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NSAIDs: Summary of Recommendations
The nonsteroidal anti-inflammatory drugs (NSAIDs) are the most frequently used medicines to treat osteoarthritis—the most common form of arthritis—and mild to moderate pain. They cost from about $4 to more than $1,500 a month. This report shows how you could save hundreds of dollars a month or more.

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. NSAIDs should be used with caution. All increase the risk of serious side effects, including stomach ulcers, gastrointestinal bleeding, kidney failure, heart attacks, and strokes. Except for low-dose aspirin and naproxen, NSAIDs might 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 NSAIDs as Consumer Reports Best Buy Drugs:
  • Naproxen - generic prescription and over-the-counter
  • Ibuprofen - generic prescription and over-the-counter

These are inexpensive medicines that are as effective as other NSAIDs when used in comparable doses. Naproxen may be a better choice for people who have higher risk of heart attacks or strokes, since the available evidence indicates it does not increase the risk of these conditions.

If you are at increased risk of bleeding due to older age, use of aspirin or other blood thinners, or a history of prior bleeding or ulcers, talk to your doctor before starting an NSAID. Celecoxib (Celebrex) may be an alternative in some situations, or taking an acid blocker to help protect the stomach. Celecoxib is no more effective at relieving pain than ibuprofen or naproxen, but is more expensive, so it is not a top choice for most people.

NSAIDs applied to the skin (topical) can be as effective as NSAID tablets or capsules for localized arthritis pain, but it is not yet clear if they cause fewer, serious side effects than oral NSAIDs. Also, they are more expensive. Our advice:
  • If you have had a stomach ulcer or bleeding, or are at high risk of either, talk with your doctor about the potential risks of taking NSAIDs and treatment alternatives. The risk of bleeding from NSAID use increases with age.
  • If you have heart disease or are at risk of a heart attack or stroke, talk with your doctor about the potential risks of taking any NSAID.
  • If you have kidney disease or high blood pressure, talk with your doctor about the risks of taking NSAIDs for long periods of time.
  • Take the lowest dose of an NSAID that brings relief and do not take any longer than necessary.
  • NSAIDs can interact with other medicines, including other NSAIDs, such as aspirin, and increase the risk of serious side effects. If your doctor prescribes an NSAID, tell him or her about any other medicines or dietary supplements you are taking, including daily aspirin to reduce your risk of heart attack or stroke.
NSAIDs Cost Comparison
Note: If the price box contains a , that indicates the dose of that drug may be available for a low monthly cost through programs offered by large chain stores. For example, Kroger, Sam's Club, Target, and Walmart offer a month's supply of selected generic drugs for $4 or a three-month supply for $10. Other chain stores, such as Costco, CVS, Kmart, and Walgreens, offer similar programs. Some programs have restrictions or membership fees, so check the details carefully for restrictions and to make sure your drug is covered.
Generic Name and Dose Brand Name(s)A Drug is a Generic? Frequency of Dose (per Day)B Average Cost for Month's SupplyC Compare Prices
  Celecoxib 100 mg capsule Celebrex No Two $219
  Celecoxib 200 mg capsule Celebrex No One $181
  Celecoxib 400 mg capsule Celebrex No One $282
  Diclofenac 25 mg capsule Zipsor No Four $412
  Diclofenac 50 mg tablet Generic Yes Three $46
  Diclofenac 25 mg delayed-release tablet Generic Yes Three $110
  Diclofenac 50 mg delayed-release tablet Generic Yes Three $109
  Diclofenac 75 mg delayed-release tablet Generic Yes Two $100
  Diclofenac 100 mg extended-release tablet Generic Yes Two $24
  Diclofenac 1% topical gel Voltaren gel No Maximum dose of 32 grams per day $196
  Diclofenac 1.3% topical patch Flector patch No Two patches $478 per area
  Diclofenac 1.5% topical solution Pennsaid solution No 40 drops per knee, four times per day $220 per area
  Diflunisal 500 mg tablet Generic Yes Two $96
  Etodolac 200 mg tablet Generic Yes Three $82
  Etodolac 300 mg tablet Generic Yes Two $92
  Etodolac 400 mg capsule Generic Yes Two $82
  Etodolac 500 mg capsule Generic Yes Two $81
  Etodolac 400 mg extended-release tablet Generic Yes One $41
  Etodolac 500 mg extended-release tablet Generic Yes One $44
  Etodolac 600 mg extended-release tablet Generic Yes One $81
  Fenoprofen 400 mg capsule Nalfon No Three $250
  Fenoprofen 600 mg tablet Generic Yes Three $169
  Flurbiprofen 50 mg tablet Generic Yes Three $65
  Flurbiprofen 100 mg tablet Generic Yes Two $91
  Ibuprofen 200 mg tablet AdvilD OTCE Six $18
  Ibuprofen 200 mg tablet MotrinD OTCE Six $21
Ibuprofen 200 mg tablet GenericD OTCE Six $11
  Ibuprofen 200 mg liquid-filled capsule Advil LiquigelD OTCE Six $31
  Ibuprofen 200 mg liquid-filled capsule GenericD OTCE Six $24
Ibuprofen 400 mg tablet Generic Yes Four $15
Ibuprofen 600 mg tablet Generic Yes Four $19
Ibuprofen 800 mg tablet Generic Yes Three $18
  Indomethacin 25 mg capsule Generic Yes Three $21
  Indomethacin 50 mg capsule Generic Yes Two $35
  Indomethacin 75 mg extended-release capsule Generic Yes One $88
  Ketoprofen 50 mg capsule Generic Yes Three $119
  Ketoprofen 75 mg capsule Generic Yes Three $128
  Ketoprofen 200 mg extended-release capsule Generic Yes One $211
  Meclofenamate 100 mg capsule Generic Yes Three $608
  Mefenamic acid 250 mg capsule Generic Yes Four $1,588
  Meloxicam 7.5 mg tablet Mobic No One $187
  Meloxicam 7.5 mg tablet Generic Yes One $95
  Meloxicam 15 mg tablet Mobic No One $288
  Meloxicam 15 mg tablet Generic Yes One $147
  Nabumetone 500 mg tablet Generic Yes Two $35
  Nabumetone 750 mg tablet Generic Yes Two $42
  Naproxen 220 mg tablet AleveD OTCE Three $13
Naproxen 220 mg tablet GenericD OTCE Three $10
Naproxen 250 mg tablet Generic Yes Two $45
Naproxen 275 mg tablet Generic Yes Two $52
Naproxen 375 mg tablet Generic Yes Two $61
Naproxen 500 mg tablet Generic Yes Two $70
Naproxen 375 mg delayed-release tablet Generic Yes One $59
Naproxen 500 mg delayed-release tablet Generic Yes Two $71
Naproxen 550 mg tablet Generic Yes Two $39
  Naproxen 375 mg extended-release tablet Naprelan No One $310
  Naproxen 500 mg extended-release tablet Naprelan No One $308
  Naproxen 750 mg extended-release tablet Naprelan No One $307
  Oxaprozin 600 mg tablet Generic Yes Two $104
  Piroxicam 10 mg capsule Generic Yes One $71
  Piroxicam 20 mg capsule Generic Yes One $126
  Salsalate 500 mg tablet Generic Yes Six $135
  Salsalate 750 mg tablet Generic Yes Four $118
  Sulindac 150 mg tablet Generic Yes Two $52
  Sulindac 200 mg tablet Generic Yes Two $65
A. "Generic" means this is a generic drug, as noted in column three as well.

B. As commonly recommended or prescribed. Many NSAIDs must be taken multiple times per day. Convenience of dosing might 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.

C. Monthly cost reflects national average retail prices for March 2013, rounded to the nearest dollar. Data provided by Source Healthcare Analytics, Inc., which is not involved in our analysis or recommendations.

D. This is a nonprescription medicine. Generic versions or store brand might be less expensive. Prices for these medications were obtained by Consumer Reports secret shoppers from five major chain pharmacies (CVS, Rite Aid, Target, Walgreens, and Walmart) and local supermarkets across the U.S. in January 2013. The prices from the various stores were averaged to yield per-pill prices, which were then converted into a monthly price based on the maximum recommended number of pills per day.

E. OTC stands for over-the-counter, meaning it is a nonprescription drug.