Anti-inflammatory: what it is, classes, side effects

Contents

What is anti-inflammatory?

Anti-inflammatory drugs, or anti-inflammatory drugs, are remedies that treat inflammation of the tissues and their resulting symptoms (pain and fever ). In general, they can be divided into non-steroidal (NSAIDs) and steroidal (corticosteroids).

Some of these drugs can be sold freely in pharmacies, but many require a prescription – especially NSAIDs, which are often red-streaked.

In the case of corticosteroids, for example, it is even more rigorous.

All have red stripe and therefore require a prescription for sale.

The uncontrolled use of anti-inflammatory drugs can bring serious health risks, such as gastrointestinal, cardiac, kidney and even liver problems.

Therefore, it is very important to be careful when using these drugs and to always do so with medical advice.

In this article, we are going to deal specifically with NSAIDs.

Find out more about its indications, contraindications and side effects in the following text! Good reading

What is the difference between anti-inflammatories, antibiotics and painkillers?

The difference is simple and can be easily noticed by the name of each substance.

Anti-inflammatory drugs, as we have seen, have 3 functions, the main one being anti-inflammatory, while analgesics and antipyretics are adjuvant.

On the other hand, the antibiotic is a medicine that seeks to fight infections caused by bacteria.

As stated earlier, it is possible to note its function in its name: anti (which means “against” in Greek) and biotic (which means “living being” in Greek).

In other words, an antibiotic medication is a medication “against a living being”.

Analgesics, on the other hand, are drugs that decrease or interrupt nerve transmission routes in order to reduce pain perception.

The name derives from the Greek “an”, which means “without” and “algae”, which means “pain”. In other words: analgesic is the same as “without pain”.

What is the anti-inflammatory for?

In addition to being used for the treatment of inflammation, these medications help to reduce the symptoms and signs caused by the inflammatory process, as they normally have analgesic and antipyretic action.

They differ from each other especially because of the potency of each of these effects in the body.

Anti-inflammatory drugs are mainly indicated to relieve the symptoms of high fever, inflammation and pain.

In addition, they can be used for the treatment of various diseases, such as:

  • Arthritis;
  • Back pain;
  • Cold;
  • Gripe;
  • Headache;
  • Menstrual pain;
  • Toothache;
  • Weaknesses in muscles or joints;
  • Joint or bone injuries.

Classes of anti-inflammatory drugs

There are several types of anti-inflammatory drugs. They are divided between non-steroidal (NSAIDs) and steroidal (corticosteroids). Understand the difference:

Non-steroidal anti-inflammatory drugs (NSAIDs / NSAIDs)

Non-steroidal anti-inflammatory drugs differ from corticosteroids, mainly because of their mechanism of action.

While corticosteroids prevent the production of hormones and inflammatory signaling agents, NSAIDs prevent the activation of these substances.

Mainly, NSAIDs act under an enzyme called cyclooxygenase (COX), inhibiting its action.

For this reason, they are called cyclooxygenase inhibitors.

There are 2 types of cyclooxygenases, COX-1 and COX-2.

COX-1 acts in the production of prostaglandins, causing the body to maintain blood flow, homeostasis or vascular balance and gastric protection.

COX-2, on the other hand, has a concentrated action on inflammatory processes.

For this reason, there are 3 types of NSAIDs: non-selective COX inhibitors, selective COX-2 inhibitors and highly selective COX-2 inhibitors.

Find the difference:

Non-selective COX inhibitors

These NSAIDs, on the other hand, do not act specifically on some type of COX. On the contrary, they affect the two enzymes, both COX-1 and COX-2.

One of the main examples of this type of NSAID is piroxicam.

Selective COX-2 inhibitors

Unlike other NSAIDs, this type of medicine has its action concentrated mainly on COX-2.

It acts, albeit little, on COX-1 enzymes, but its action is more focused on COX-2.

They can cause fewer side effects than non-selective inhibitors, but they can still cause adverse reactions such as cardiovascular problems.

The main example of this type of selective inhibitor is nimesulide.

Highly selective COX-2 inhibitors

Like selective COX-2 inhibitors, these NSAIDs act directly on COX-2 molecules.

The difference, which is evidenced in the name, is that these are highly selective, that is, they act almost exclusively on COX-2.

The main example of this type of NSAID is celecoxib.

However, it is worth remembering that there is no NSAID that is completely safe and that completely avoids the risk of complications.

Corticosteroids

Corticosteroids, in turn, have anti-inflammatory effects that can be beneficial for the treatment of this symptom.

Despite being effective against inflammation, corticosteroids should be used in specific situations, only with a medical prescription, as they have several side effects and interactions with other medications.

This article, however, will not focus its explanations on corticosteroids, but on non-steroidal anti-inflammatory drugs.

If you want to know more information about corticosteroids, their functions, indications, contraindications and mechanisms of action, click here .

How does the anti-inflammatory act in the body?

As stated earlier, non-steroidal anti-inflammatory drugs (NSAIDs) act on the body by reducing the symptoms of inflammation, pain and fever.

But how does he do it? What is its mechanism of action?

These are questions that are a little difficult to answer, but we can begin the explanation with a simple molecule, an essential fatty acid from the omega-6 family widely present in our organism: Arachidonic Acid (AA).

Arachidonic acid undergoes the action of another molecule, an enzyme called cyclooxygenase (COX), and is oxidized by it, transforming into another substance: prostaglandin (PG).

Prostaglandins are chemical signals similar to hormones and act in the body as a kind of signal.

Among its various functions, it is responsible for inducing an inflammatory process.

It seems strange that our body produces a molecule that causes an inflammatory process naturally, but this is essential for the body to fight infections and injuries.

It is necessary that the space between the cells widen so that the macrophages – a kind of defense cell responsible for killing foreign bodies and cleaning up debris – can pass and perform their functions.

But, how to know when to use anti-inflammatory drugs, without disrupting the natural healing process?

The answer depends on the cause of the problem – which may be a microorganism or a rupture of tissue (cut) – and its symptoms.

For example, the presence of fever can be a warning sign and indicate the need for medication.

To assess the condition, it is important to always consult the specialist.

So, in summary: arachidonic acid is transformed into prostaglandin through the action of an enzyme called cyclooxygenase.

That’s where NSAIDs come into play. When you take an anti-inflammatory pill, the drug’s molecules will compete with COX enzymes for their respective receptors, preventing the oxidation of AA and, consequently, the synthesis of PGs.

It is as if the anti-inflammatory was a car that takes the place of cyclooxygenase in the parking lot. COXs are unable to park in their spaces and this prevents the transformation of arachidonic acid into prostaglandins.

Still, it is worth remembering that, in addition to serving as an inducer of inflammatory processes, prostaglandins are varied and have other functions, such as, for example, protecting the stomach wall from stomach acid damage, among others.

Therefore, the indiscriminate and prolonged use of non-steroidal anti-inflammatory drugs can have serious consequences for the body, causing gastrointestinal problems and even affecting important organs, such as the heart and kidneys (see more in the topic “Side effects”).

Names: what are non-steroidal anti-inflammatory drugs?

Non-steroidal anti-inflammatory drugs are divided into different categories due to their mechanism of action and effects on the body. Check out:

Non-selective COX inhibitors

  • Potassium Diclofenac ;
  • Diclofenac Cholestyramine ;
  • Diclofenac Sodium ;
  • Piroxicam ;
  • Indomethacin ;
  • Ibuprofen .

Selective COX-2 inhibitors

These drugs preferentially inhibit the COX-2 enzyme:

  • Meloxicam;
  • Etodolaco;
  • Nimesulida.

Highly selective COX-2 inhibitors

  • Celecoxibe;
  • Parecoxibe;
  • Etoricoxibe;
  • Lumiracoxibe.

Anti-inflammatories according to the inflamed site

It is common for people to look for an anti-inflammatory in a specific way for what they need, according to the place where the inflammation occurs.

However, there is no difference between the action or the type of medication depending on the inflamed place.

Thus, both a person with muscle inflammation and another with throat inflammation can have the same medication prescription.

The differences are in the dosage and in the way the medication is administered, and it can be used in the form of a pill, eye drops, spray or topical (cream or ointment).

These determinations depend on the medical evaluation.

Read more: How to apply creams and ointments to treat external hemorrhoids?

Knowing this, see some of the recommended options according to each case:

Anti-inflammatory for throat

They are recommended to help treat inflammation at the site and to relieve pain. They should be taken after meals. Some options that may be prescribed by the doctor include:

  • Ibuprofen;
  • Diclofenac;
  • Ketoprofen;
  • Benzydamine hydrochloride.

Anti-inflammatory for the tooth

Normally, anti-inflammatory drugs indicated for dental inflammations also have analgesic and antipyretic action, such as:

  • Nimesulida;
  • Ibuprofen;
  • Naproxen.

Anti-inflammatory for muscles, knee and spine

In these cases, in addition to the pills, anti-inflammatory drugs can also be used in the form of spray and ointment, for direct application on the spot. Some options include:

  • Nimesulida;
  • Naproxen;
  • Ibuprofen.

Anti-inflammatory for hemorrhoids

For hemorrhoids, the most common is the prescription of ointments with anti-inflammatory action, which also help in relieving symptoms such as pain and itching.

Read more: Hemorrhoid remedy (internal, external): pills and ointments

Anti-inflammatory for skin

Some of the topical anti-inflammatory drugs recommended for skin inflammation are medications produced from the active ingredients betamethasone valerate and hydrocortisone , both corticosteroids.

Betamethasone valerate, for example, can be indicated for the treatment of conditions such as acne vulgaris, dermatitis , rosacea, pruritus, eczema and other pathologies.

Hydrocortisone is most recommended in conditions where the patient has seborrheic dermatitis , eczema and sunburn.

For light beats or twists, an NSAID option is diethylammonium diclofenac.

Anti-inflammatory eye drops

They can be used to help reduce eye pain, burning, tearing, photophobia and after corneal surgery, for example.

Like all other anti-inflammatory drugs, they should also be used only when prescribed by a doctor.

In that case, it is necessary to consult the ophthalmologist. One example is ketorolac trometamol.

Attention!

NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

How to take?

The vast majority of people believe that medications should be taken on an empty stomach, as there is greater absorption and better use of the medication by the body.

However, this does not apply to non-steroidal anti-inflammatory drugs.

NSAIDs can cause a systemic effect because, as explained in the previous topics, they inhibit the action of an enzyme called cyclooxygenase 1 and, consequently, prostaglandins, which protect the gastric mucosa against the acid present in the stomach.

Because of this, indiscriminate or long-term use, as in the case of some elderly patients, of NSAIDs can result in very negative effects, such as gastrointestinal ulcers and severe bleeding.

Therefore, avoid fasting NSAIDs .

It is very important that you always take anti-inflammatory drugs with a glass full of water , at least, or together with some food , even if it reduces the absorption of the medicine by the body.

If it is not possible to eat before taking the medicine, make sure to take it with a full glass of water.

Side effects

Most people do not usually experience side effects when using non-steroidal anti-inflammatory drugs.

However, especially in people who take these drugs frequently to relieve pain, some problems can occur.

A single pill affects the body completely, not just the part that is hurting or inflamed.

So even though NSAIDs can have a positive effect on pain and other discomfort, it can still (negatively) affect other parts of your body.

Some of the side effects that can arise from the use of anti-inflammatory drugs include:

  • Diarrhea;
  • Constipation;
  • Loss of appetite;
  • Dyspepsia (indigestion);
  • Vomiting;
  • Somnolence;
  • Headache;
  • Dizziness;
  • Water retention;
  • Skin irritation;
  • Wheezing in the ear;
  • Blurred vision;
  • Rash.

Still, more serious effects can occur, especially due to the indiscriminate use of these drugs. Check out:

Gastrointestinal problems

The most common problem with the use of NSAIDs are ulcers and other problems in the esophagus, stomach and small intestine, causing nausea, vomiting and abdominal discomfort.

That’s because they prevent the production of prostaglandins, substances similar to hormones that are responsible for the swelling and pain from inflammation.

NSAIDs would work very well if prostaglandins had only this function, but this is not the case.

In reality, there are different types of prostaglandins in our body. Some, for example, are responsible for protecting the gastric mucosa from acidity in the region.

As the anti-inflammatory cannot distinguish one from the other and inhibit the production of prostaglandins that are causing the pain only, it ends up having an effect on all of them, even those that are not “harmful”.

And it is for this reason that prolonged use can bring several damages to the organism.

During occasional use of NSAIDs, it is recommended to take the medication with lunch or dinner.

Increased blood pressure and kidney damage

Prostaglandins are substances that help the kidneys to function normally, as they cause vasodilation of the renal blood vessels and thus guarantee an adequate flow.

However, when NSAIDs cause an inhibition of prostaglandins, a reduction in blood flow in the kidneys can occur, which impairs the organ’s ability to filter blood.

This poor filtration can activate systems in the body that can favor the retention of water, sodium and vasoconstriction. All of these effects combined can cause an increase in blood pressure.

In healthy people, these side effects are considered rare and reversible after the end of the medication.

However, in people who are predisposed to kidney disease and high blood pressure , continuous use without a prescription may be more dangerous.

Allergic reactions

Nonsteroidal anti-inflammatory drugs can also cause severe allergic reactions, especially in people with asthma .

It is not yet known exactly why this is, but it is known that NSAIDs, by inhibiting COX, can favor the activity of an enzyme called lipooxygenase, an enzyme that acts in the formation of leukotrienes, mediators present in the asthmatic process causing inflammation in the lungs and bronchoconstriction.

Therefore, the recommendation is that people suffering from asthma stay away from non-steroidal anti-inflammatory drugs, even more so if they have problems such as sinusitis or nasal polyp.

Medicated hepatitis

Medicinal hepatitis has already been registered as a result of more than 900 different medications and NSAIDs do not escape this list. That’s because anti-inflammatory drugs like ibuprofen can cause inflammation in the liver.

It is not possible to know whether the use of these drugs in a patient will necessarily develop into hepatitis.

Therefore, it is extremely important to avoid unnecessary medication and self-medication.

Therefore, before starting treatment with any medication, consult a doctor.

Contraindications

Anti-inflammatories should be used with caution in elderly people and people allergic to NSAIDs.

That is, people who have had an episode of asthma, angioedema, hives or rhinitis caused by the use of these drugs should not take them.

People with a history of ulcers or gastrointestinal bleeding should take greater precautions before using the drug, as well as patients with hypertension and other blood pressure problems.

Its use should also be monitored during pregnancy and lactation, and a doctor should be consulted before starting to administer the medications.

In addition, it is contraindicated for the following people:

  • Patients with renal failure;
  • Heart failure patients;
  • Cirrhosis patients;
  • People who consume, on average, more than 3 doses of alcohol a day;
  • Patients receiving warfarin;
  • Patients at risk of bleeding.

Can pregnant women take anti-inflammatory drugs?

The use of anti-inflammatory drugs during pregnancy and during the breastfeeding period should only be done with a medical prescription , as seen in the topic of contraindications.

And even when released, the restriction is much greater, due to the risks they can cause. For example, some substances can “pass” into breast milk or the baby, even during pregnancy.

Complications in the inappropriate use of anti-inflammatory drugs for pregnant women imply the risk of miscarriage.

For the fetus, cleft palate (cleft lip), abnormalities or heart failure, intracranial and gastrointestinal bleeding and kidney dysfunction, for example , may appear .

To help with inflammatory processes during this period, pregnant women may also choose to eat anti-inflammatory foods and teas, to strengthen the immune system.

It is worth mentioning that some herbs have abortion potential, so it is important to consult a doctor before ingestion.

In more severe cases, the doctor should advise on the use of medications, in the correct dose and for the number of days needed.

It is also important to be aware of which category of risk in pregnancy the medication belongs to – information contained in the package insert.

Read more: Can pregnant women take dipyrone? Does it harm the baby?

Drug and food interaction

NSAIDs can have interactions with some drugs, since their action is quite diverse, not only affecting the production of prostaglandin.

They can reduce the effectiveness of certain medications, such as those used to treat hypertension, as they can have a side effect of an increase in blood pressure due to changes in kidney functions.

It is precisely for this same reason that patients using lithium should be more attentive when taking anti-inflammatory drugs.

NSAIDs can reduce the elimination of this substance, as well as methotrexate, found in medicines like Metrexate.

In addition, NSAIDs can also interfere with the action of diuretics, as they cause a reduction in prostaglandins, present in the process of renal homeostasis.

Medicines like warfarin can also have some consequences. They have action in the body that prevents the formation of clots, which is beneficial for the prevention of diseases such as heart attacks and strokes.

However, NSAIDs also have anticoagulant action, especially non-selective ones.

Therefore, when used together with drugs with anticoagulant action such as warfarin, they can cause complications such as bleeding and bleeding.

It is always good to point out that, while you are using any NSAID, you should not drink alcohol , as the risk of irritation in the stomach increases.

Where to find?

You can find anti-inflammatory drugs in pharmacies throughout Brazil, some with affordable prices, others more expensive.

To get an idea of ​​how contrasting drug prices can be, a survey by the Institute of Technological Sciences and Industrial Quality (ICTQ), 2016, reveals that the variation in the price of a reference drug for a generic can reach 700% !

Therefore, the best thing to do is to talk to your doctor about the most suitable alternative for you and, to find the best option for your pocket, use a price comparator !

Complementary treatments

There are some complementary treatments to help fight inflammation. However, it is worth remembering that they do not replace the use of anti-inflammatory drugs. Check out:

Physiotherapy

Physical therapy is a great way to fight inflammation. However, it will only resolve inflammatory processes in defined regions, such as muscles, tendons, ligaments, nerves and bones.

In cases of tendonitis and muscle inflammation, the main cause is overuse of the muscle or tendon. There is an excess of fatigue in these regions, which causes an inflammatory process in the area.

In addition, inflammation can often be painful as it affects the nerves. And as the nerves extend in many directions, sometimes the inflamed region is not even the one that is really hurting.

Physiotherapy plays an important role in reducing these effects, as it can help to relieve tension on inflamed nerves and muscles and tendons.

However, it does not replace the use of anti-inflammatory drugs.

Natural anti-inflammatories

There are many foods with anti-inflammatory potential as well. They have this action due to the presence of substances such as omega 3, vitamin C and allicin.

In order to obtain this benefit, a variety of fish, cereals, fruits, spices, greens and vegetables should be adopted on the menu.

Maintaining an anti-inflammatory diet is important for disease prevention and treatment, as it contributes to the strengthening of the immune system.

In addition, these foods help to accelerate healing processes, in weight control and collaborate in the prevention of cardiovascular diseases, arthritis and other pathologies.

Check out some of the main natural alternatives that can help reduce the effects of chronic inflammation.

  • Fruits : grape, avocado, lemon, apple, pineapple, coconut, mango, cashew, açaí, guarana;
  • Seasonings: garlic, ginger, pepper, rosemary, turmeric, sage, oregano, cloves, cinnamon, bay leaves;
  • Vegetables and legumes : broccoli, red pepper, onion, tomato, pumpkin, beet, spinach, arugula, sweet potato, basil;
  • Cereals and legumes : lentils, peas, beans, oats, barley, rye, corn cereals, peanuts, rice (black, red and brown), soybeans;
  • Fish : tuna, sardines, salmon.

Anti-inflammatory teas

It is common for people to have a recipe to help fight inflammation, combining anti-inflammatory ingredients in a practical and easy-to-make drink, such as tea.

Thinking about the anti-inflammatory ingredients listed, we have separated the following tea options to help you fight and prevent inflammation:

  • Lemon and ginger tea;
  • Clove and ginger tea;
  • Fennel tea, mustard seed and cinnamon.

Foods that can increase inflammation in the body

There are beneficial foods in the fight against inflammation, but there are also those that contribute to this process in the body.

However, they should not necessarily be seen as villains, but as items to be consumed in moderation.

After all, healthy eating is based on balance and common sense.

To prevent inflammation it is important to consume a proportionally larger amount of anti-inflammatory foods and less of the items below:

  • Red meat: in excess, red meat can favor the development of cardiovascular diseases, by inducing in the liver the production of substances that cause inflammation in the arteries. Processed meats, such as sausage, bologna, salami and other sausages should also be avoided;
  • Trans fat: the consumption of this type of fat should not exceed 2g per day, so it is important to avoid sweets, meat broth, crackers, ice cream and industrialized breads;
  • Ready meals: breaded chicken, fish, nuggets, soups or any ready meal that has the presence of flavor enhancers, dyes, artificial flavors and preservatives;
  • Shall;
  • Excess alcohol;
  • Industrialized soft drinks and juices.

Anti-inflammatory for dogs

The ideal thing to do, when noticing your sick pet – be it a dog or another animal – is to take it to a veterinarian.

Just as we should seek a doctor for the best diagnosis, the same goes for pets.

The self-medication is a risk for us and also should not be a practice adopted for pets.

Giving the dog a non-prescription medication can end up further aggravating his health condition, not to mention the adverse effects.

This is because the organism of animals can be even more sensitive to drugs compared to humans, and the administration of wrong doses is quite dangerous.

In severe cases, especially in the case of older animals, the use of anti-inflammatory drugs inappropriately can cause the death of the pet.

Regarding medications, there is not a big difference between those prescribed for humans and for dogs, from a pharmacological point of view. What is different, most of the time, is the dosage.

That is why it is so important not to give your pet any medication without first consulting a professional.

Common questions

Do anti-inflammatory drugs hinder the injury recovery process?

This doubt arises precisely because of the modus operandi of anti-inflammatory drugs.

As stated earlier in the article, inflammation is a beneficial manifestation of the body.

It serves to let the body fight the cause of an infection or injury and to clean up any dead cells and “debris”.

That’s when the question arises: if inflammation is a beneficial process, wouldn’t interrupting it affect the body’s recovery?

The answer is: it depends .

Anti-inflammatory drugs have a very specific use. They should be used only if the inflammation is causing pain and discomfort and, preferably, under medical advice.

If used indiscriminately, they can end up masking symptoms of infections that need the use of antibiotics to be eliminated, for example.

Therefore, only use anti-inflammatory drugs when strictly necessary. And no self-medication.

The medical indication is extremely important for a healthy recovery and without major complications.

Can overuse of anti-inflammatories be bad for your health?

Of course yes! Like all medications, non-steroidal anti-inflammatory drugs also have beneficial and side effects that can be harmful to the body.

As we saw in the topic “Side effects”, the abusive use of these drugs can cause gastrointestinal problems, increased blood pressure, kidney damage, allergic reactions and even cause drug hepatitis!

So be very careful when taking anti-inflammatories.

Never use them without a prescription. Your body and your health will thank you!

Is it healthy to take anti-inflammatory drugs before exercising?

Definitely not! This is a habit that many amateur athletes cultivate to stop feeling pain and discomfort during physical exercise.

However, what needs to be clarified is that this pain is good! It is a sign of nature that something is happening and can be indicative of problems.

Wanting to get rid of it without knowing what started it can be very dangerous and make possible injuries worse!

It is also worth remembering that the abusive or unnecessary use of anti-inflammatory drugs can bring a series of gastrointestinal, cardiac and liver problems!

So, if you have this habit, leave this silliness aside, start paying more attention to the signs that your body gives you and don’t leave your health aside!

Is Ibuprofen anti-inflammatory?

-Yeah . Ibuprofen is an anti-inflammatory, but it also has antipyretic and analgesic action, so it helps in the temporary relief of headaches, fever, colds and flu, muscle pain, toothache and menstrual cramps.

Is Dorflex anti-inflammatory?

Not exactly . Dorflex is a muscle relaxant used to treat muscle contractures, including headache and tension.

However, in its composition, it presents dipyrone monohydrate, a type of anti-inflammatory. In addition, it contains orphenadrine citrate and anhydrous caffeine.

In general, Dorflex does not act on inflammations present in the body, it only works to relieve pain.

Read more: What is it and what is muscle relaxant for? (pharmacy and natural options)


Anti-inflammatory drugs are very effective remedies and the easy access to them should not be a reason for abuse.

This is because its indiscriminate use can have serious consequences. Before self-medicating, always consult a doctor.

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