Non-steroidal anti-inflammatory drugs (NSAIDs)

Most drugs of the group of non-steroidal anti-inflammatory drugs (NSAIDs), or prostaglandin synthase inhibitors, are non-specific COX inhibitors. These drugs inhibit allisoforms of the cyclo-oxygenase enzyme: COX-1, COX-2, and COX-3. They thus inhibit the conversion of arachidonic acid into prostaglandins. These drugs are used to inhibit pain stimuli (decrease pain intensity) and to lower inflammatory reactions and fever.


The non-specific nature of these drugs is responsible for most of the side effects. Because conventional NSAIDs also inhibit COX-1, general household functions like protection of the gastrointestinal tract, renal perfusion and platelet function are disturbed. Consequently, peptic ulcus can develop and/or renal function can diminish. Since both, COX-1 and COX-2 influence platelet function in opposite way, the use of non-specific COX inhibitors usually does not result in side effects such as arterial thrombosis etc.

Examples of NSAIDs are aspirin, diclofenac, naproxen, ibuprofen, piroxicam, and indomethacin.


In order to control the pain of a patient with peptic ulcer, aspirin is first choice.


Physiological concentrations of prostaglandins do NOT cause pain.