Reviewed by: HU Medical Review Board | Last reviewed: June 2023

Nonsteroidal anti-inflammatory drugs (NSAIDs) are taken by 80 percent of people with lupus to relieve joint pain, headaches, fever, and chest pain.1

How do NSAIDs work?

NSAIDs reduce the inflammation caused by lupus, which in turn reduces pain and helps make joints and muscles less stiff or sore.1-4

NSAIDs prevent your body from making some of the chemicals that lead to inflammation. They stop the enzyme cyclooxygenase (COX) from making certain chemicals, including prostaglandins. Prostaglandins cause inflammation, pain, and swelling when you are injured or sick. Prostaglandins are controlled by proteins (enzymes) known as COX-1 and COX-2.2-4

Most NSAIDs stop your body from making prostaglandins by blocking the COX-1 and COX-2 enzymes. Some newer NSAIDs block only COX-2, such as celecoxib (Celebrex), which is called a Cox-2 inhibitor.2-4


There are many types and brands of NSAIDs. In the United States, more than 20 different NSAIDs are approved by the US Food and Drug Administration (FDA). Some NSAIDs are widely available over the counter (OTC) at drugstore pharmacies. Others are available only with a prescription from a doctor.3

OTC NSAIDs include:3,5

  • Aspirin (Bayer)
  • Ibuprofen (Motril, Advil)
  • Naproxen (Aleve)

Prescription NSAIDs include:3,5

  • Celecoxib (Celebrex®)
  • Diclofenac (Voltaren)
  • Diflunisal
  • Etodolac (Lodine)
  • Fenoprofen (Fenortho™, Nalfon®)
  • Flurbiprofen (Ansaid®)
  • Indomethacin (Indocin®)
  • Ketoprofen (Orudis®)
  • Ketorolac (Toradol®)
  • Mefenamic acid
  • Meloxicam (Mobic)
  • Nabumetone (Relafen®)
  • Oxaprozin (Daypro®)
  • Piroxicam (Feldene®)
  • Sulindac (Clinoril®)
  • Tolmetin (Tolectin®)

What are the possible side effects?

Side effects can vary depending on the specific drug you are taking. They also depend on how much you take and how often you take the drug. Some side effects are similar to symptoms of a lupus flare.

Common side effects of NSAIDs include:4,5

  • Stomach upset
  • Nausea
  • Vomiting
  • Heartburn
  • Bloating

NSAIDs can cause serious side effects in some people. Again, this is based on the type and amount of drug taken. Serious side effects may include:3-5

  • Stomach ulcers and bleeding
  • Kidney problems
  • Increased risk of heart and blood vessel disease
  • Allergic reactions

Call your doctor right away if you have any of the following:5

  • Black or bloody stools
  • Cloudy or bloody urine
  • Problems urinating
  • Yellowing of the skin, eyes, or mucus membranes
  • Severe belly pain
  • Unexplained weight gain
  • Blurry vision
  • Puffiness or swelling in the body
  • Problems breathing
  • Chest pain or feeling of heart “fluttering”
  • Flu-like symptoms

NSAIDs have a boxed warning, the strictest warning from the FDA. They have this warning because they increase your risk of heart attack, stroke, and serious gastrointestinal (GI) problems.6

These are not all the possible side effects of NSAIDs. Talk to your doctor about what to expect when taking NSAIDs. You also should call your doctor if you have any changes that concern you when taking NSAIDs.

Other things to know

Remember to always follow your doctor’s advice. Do not take more than the recommended dose for any drug. This will help you avoid potential side effects and complications. Taking NSAIDs with milk or food also may reduce stomach upset.5

If you are pregnant, you should not take NSAIDs after 20 weeks. Talk to your doctor about the risks versus the benefits of taking these drugs while you are pregnant or breastfeeding.4

NSAIDs can interact with other drugs. Before beginning treatment for lupus, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes OTC drugs.5

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