Shop products for NSAIDs 
Also indexed as: Dalfon®, Diflunisal, Dolobid®, Fenoprofen, Meclofenamate, Meclomen®, Mefenamic Acid, Meloxicam, Mobic®, Non-Steroidal Anti-Inflammatory Analgesics, NSAIDs, Ponstel®, Tolectin®, Tolmetin
Nonsteroidal anti-inflammatory drugs (NSAIDs) are a family of medications used to treat rheumatoid arthritis, osteoarthritis, mild-to-moderate pain, menstrual cramps, bursitis, gout, and migraine headaches, as well as other conditions. Ophthalmic formulations of certain NSAIDs are used during or after eye surgery. NSAIDs are divided into two categories, based on their action within the body: COX-1 and COX-2 inhibitors.
Interactions involving oral NSAIDs in general are described on this page. For interactions involving specific NSAIDs, refer to the highlighted drugs listed below.
COX-1 Inhibitors
- Diclofenac (Voltaren®, Cataflam®)
- Diclofenac and misoprostol (Arthrotec®)
- Diflunisal (Dolobid®)
- Etodolac (Lodine®)
- Fenoprofen (Dalfon®)
- Flurbiprofen (Ansaid®)
- Ibuprofen (Motrin® and others)
- Indomethacin (Indocin®)
- Ketoprofen (Orudis®, Oruvail®)
- Ketorolac (Toradol®)
- Meclofenamate (Meclomen®)
- Mefenamic acid (Ponstel®)
- Meloxicam (Mobic®)
- Nabumetone (Relafen®)
- Naproxen (Anaprox®, Naprosyn®)
- Oxaprozin (Daypro®)
- Piroxicam (Feldene®)
- Salsalate (Disalcid®, Salflex®)
- Sulindac (Clinoril®)
- Tolmetin (Tolectin®)
COX-2 Inhibitors
- Celecoxib (Celebrex®)
- Valdecoxib (Bextra®)
Summary of
Interactions with Vitamins, Herbs, and Foods
In some cases, an herb or supplement may appear in more than one category, which may seem
contradictory. For clarification, read the full article for details about the summarized
interactions.
 Avoid: Adverse interaction—Avoid these supplements
when taking this medication because taking them together may cause undesirable or dangerous
results. |
Lithium White willow |
| Depletion or interference |
None known |
| Side effect reduction/prevention |
None known |
| Supportive interaction |
None known |
| Reduced drug absorption/bioavailability |
None known |
| Interactions common to many, if not all, NSAIDs are described in this article. Interactions reported for only one or several drugs in this class may not be listed in this article. Some drugs listed in this article are linked to articles specific to that respective drug; please refer to those individual drug articles. The information in this article may not necessarily apply to drugs in this class for which no separate article exists. If you are taking an NSAID for which no separate article exists, talk with your doctor or pharmacist. | |
An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.
Interactions with Dietary Supplements
Lithium
Lithium is a mineral that may be present in some supplements and is also used in large amounts
to treat mood disorders such as manic-depression (bipolar disorder). Most NSAIDs inhibit the excretion of
lithium from the body, resulting in higher blood levels of the mineral, though sulindac may have an opposite effect.1 Since major
changes in lithium blood levels can produce unwanted side effects or interfere with its
efficacy, NSAIDs should be used with caution, and only under medical supervision, in people
taking lithium supplements.
Interactions with Herbs
White willow bark
(Salix alba)
White willow bark contains salicin, which is related to
aspirin. Both salicin and aspirin produce anti-inflammatory effects after they have been
converted to salicylic acid in the body. The administration of salicylates like aspirin to
individuals taking oral NSAIDs may result in reduced blood levels of NSAIDs.2
Though no studies have investigated interactions between white willow bark and NSAIDs, people
taking NSAIDs should avoid the herb until more information is available.
References
1. Olin BR, ed. Central Nervous System Drugs, Analgesics and Anti-inflammatory Drugs, Nonsteroidal Anti-inflammatory Agents, In Drug Facts and Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1172–90.
2. Olin BR, ed. Central Nervous System Drugs, Analgesics and Anti-inflammatory Drugs, Nonsteroidal Anti-inflammatory Agents, In Drug Facts and Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1172–90.
