Are prescription NSAIDs better?NSAIDs are available both over-the-counter and as a prescription. It is very important to understand that while there are differences between prescription and non-prescription NSAIDs, these differences are not the strength or potential relief of symptoms. Many patients find their best response from over-the-counter NSAIDs.
There has been no study showing that newer NSAIDs (the so-called COX-2 inhibitors), prescription NSAIDs, or more expensive NSAIDs treat pain or swelling any better than more traditional NSAID medications. Most of the research evaluating the effects of NSAIDs has been done using over-the-counter ibuprofen.
Why take different NSAIDs if one is not 'better'?Often patients will experience a different response to different medications. This could be why some medications have helped your symptoms while others do not have a significant effect. This is not unusual, and it is difficult to predict which medications will most benefit a given individual. The best way to determine which NSAID is best for you is to try different options. Often a physician will recommend one NSAID, and if adequate relief of symptoms is not obtained within several weeks of treatment, another NSAID can be tried.
One of the best reasons to consider some of the newer, prescription medications, such as Celebrex, is that these may be taken as once-a-day doses rather than three or four times daily. In addition the COX-2 inhibitors are thought to have fewer side-effects on the stomach. Because of the possible decreased risk of stomach problems, may doctors will recommend the COX-2 inhibitors for patients who may have risk factors for bleeding or stomach ulcers.
Berger, RG "Nonsteroidal Anti-inflammatory Drugs: Making the Right Choices" J. Am. Acad. Ortho. Surg., Oct 1994; 2: 255 - 260.