NSAID Side Effects: What You Need to Know Before Taking Them

When you reach for NSAIDs, nonsteroidal anti-inflammatory drugs used to reduce pain, fever, and inflammation. Also known as nonsteroidal anti-inflammatories, these are among the most common medications people take daily — from ibuprofen for a headache to naproxen for arthritis pain. But just because they’re sold over the counter doesn’t mean they’re harmless. Many people don’t realize how deeply these drugs affect their body beyond just numbing the pain.

NSAIDs work by blocking enzymes called COX-1 and COX-2, which help make prostaglandins — chemicals that cause pain and swelling. But prostaglandins also protect your stomach lining and help your kidneys function. When you shut them down long-term, you’re not just stopping pain — you’re risking stomach ulcers, kidney damage, or even heart problems. Studies show that regular NSAID users have a 20–30% higher risk of gastrointestinal bleeding, especially if they’re over 60 or take blood thinners. And it’s not just older adults: young people popping ibuprofen after every workout are quietly putting stress on their kidneys and gut.

Not all NSAIDs are the same. ibuprofen, a short-acting NSAID often used for headaches or menstrual cramps clears out of your system fast, so it’s less likely to build up — but you have to take it every 4–6 hours. naproxen, a longer-acting option commonly used for chronic pain like osteoarthritis only needs to be taken twice a day, but stays in your body longer, increasing the chance of side effects. Then there’s aspirin — technically an NSAID — which can thin your blood and help prevent heart attacks, but also raises bleeding risk. The real issue? Most people don’t track how much they’re taking. Two Advil here, a Aleve there, and a back pain patch with NSAID — it adds up fast.

Some side effects are obvious: upset stomach, heartburn, dizziness. Others? Silent. High blood pressure that won’t budge. Swelling in your ankles. Urinating less than usual. These aren’t just "bad days" — they could be your kidneys signaling trouble. If you’re on NSAIDs for more than a few weeks, get your kidney function checked. Talk to your doctor if you’re also taking blood pressure meds, diuretics, or SSRIs — interactions can sneak up on you.

There’s no one-size-fits-all answer. For some, the pain relief is worth the risk. For others, a simple stretch, ice pack, or physical therapy might do more than a pill. The goal isn’t to scare you off NSAIDs — it’s to make sure you’re using them with your eyes open. Below, you’ll find real comparisons between NSAIDs and other pain treatments, breakdowns of side effects in different groups, and what to do if you’ve been taking them too long. No fluff. Just what works, what doesn’t, and what your body really needs.