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Summary 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.
Sulindac is a non-steroidal anti-inflammatory drug of the arylalkanoic acid class that is marketed in the U.S. by Merck as Clinoril. Like other NSAIDs, it is useful in the treatment of acute or chronic inflammatory conditions. Its usual dosage is 150-200 milligrams twice per day, with food. It should not be used by persons with major allergic reactions (urticaria or anaphylaxis) to aspirin or other NSAIDs, and should be used with caution by persons having pre-existing peptic ulcer disease. Sulindac seems to have a property, independent of COX-inhibition, in reducing the growth of polyps and precancerous lesions in the colon, especially in association with familial adenomatous polyposis. Sulindac is an effective tocolytic and may be used in the treatment of preterm labor. According to the Cautions distributed with this prescription drug from Walgreens, this medicine has been shown to cause harm to the human fetus. In common with other NSAIDs, sulindac is currently being investigated for its role in the treatment of Alzheimer's disease.
Source: Marketdata Enterprises, Inc., Chronic Pain Management Programs: A Market Analysis, Wikipedia, various other sources
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