NSAIDs are most effective for mild to moderate pain accompanied by swelling and inflammation. These drugs relieve pain by inhibiting an enzyme in your body called cyclooxygenase. This enzyme makes hormone-like substances called prostaglandins, which are involved in the development of pain and inflammation. NSAIDs are especially helpful for arthritis and pain resulting from muscle sprains, strains, back and neck injuries or cramps.

When taken as directed, NSAIDs are generally safe. But if more than the recommended dosage is taken — and sometimes even the recommended dosage — NSAIDs may cause nausea, stomach pain, stomach bleeding or ulcers. Large doses of NSAIDs can lead to kidney problems and fluid retention. Risk increases with age. If you regularly take NSAIDs, talk to your doctor so that he or she can monitor you for side effects.

NSAIDs have a so-called ceiling effect, or limit to how much pain they can control. This means that beyond a certain dosage, they don't provide additional benefit. If someone has moderate to severe pain, exceeding the dosage limit may not help relieve the pain.

Many NSAIDs require a prescription, but some lower-dose NSAIDs, such as aspirin and ibuprofen, are available over-the-counter.

Etodolac (Lodine)

Etodolac is used for the treatment of inflammation and pain caused by osteoarthritis and rheumatoid arthritis as well as soft tissue injuries, such as tendinitis and bursitis. Etodolac is also used for rapid relief of mild to moderate pain, such as with menstrual cramps. It should be taken with food.

As for side effects, Etodolac should be avoided by patients with a history of asthma attacks, hives, or other allergic reactions to aspirin or other NSAIDs. Rare but severe allergic reactions have been reported in such individuals. It also should be avoided by patients with peptic ulcer disease or poor kidney function, since this medication can aggravate both conditions. Etodolac is generally used with caution in patients taking blood thinning medications (anticoagulants), such as warfarin (Coumadin), because of increased risk of bleeding.

The majority of patients benefit from etodolac and other NSAIDs with few side effects. However, serious side effects can occur, and generally tend to be dose related. Therefore, it is desirable to use the lowest effective dose to minimize side effects. The most common side effects of etodolac involve the gastrointestinal system. It can cause ulcerations, abdominal burning, pain, cramping, nausea, gastritis, and even serious gastrointestinal bleeding and liver toxicity. Sometimes, stomach ulceration and bleeding can occur without any abdominal pain. Black tarry stools, weakness, and dizziness upon standing may be the only signs of internal bleeding. Rash, kidney impairment, ringing in the ears, and lightheadedness can also occur.