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Class Explorer · Pain & inflammation

NSAIDs

COX inhibition: prostaglandin-dependent pain and inflammation fall, and so do the prostaglandin-dependent defenses (gastric mucosa, renal perfusion, platelets).

Members

Also in this class: Naproxen (longer, least CV signal) · Diclofenac (most CV signal, topical form) · Celecoxib (COX-2 selective, GI-sparing) · Ketorolac (potent, short-course only). Full pages arrive as the library grows.

Compare the members

Ibuprofen
GI risk
Moderate
CV risk
Low-moderate
Note
OTC default

Shared across the class

Indications
Pain, fever, inflammation
Adverse effects
GI ulceration/bleeding · Hemodynamic AKI · BP elevation and fluid retention · CV thrombotic risk (varies)
Contraindications
Active GI bleed · Third-trimester pregnancy · Severe HF · Post-CABG
Monitoring
BP with regular use · Renal function in the at-risk · GI symptoms

What makes each agent different

  • GI risk falls with COX-2 selectivity (celecoxib); CV risk rises with it (and with diclofenac); naproxen sits kindest on the heart.
  • Topical NSAIDs deliver local benefit at a fraction of systemic exposure.

There is no 'safe NSAID', only a best-matched one at the lowest dose for the shortest time.

Last reviewed 2026-08-15 · Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed.