is prepared immediately before administration.

When using the drug, the likelihood of complications in people with gastroenterological pathologies increases, therefore, the drug is not used for diseases of the gastrointestinal tract, as well as during pregnancy, lactation, pathologies of the heart, liver and in childhood.

Meloxicam (Movalix, Revmoxicam, Melox)

Preparations based on enolic acid belong to the class of selective COX-2 inhibitors. In this regard, they cause fewer side effects from the digestive system and do not provoke toxic damage to the kidneys and liver. Meloxicam tablets, rectal suppositories and injections in ampoules are available.

Indications for the use of the drug are diseases of the joints of an inflammatory and degenerative nature with severe pain - spondyloarthritis, osteoarthrosis and arthritis. As a rule, in the first days of treatment, the drug is used in the form of intramuscular injections; after the acute inflammatory process subsides, they switch to taking Meloxicam in tablet form (1 tablet twice a day).

Nimesulide (Nimesil, Nimesin, Remesulide)

The drug belongs to the group of highly selective COX-2 inhibitors and has a powerful anti-inflammatory effect, which is complemented by antipyretic and analgesic properties. Nimesulide is produced in the form of tablets, granules for preparing a suspension, and in the form of a gel for topical use. A single dose of the drug in tablets is 100 mg, taken twice a day.

The gel is applied to the affected area several times a day (3-4), lightly rubbing. The suspension with a pleasant orange flavor can be prescribed to children from 12 years of age. The drug is intended for the treatment of post-traumatic and postoperative pain, degenerative joint lesions (accompanied by inflammation), bursitis, tendinitis.

In addition, Nimesulide is prescribed for atralgia, myalgia, painful periods, as well as to relieve headaches and toothaches. The drug can have a toxic effect on the liver and kidneys, so in case of diseases of these organs, the dose of the drug must be reduced.

Celecoxib (Revmroxib, Celebrex)

A drug from the coxib group, used in the treatment of inflammatory joint diseases, acute pain syndrome, and menstrual pain. Available in the form of capsules, which may contain 100 or 200 mg of active substance. It exhibits a pronounced analgesic and anti-inflammatory effect, while, if the therapeutic dose is not exceeded, it has virtually no negative effect on the gastrointestinal mucosa.

The maximum permissible daily dose of the drug is 400 mg, divided into 2 doses. With long-term use of Celecoxib in high doses, side effects develop - ulceration of the mucous membrane, disorders of the hematopoietic system and other undesirable reactions from the nervous, cardiovascular and genitourinary systems.

(Zerodol)

The effect of the drug is similar to Diclofenac and is available in the form of tablets containing 100 mg of the active substance. Adults are recommended to take 1 tablet twice a day. The drug is intended for the treatment of gout, arthritis of various etiologies, osteoarthritis and spondylitis.

This medication is much less likely than other NSAIDs to provoke erosive lesions of the gastrointestinal tract, but its use may be accompanied by a number of side effects from the digestive, nervous, hematopoietic, and respiratory systems. The drug is prescribed with extreme caution for pathologies of the liver, kidneys, diabetes mellitus, ischemia, arterial hypertension and other conditions, a list of which is given in the instructions for the drug.

Rofecoxib

This is a modern remedy from the category of highly selective COX-2 inhibitors, which have virtually no negative effect on the gastrointestinal mucosa and kidneys. It is used as a strong analgesic and anti-inflammatory agent for most inflammatory and degenerative lesions of the musculoskeletal system. In addition, the medication is prescribed for migraine, neuralgia, lumbago, osteochondrosis, pain syndrome due to injury to muscles and ligaments.

This universal remedy is often included in the complex treatment regimen for thrombophlebitis, diseases of the genitourinary system, and is used in ophthalmology, for diseases of the ENT organs or for dental problems (stomatitis, pulpitis). In case of severe pain, you can take up to 4 tablets at a time. The drug is prescribed with caution for bronchial asthma, in early pregnancy, and during lactation. This medication has much fewer contraindications and side effects than other anti-inflammatory drugs.

Combined NSAIDs

New generation drugs with anti-inflammatory effects combine a combination of the active substance with vitamins or other active ingredients that enhance their therapeutic effect. We present to your attention a list of the most popular combination drugs:

Flamidez (diclofenac + paracetamol);
Neurodiclovit (diclofenac + vitamins B1, B6, B12);
Olfen-75 (diclofenac + lidocaine);
Dilocaine (lidocaine + diclofenac in low dosage);
Dolaren gel (diclofenac + flax oil + menthol + methyl salicylate);
Nimid Forte (nimesulide + tizanidine);
Alite (soluble tablets containing nimesulide and the muscle relaxant dicycloverine);

This is not a complete list of combined anti-inflammatory drugs that are used to treat joints and degenerative lesions of the musculoskeletal system. For each patient, the doctor selects a treatment regimen individually, taking into account many factors. Drugs from the NSAID group have many contraindications and can cause a number of undesirable side reactions from various organs and systems.

Therefore, you cannot self-medicate! Only a specialist can recommend the optimal remedy, taking into account the clinical picture of the disease, the severity of symptoms, concomitant pathologies and determine the required dosage of the drug and the duration of the course of treatment. This will help avoid unwanted complications, alleviate the patient’s condition and speed up recovery.

Who should I contact?

Depending on the nature of the pathology, the following specialists can treat a patient with joint diseases: a neurologist, a therapist, an orthopedist or a rheumatologist. It is these doctors who have the right to prescribe drugs from the NSAID group for the treatment of specialized diseases.

If taking anti-inflammatory drugs leads to adverse reactions, specialists such as a gastroenterologist, cardiologist, allergist, nephrologist can join the patient’s treatment. If the patient is forced to take NSAIDs for a long time, be sure to consult with a nutritionist and choose the optimal diet that will protect the gastric mucosa from damage.

Non-steroidal anti-inflammatory drugs (NSAIDs, NSAIDs) are drugs that have analgesic, antipyretic and anti-inflammatory effects.

The mechanism of their action is based on blocking certain enzymes (COX, cyclooxygenase), they are responsible for the production of prostaglandins - chemicals that promote inflammation, fever, pain.

The word “non-steroidal”, which is contained in the name of the group of drugs, emphasizes the fact that the drugs in this group are not synthetic analogues of steroid hormones - powerful hormonal anti-inflammatory drugs.

The most famous representatives of NSAIDs: aspirin, ibuprofen, diclofenac.

How do NSAIDs work?

While analgesics directly combat pain, NSAIDs reduce both of the most unpleasant symptoms of the disease: pain and inflammation. Most drugs in this group are non-selective inhibitors of the cyclooxygenase enzyme, suppressing the action of both of its isoforms (varieties) - COX-1 and COX-2.

Cyclooxygenase is responsible for the production of prostaglandins and thromboxane from arachidonic acid, which in turn is obtained from cell membrane phospholipids by the enzyme phospholipase A2. Prostaglandins, among other functions, are mediators and regulators in the development of inflammation. This mechanism was discovered by John Wayne, who later received the Nobel Prize for his discovery.

When are these drugs prescribed?

Typically, NSAIDs are used to treat acute or chronic inflammation accompanied by pain. Non-steroidal anti-inflammatory drugs have gained particular popularity for the treatment of joints.

Let us list the diseases in which these drugs are prescribed:

(menstrual pain);
bone pain caused by metastases;
postoperative pain;
fever (increased body temperature);
intestinal obstruction;
renal colic;
moderate pain due to inflammation or soft tissue injury;
lower back pain;
pain when

Many pathological changes occurring in the body accompany pain. NSAIDs, or drugs, have been developed to combat such symptoms. They provide excellent pain relief, relieve inflammation, and reduce swelling. However, the drugs have a large number of side effects. This limits their use in some patients. Modern pharmacology has developed the latest generation of NSAIDs. Such medications are much less likely to cause unpleasant reactions, but remain effective drugs against pain.

Impact principle

What causes the effect of NSAIDs on the body? They act on cyclooxygenase. COX has two isoforms. Each of them has its own functions. This enzyme (COX) causes a chemical reaction, as a result of which it turns into prostaglandins, thromboxanes and leukotrienes.

COX-2 is normally absent and is a specific inflammatory enzyme synthesized due to cytotoxins, as well as other mediators.

The action of NSAIDs, such as inhibition of COX-1, carries many side effects.

New developments

Indications for use

The effects of NSAIDs are widely known. The effect of such drugs is aimed at preventing or reducing the inflammatory process. These medications provide an excellent antipyretic effect. Their effect on the body can be compared with the influence of In addition, they provide analgesic and anti-inflammatory effects. The use of NSAIDs is widespread in clinical settings and in everyday life. Today these are one of the popular medical drugs.

A positive effect is noted under the following factors:

Diseases of the musculoskeletal system. For various sprains, bruises, and arthrosis, these medications are simply irreplaceable. NSAIDs are used for osteochondrosis, inflammatory arthropathy, and arthritis. The medicine has an anti-inflammatory effect in myositis, herniated intervertebral discs.
Severe pain. The drugs are quite successfully used for biliary colic and gynecological ailments. They eliminate headaches, even migraines, and kidney discomfort. NSAIDs are successfully used for patients in the postoperative period.
High temperature. The antipyretic effect allows the drugs to be used for a variety of ailments by both adults and children. Such medicines are effective even for fever.
Thrombosis. NSAIDs are antiplatelet drugs. This allows them to be used for ischemia. They are a preventative against heart attack and stroke.

Classification

The classification of NSAIDs involves division into two groups:

Old drugs (first generation). This category includes well-known drugs: Citramon, Aspirin, Ibuprofen, Naproxen, Nurofen, Voltaren, Diklak, Diclofenac, Metindol, Movimed, Butadione .
New NSAIDs (second generation). Over the past 15-20 years, pharmacology has developed excellent drugs, such as Movalis, Nimesil, Nise, Celebrex, Arcoxia.

However, this is not the only classification of NSAIDs. New generation drugs are divided into non-acid derivatives and acids. Let's look at the last category first:

Salicylates. This group of NSAIDs contains the following drugs: Aspirin, Diflunisal, Lysine monoacetylsalicylate.
Pyrazolidines. Representatives of this category are the following drugs: “Phenylbutazone”, “Azapropazone”, “Oxyphenbutazone”.
Oxycams. These are the most innovative NSAIDs of the new generation. List of drugs: Piroxicam, Meloxicam, Lornoxicam, Tenoxicam. The drugs are not cheap, but their effect on the body lasts much longer than other NSAIDs.
Derivatives of phenylacetic acid. This group of NSAIDs contains the following drugs: Diclofenac, Tolmetin, Indomethacin, Etodolac, Sulindac, Aceclofenac.
Anthranilic acid preparations. The main representative is the drug Mefenaminat.
Propionic acid agents. This category contains many excellent NSAIDs. List of drugs: “Ibuprofen”, “Ketoprofen”, “Benoxaprofen”, “Fenbufen”, “Fenoprofen”, “Tiaprofenic acid”, “Naproxen”, “Flurbiprofen”, “Pirprofen”, “Nabumeton”.
Derivatives of isonicotinic acid. The main medicine is Amizon.
Pyrazolone preparations. The well-known remedy “Analgin” belongs to this category.

Non-acid derivatives include sulfonamides. This group includes the following drugs: Rofecoxib, Celecoxib, Nimesulide.

Side effects

However, even such effective means can provoke a number of undesirable effects. You should know them, especially if the drug is used for a long time.

The main side effects may be:

dizziness;
drowsiness;
headache;
fatigue;
increased heart rate;
increased blood pressure;
slight shortness of breath;
dry cough;
indigestion;
the appearance of protein in the urine;
increased activity of liver enzymes;
skin rash (spot);
fluid retention;
allergy.

However, damage to the gastric mucosa is not observed when taking new NSAIDs. The drugs do not cause exacerbation of the ulcer with bleeding.

The best anti-inflammatory properties are phenylacetic acid drugs, salicylates, pyrazolidones, oxicams, alkanones, propionic acid and sulfonamide drugs.

Effective analgesics are the drugs Ketorolac, Ketoprofen, Indomethacin, Diclofenac.

The drug "Movalis"

Indications for use of the drug are osteoarthritis, ankylosing spondylitis, rheumatoid arthritis.

However, you should know that there are also contraindications to taking the drug:

hypersensitivity to any of the components of the drug;
peptic ulcer in the acute stage;
severe renal failure;
ulcerative bleeding;
severe liver failure;
pregnancy, breastfeeding;
severe heart failure.

The drug should not be taken by children under 12 years of age.

For adult patients diagnosed with osteoarthritis, it is recommended to take 7.5 mg per day. If necessary, this dose can be increased by 2 times.

For rheumatoid arthritis and ankylosing spondylitis, the daily dose is 15 mg.

Patients prone to side effects should take the drug with extreme caution. People who have severe renal failure and are on hemodialysis should take no more than 7.5 mg per day.

The cost of the drug "Movalis" in tablets of 7.5 mg, No. 20, is 502 rubles.

Consumer opinion about the medicine

The drug "Celecoxib"

Indications for use given in the instructions are:

osteoarthritis;
rheumatoid arthritis;
ankylosing spondylitis.

The cost of the drug varies, depending on the packaging, in the region of 500-800 rubles.

Consumer Opinion

In addition, you should not take the drug yourself. In some European countries, this medicine is banned because it has cardiotoxic effects, which is quite harmful to the heart.

The drug "Nimesulide"

The product is used for:

arthritis;
arthrosis;
osteoarthritis;
myalgia;
arthralgia;
bursitis;
fever;
various pain syndromes.

Almost always, the medicine is well tolerated by patients. But sometimes side effects may occur, such as dizziness, drowsiness, headache, nausea, heartburn, hematuria, oliguria, urticaria.

The average price of the medicine is 76.9 rubles.

There is practically no disease for which non-steroidal anti-inflammatory drugs (NSAIDs, NSAIDs) would not be used. This is a huge class of tablets, injections and ointments, the ancestor of which is regular Aspirin. The most common indications for their use are joint diseases accompanied by pain and inflammation. In our pharmacies, both long-tested, well-known drugs and new generation anti-inflammatory non-steroidal drugs are popular.

The era of such drugs began quite a long time ago - in 1829, when salicylic acid was first discovered. Since then, new substances and dosage forms have begun to appear that can eliminate inflammation and pain.

With the creation of Aspirin, NSAID drugs were classified as a separate group of non-steroidal anti-inflammatory drugs. Their name determines that they do not contain hormones (steroids) and have fewer side effects than steroid ones.

Despite the fact that in our country most NSAIDs can be bought in pharmacies without a prescription, there are some points that you need to know about. Especially for those people who are wondering what is better to choose – drugs that have been offered for years, or modern NSAIDs.

The principle of action of NSAIDs is the effect on the enzyme cyclooxygenase (COX), namely its two varieties:

COX-1 is a protective enzyme in the gastric mucosa, protecting it from acidic contents.
COX-2 is an inducible, that is, a synthesized enzyme that is produced in response to inflammation or damage. Thanks to it, the inflammatory process plays out in the body.

Since first-generation non-steroids are non-selective, that is, they act on both COX-1 and COX-2, along with the anti-inflammatory effect, they also have strong side effects. It is important to take these tablets after meals, as they are irritating to the stomach and can lead to erosions and ulcers. If you already have stomach ulcers, you need to take them with proton pump inhibitors (Omeprazole, Nexium, Controloc, etc.), which protect the stomach.

Time does not stand still, non-steroids are developing and becoming more selective for COX-2. Now at the moment there are drugs that selectively act on the COX-2 enzyme, on which inflammation depends, without affecting COX-1, that is, without damaging the gastric mucosa.

About a quarter of a century ago there were only eight groups of NSAIDs, but today there are more than fifteen. Having gained widespread popularity, non-steroidal tablets quickly replaced the opioid painkillers of the analgesics group.

Today, there are two generations of non-steroidal anti-inflammatory drugs. The first generation is NSAID drugs, most of them non-selective.

These include:

Aspirin;
Citramon;
Naproxen;
Voltaren;
Nurofen;
Butadion and many others.

New generation non-steroidal anti-inflammatory drugs are safer in terms of side effects, and they have a greater ability to relieve pain.

These are selective non-steroids such as:

Nimesil;
Nise;
Nimesulide;
Celebrex;
Indomethaxin.

This is not a complete list and not the only classification of new generation NSAIDs. There is a division into non-acidic and acidic derivatives.

Among the latest generation of NSAIDs, the most innovative drugs are oxicams. These are non-steroidal anti-inflammatory drugs of a new generation of the acid group, which affect the body much longer and more clearly than others.

This includes:

Lornoxicam;
Piroxicam;
Meloxicam;
Tenoxicam.

The acid group of drugs also includes the following series of non-steroids:

Non-acid drugs, that is, those that do not affect the gastric mucosa, include new generation NSAIDs of the sulfonamide group. Representatives of this group are Nimesulide, Rofecoxib, Celecoxib.

New generation NSAIDs have gained widespread use and popularity due to their ability not only to relieve pain, but also to have an excellent antipyretic effect. The drugs stop the inflammatory process and prevent the disease from developing, so they are prescribed for:

Diseases of musculoskeletal tissue. Nonsteroids are used to treat injuries, wounds, and bruises. They are indispensable for arthrosis, arthritis and other diseases of a rheumatic nature. Also, for herniated intervertebral discs and myositis, the drugs have an anti-inflammatory effect.
Severe pain syndromes. They are successfully used in the postoperative period, for biliary and renal colic. The tablets have a positive effect on headaches and gynecological pain, and successfully relieve pain from migraines.
Risk of blood clots. Since nonsteroids are antiplatelet, that is, they thin the blood, they are prescribed for ischemia and for the prevention of strokes and heart attacks.
High temperature. These tablets and injections are the primary antipyretic for adults and children. They are recommended for use even in feverish conditions.

The drugs are also used for gout and intestinal obstruction. In case of bronchial asthma, it is not recommended to use NVPP on its own; prior consultation with a doctor is necessary.

Unlike non-selective anti-inflammatory drugs, new generation NSAIDs do not irritate the body’s gastrointestinal system. Their use in the presence of gastric and duodenal ulcers does not lead to exacerbation and bleeding.

However, their long-term use can cause a number of undesirable effects, such as:

increased fatigue;
dizziness;
dyspnea;
drowsiness;
destabilization of blood pressure.
the appearance of protein in the urine;
indigestion;

Also, with long-term use, allergies may occur, even if previously there was no susceptibility to any substances.

Non-selective non-steroids such as Ibuprofen, Paracetamol or Diclofenac have greater hepatotoxicity. They have a very strong effect on the liver, especially Paracetamol.

In Europe, where all NSAIDs are prescription drugs, over-the-counter Paracetamol is widely used (taken as a pain reliever up to 6 tablets per day). There appeared such a medical concept as “paracetamol liver damage,” that is, cirrhosis while taking this medicine.

Several years ago, a scandal broke out abroad regarding the influence of modern non-steroids, coxibs, on the cardiovascular system. But our scientists did not share the concerns of their foreign colleagues. The Russian Association of Rheumatologists acted as an opponent to Western cardiologists and proved that the risk of cardiac complications while taking new generation NSAIDs is minimal.

Most anti-inflammatory non-steroids should absolutely not be used during pregnancy, especially in the third trimester. Some of them can be prescribed by a doctor in the first half of pregnancy for special indications

By analogy with antibiotics, new generation NSAIDs should not be taken in too short courses (drink for 2-3 days and stop). This will be harmful, because in the case of antibiotics, the temperature will go away, but the pathological flora will acquire resistance (resistance). The same is with non-steroids - you need to take them for at least 5-7 days, since the pain may go away, but this does not mean that the person has recovered. The anti-inflammatory effect occurs a little later than the analgesic and proceeds more slowly.

Do not combine non-steroids from different groups under any circumstances. If you take one tablet for pain in the morning and then another, their beneficial effects do not add up and are not enhanced. And side effects increase exponentially. Especially you should not combine cardiac Aspirin (Aspirin-Cardio, Cardiomagnyl) and other NSAIDs. In this situation, there is a danger of a heart attack, since the effect of aspirin, which thins the blood, is blocked.
If any joint hurts, it is better to start with ointments, for example, based on ibuprofen. They should be used 3-4 times a day, especially at night, and rubbed intensively into the sore spot. You can use the ointment to self-massage the sore spot.

The main condition is peace. If you continue to actively work or play sports during treatment, the effect of using the medications will be very small.

The best drugs

Coming to the pharmacy, every person thinks about which non-steroidal anti-inflammatory drugs to choose, especially if he came without a doctor’s prescription. The choice is huge - non-steroids are available in ampoules, tablets, capsules, ointments and gels.

Tablets that are derivatives of acids have the greatest anti-inflammatory effect.

The following have a good analgesic effect in diseases of the musculoskeletal tissue:

Ketoprofen;
Voltaren or Diclofenac;
Indomethacin;
Xefocam or Lornoxicam.

But the most powerful drugs against pain and inflammation are the newest selective NSAIDs - coxibs, which have the least side effects. The best non-steroidal anti-inflammatory drugs in this series are Arcoxia, Nise, Movalis, Celecoxib, Xefocam, Etoricoxib.

Xefocam

Analogues of the drug are Lornoxicam, Rapid. The active ingredient is xefocam. An effective medicine with a pronounced anti-inflammatory effect. Does not affect heart rate, blood pressure and respiratory rate.

Available in the form:

tablets;
injections.

For elderly patients, no special dosage is required in the absence of renal failure. In case of kidney disease, the dose must be reduced, since the substance is excreted by these organs.

With excessive duration of treatment, manifestations in the form of conjunctivitis, rhinitis and shortness of breath are possible. For asthma, use with caution, as an allergic reaction in the form of bronchospasm is possible. When the injection is administered intramuscularly, pain and hyperemia at the injection site are possible.

The drug Arcoxia or its only analogue Exinev are drugs used for acute gouty arthritis, osteoarthritis of the rheumatoid type, and in the treatment of postoperative conditions associated with pain. Available in the form of tablets for oral use.

The active ingredient of this drug is etoricoxib, which is the most modern and safe substance among the selective COX-2 inhibitors. The product perfectly relieves pain and begins to act on the source of pain within 20-25 minutes. The active substance of the drug is absorbed into the bloodstream and has high bioavailability (100%). It is excreted unchanged in the urine.

Nimesulide

Most sports traumatology specialists identify a non-steroid such as Nise or its analogues Nimesil or Nimulid. There are many names, but they have one active ingredient – nimesulide. This medicine is quite cheap and occupies one of the first places in sales.

This is a good pain reliever, but Nimesulide-based products should not be used by children under 12 years of age, as there is a high risk of allergic reactions.

Available in:

powders;
suspensions;
gels;
tablets.

It is used in the treatment of arthritis, arthrosis, ankylosing spondylitis, sinusitis, lumbago, and pain of various localizations.

Movalis is much more selective for COX-2 than Nise, and accordingly has even fewer side effects in relation to the stomach.

Release form:

candles;
pills;
injections.

With long-term use, the risk of developing cardiac thrombosis, heart attacks, and angina is increased. Therefore, people with a predisposition to these diseases need to be careful in use. It is also not recommended for women planning pregnancy as it affects fertility. It is excreted in the form of metabolites, mainly in urine and feces.

Celecoxib

In the group with the most proven safety base is the new generation NSAID Celecoxib. This was the first drug from the group of selective coxibs, combining the three strengths of this class - the ability to reduce pain, inflammation, and fairly high safety. Release form: capsules of 100 and 200 mg.

The active component celecoxib selectively acts on COX-2 without affecting the gastric mucosa. Quickly absorbed into the blood, the substance reaches its highest concentration after 3 hours, but simultaneous use with fatty foods can slow down the absorption of the drug.

Celecoxib is prescribed for soriatic and rheumatoid arthritis, osteoarthritis and ankylosing spondylitis. This drug is not prescribed for liver and kidney failure.

Rofecoxib

The main substance rofecoxib effectively helps restore motor function of joints, quickly relieving inflammation.

Available in:

injection solutions;
tablets;
candles;
gel.

The substance is a highly selective inhibitor of cyclooxygenase 2, which is quickly absorbed by the gastrointestinal tract after administration. The substance reaches its maximum concentration in the blood after 2 hours. It is excreted mainly in the form of inactive metabolites by the kidneys and intestines.

The result of long-term use may be disorders of the nervous system - sleep disorders, dizziness, confusion. It is recommended to start treatment with injections, then switch to tablets and external agents.

When choosing any NSAIDs, you should be guided not only by price and their modernity, but also take into account the fact that all such drugs have their contraindications. Therefore, you should not self-medicate; it is best if they are prescribed by a doctor, taking into account age and history of diseases. It should be remembered that thoughtless use of medications may not only not bring relief, but will also force a person to treat many complications.