NSAIDs: Summary of affordable alternatives
The non-steroidal anti–inflammatory drugs (NSAIDs) are the most frequently used medicines to treat osteoarthritis and mild to moderate pain. Their costs vary from about $25 to about $280 a month.
This class of drugs has been at the center of a two–year controversy. Two NSAIDs – Vioxx and Bextra – have been removed from the market in the last year. The Food and Drug Administration (FDA) in April 2005 issued an important warning about the use and safety of all NSAIDs. This updated Consumer Reports Best Buy Drugs report incorporates the FDA’s findings and warnings.
It adds our own guidance as well, and the latest cost information – showing how you could save $180 a month ($2160 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. All can have dangerous side effects, especially stomach ulcers and gastrointestinal bleeding. The FDA has warned that prolonged use at high doses of any NSAID may raise the risk of heart attack or stroke. NSAIDs (except low–dose aspirin) may not be appropriate for people already 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 three generic NSAIDs as Consumer Reports Best Buy Drugs:
- Ibuprofen – costing an average $26 to $30 per month.
- Naproxen – costing an average $44 to $50 per month
- Salsalate – costing an average $26 to $35 per month
These medicines are less expensive than other NSAIDs and are as effective and safe as any of them 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, for the shortest period.
- NSAIDs can interact with other medicines to cause serious side effects. If your doctor prescribes an NSAID, tell him or her about any other medicine or dietary supplement you are taking.
NSAIDs: Cost Comparison and Best Buy Drugs
Download- Full Report (332k PDF)
- 2-Page summary (212k PDF)
| Recommendations: NSAIDs | ||||||
| CR Best Buy | Generic Name and Dose | Brand Name1 | Drug Is a Generic | Frequency of Dose (per Day)2 | Average Cost for Month's Supply3 | Compare Prices |
| Celecoxib 100mg | Celebrex | No | Two | $148 |  |
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| Celecoxib 200mg | Celebrex | No | Two | $242 | |
|
| Diclofenac 50mg | Voltaren, Cataflam | No | Three | $213 | |
|
| Diclofenac 50mg | Generic | Yes | Three | $65 | |
|
| Diclofenac Long-Acting 100mg | Voltaren-XR | No | One | $176 | |
|
| Diclofenac Long-Acting 100mg | Generic | Yes | One | $71 | |
|
| Diflunisal 500mg | Dolobid | No | Two | $94 | |
|
| Diflunisal 500mg | Generic | Yes | Two | $77 | |
|
| Diflunisal 250mg | Dolobid | No | Two | $70 | |
|
| Diflunisal 250mg | Generic | Yes | Two | $40 | |
|
| Etodolac 200mg | Lodine | No | Three | $158 | |
|
| Etodolac 200mg | Generic | Yes | Three | $97 | |
|
| Etodolac 400mg | Lodine | No | Three | $182 | |
|
| Etodolac 400mg | Generic | Yes | Three | $90 | |
|
| Etodolac Sustained Release 600mg | Lodine XL | No | One | $1094 | |
|
| Etodolac Sustained Release 600mg | Generic | Yes | One | $794 | |
|
| Fenoprofen 300mg | Nalfon | No | Three | $80 | |
|
| Fenoprofen 600mg | Generic | Yes | Three | $43 | |
|
| Flurbiprofen 100mg | Ansaid | No | Three | $283 | |
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| Flurbiprofen 100mg | Generic | Yes | Three | $64 | |
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| Ibuprofen 400mg | Motrin | No | Three | $36 | |
|
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Ibuprofen 400mg | Generic | Yes | Three | $28 | |
| Ibuprofen 200mg | Advil5 | OTC6 | Six | $3 - $205 | |
|
| Ibuprofen 200mg | Advil5 | OTC | Twelve | $6 - $405 | |
|
| Ibuprofen 600mg | Motrin | No | Three | $48 | |
|
| Ibuprofen 600mg | Ibu | Yes | Three | $18 | |
|
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Ibuprofen 600mg | Generic | Yes | Three | $31 | |
| Ibuprofen 800mg | Motrin | No | Three | $58 | |
|
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Ibuprofen 800mg | Generic | Yes | Three | $31 | |
| Indomethacin 25mg | Indocin | No | Three | $63 | |
|
| Indomethacin 25mg | Generic | Yes | Three | $32 | |
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| Indomethacin 50mg | Indocin | No | Three | $105 | |
|
| Indomethacin 50mg | Generic | Yes | Three | $46 | |
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| Indomethacin 75mg Sustained Release | Indocin SR | No | Two | $146 | |
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| Indomethacin 75mg Sustained Release | Generic | Yes | Two | $111 | |
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| Ketoprofen 75mg | Orudis | No | Two | $91 | |
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| Ketoprofen 75mg | Generic | Yes | Two | $50 | |
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| Ketoprofen 12.5mg | Orudis KT5 | OTC | Six | $5 - $255 | |
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| Ketoprofen 12.5mg | Orudis KT5 | OTC | Twelve | $10 - $505 | |
|
| Meclofenamate 100mg | Generic | Yes | Three | $295 | |
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| Meloxicam 7.5mg | Mobic | No | One | $123 | |
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| Meloxicam 7.5mg | Generic | Yes | One | $82 | |
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| Meloxicam 15mg | Mobic | No | One | $184 | |
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| Meloxicam 15mg | Generic | Yes | One | $123 | |
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| Nabumetone 500mg | Relafin | No | Two | $146 | |
|
| Nabumetone 500mg | Generic | Yes | Two | $71 | |
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| Nabumetone 750mg | Relafin | No | Two | $186 | |
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| Nabumetone 750mg | Generic | Yes | Two | $85 | |
|
| Naproxen 375mg | Naprosyn | No | Three | $154 | |
|
|
Naproxen 375mg | Generic | Yes | Three | $44 | |
| Naproxen 500mg | Naprosyn | No | Three | $189 | |
|
|
Naproxen 500mg | Generic | Yes | Three | $51 | |
| Naproxen 220mg | Aleve5 | OTC | Six | $9 - $305 | |
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| Naproxen 220mg | Aleve5 | OTC | Twelve | $18 - $605 | |
|
| Oxaprozin 600mg | Daypro | No | One | $88 | |
|
| Oxaprozin 600mg | Generic | Yes | One | $30 | |
|
| Oxaprozin 600mg | Daypro | No | Three | $264 | |
|
| Oxaprozin 600mg | Generic | Yes | Three | $91 | |
|
| Piroxicam 20mg | Feldene | No | One | $120 | |
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| Piroxicam 20mg | Generic | Yes | One | $32 | |
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| Salsalate 750mg | Disalcid | No | Three | $744 | |
|
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Salsalate 750mg | Generic | Yes | Three | $30 | |
|
Salsalate 750mg | Generic | Yes | Four | $40 | |
| Sulindac 150mg | Clinoril | No | Two | $72 | |
|
| Sulindac 150mg | Generic | Yes | Two | $38 | |
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| Sulindac 200mg | Clinoril | No | Two | $103 | |
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| Sulindac 200mg | Generic | Yes | Two | $41 | |
|
| Tolmetin 200mg | Generic | Yes | Three | $79 | |
|
| Tolmetin 400mg | Tolectin DS | No | Three | $1484 | |
|
| Tolmetin 400mg | Generic | Yes | Three | $119 | |
|
(1) "Generic" means this is a generic drug, as underscored in column three.
(2) As commonly recommended or prescribed. Many NSAIDs must be taken multiple times per day. Convenience of dosing may be a factor for some patients. If switching from one NSAID to another, talk with your doctor about equivalency of dosing between the different NSAIDs. They come in a wide variety of recommended doses.
(3) Monthly cost reflects national average retail prices for September 2006, rounded to the nearest dollar. Information derived by Consumer Reports Best Buy Drugs from data provided by Wolters Kluwer Health, Pharmaceutical Audit Suite.
(4) Unable to obtain an updated price, Sept. 2006. This is price as of April 2006.
(5) This is a nonprescription medicine. These drugs are available as brands such as Advil and Aleve, but also as generics or store-branded versions. The prices vary widely. The ranges we present here are based on a sampling of prices from two well-known online pharmacies and several pharmacy chain stores in the Washington DC area and Maryland, for various sized bottles (24 pills, 50 pills, 200 pills, and up to 700 pills. Prices may vary in your area. Be aware that generic and store brand versions are often 30% to 60% less expensive. You can also save substantial amounts of money – 250% or more – by buying larger bottles containing 200 pills or more compared to small bottles.
(6) OTC stands for over-the-counter, meaning it is a nonprescription drug.
(2) As commonly recommended or prescribed. Many NSAIDs must be taken multiple times per day. Convenience of dosing may be a factor for some patients. If switching from one NSAID to another, talk with your doctor about equivalency of dosing between the different NSAIDs. They come in a wide variety of recommended doses.
(3) Monthly cost reflects national average retail prices for September 2006, rounded to the nearest dollar. Information derived by Consumer Reports Best Buy Drugs from data provided by Wolters Kluwer Health, Pharmaceutical Audit Suite.
(4) Unable to obtain an updated price, Sept. 2006. This is price as of April 2006.
(5) This is a nonprescription medicine. These drugs are available as brands such as Advil and Aleve, but also as generics or store-branded versions. The prices vary widely. The ranges we present here are based on a sampling of prices from two well-known online pharmacies and several pharmacy chain stores in the Washington DC area and Maryland, for various sized bottles (24 pills, 50 pills, 200 pills, and up to 700 pills. Prices may vary in your area. Be aware that generic and store brand versions are often 30% to 60% less expensive. You can also save substantial amounts of money – 250% or more – by buying larger bottles containing 200 pills or more compared to small bottles.
(6) OTC stands for over-the-counter, meaning it is a nonprescription drug.
