Non-steroidal anti-inflammatory medications over the counter

Formulations of topical diclofenac, ibuprofen, ketoprofen, piroxicam, and indomethacin demonstrated significantly higher rates of clinical success (more participants with at least 50% pain relief) than matching topical placebo (moderate or high quality data ). Benzydamine did not. Three drug and formulation combinations had NNTs for clinical success below 4. For diclofenac, the Emulgel® formulation had the lowest NNT of (95% CI to ) in two studies using at least 50% pain intensity reduction as the outcome . Diclofenac plasters other than Flector® also had a low NNT of ( to ) based on good or excellent responses in some studies. Ketoprofen gel had an NNT of ( to ), from five studies in the 1980s, some with less well defined outcomes. Ibuprofen gel had an NNT of ( to ) from two studies with outcomes of marked improvement or complete remission. All other drug and formulation combinations had NNT values above 4, indicating lesser efficacy .

NSAIDs have anti-inflammatory (reduce inflammation), analgesic (relieve pain) and antipyretic (lower temperature) effects. Although different NSAIDs have different structures, they all work by blocking cyclooxygenase (COX) enzymes. There are two main types of COX enzymes: COX-1 and COX-2. Both types produce prostaglandins; however, the main function of COX-1 enzymes is to produce baseline levels of prostaglandins that activate platelets and protect the lining of the gastrointestinal tract, whereas COX-2 enzymes are responsible for releasing prostaglandins after infection or injury. Prostaglandins have a number of different effects, one of which is to regulate inflammation. Most NSAIDs inhibit both enzymes, although a few are available that mainly inhibit COX-2. The pain-relieving and anti-inflammatory effects of NSAIDs are mainly due to inhibition of COX-2, and their unwanted side effects are largely due to inhibition of COX-1.

The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

Hi Norman, You might be interested in the following:
1) Turmeric extract – See more information and studies in my article “ Turmeric Extract is Effective as Ibuprofen for Knee Osteoarthritis “.
2) Gelatin – see more information and research in my article “ Gelatin and Osteoarthritis of the Knees “.
3) Sesame seeds – more information in my article “ How To Use Sesame Seeds For Knee Osteoarthritis “.
4) Tart cherries – see “ How to Fight Joint Pain and Inflammation With Tart Cherries “.
5) Anti-Inflammatory Smoothie for Joint Pain .
6) For pain relief – massaging the area with these 20 essential oils to relieve pain and inflammation , and/or consuming this anti-inflammatory and pain relieving turmeric ginger tea .
7) See more possible natural treatments HERE , and HERE .

Non-steroidal anti-inflammatory medications over the counter

non-steroidal anti-inflammatory medications over the counter

Hi Norman, You might be interested in the following:
1) Turmeric extract – See more information and studies in my article “ Turmeric Extract is Effective as Ibuprofen for Knee Osteoarthritis “.
2) Gelatin – see more information and research in my article “ Gelatin and Osteoarthritis of the Knees “.
3) Sesame seeds – more information in my article “ How To Use Sesame Seeds For Knee Osteoarthritis “.
4) Tart cherries – see “ How to Fight Joint Pain and Inflammation With Tart Cherries “.
5) Anti-Inflammatory Smoothie for Joint Pain .
6) For pain relief – massaging the area with these 20 essential oils to relieve pain and inflammation , and/or consuming this anti-inflammatory and pain relieving turmeric ginger tea .
7) See more possible natural treatments HERE , and HERE .

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