The nonsteroidal anti–inflammatory drugs (NSAIDs) are used to treat mild and moderate pain due to certain conditions, including osteoarthritis, headaches and migraines, menstrual periods and muscle soreness. With 70 million prescriptions each year in the U.S., NSAIDs are one of the most commonly used types of medications.

Our report focuses primarily on osteoarthritis, which affects about 27 million Americans, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. It's more common in older people, with up to nearly a third of adults age 65 and older suffering from the condition.

A good way to treat osteoarthritis, if medication is needed, is with an NSAID. These drugs block the production of substances in the body called prostaglandins, which play a role in pain, inflammation, fever, and muscle cramps and aches. At low doses, NSAIDs work essentially as pain relievers. At higher doses, though, they can actually reduce the body’s inflammatory response to tissue damage as well as relieve pain.

Most oral forms of NSAIDs are now available as less expensive generic drugs. And three are available, in lower-dose formulations, as nonprescription over–the–counter drugs: acetylated salicylates (Aspirin, Bayer, Bufferin, and generic), ibuprofen (Advil, Motrin, and generic), and naproxen (Aleve and generic). Their costs vary from about $4 to more than $300 a month. This report shows how you could save $135 a month ($1,640 a year) or more if you need to take an NSAID. Since individual needs vary, use the information in this report to talk with your doctor about the medicine and dose that is right for you, and the possible risks.

All NSAIDs should be used with caution: they can cause serious side effects, including stomach ulcers, gastrointestinal bleeding, heart attack, and stroke. NSAIDs (except low–dose aspirin) may not be appropriate for people at risk of heart disease or stroke. Don’t take them for long periods of time without consulting a doctor.   Taking effectiveness, safety and cost into account, we have chosen two generic NSAIDs as Consumer Reports Health Best Buy Drugs:

• Ibuprofen – (generic only) prescription and over-the-counter
• Naproxen – (Aleve and generic) prescription and over-the-counter

These medicines are inexpensive and are as effective and safe as other NSAIDs when used appropriately. Our advice:

• If you have had a stomach ulcer or bleeding, or are at high risk of either, avoid using NSAIDs. The risk of bleeding from NSAID use increases with age.
• If you have heart disease or are at risk of heart attack or stroke, talk with your doctor about the potential risks of taking any NSAID regularly for long periods.
• Take the lowest dose of an NSAID that brings relief and do not take any longer than necessary.
• If you have kidney disease or high blood pressure, talk with your doctor about the risks of taking NSAIDs for long periods of time.
• NSAIDs can interact with other medicines to cause serious side effects. If your doctor prescribes an NSAID, tell him or her about any other medicines or dietary supplements you are taking.