If you have arthritis, chances are you're taking some type of pain reliever. For many people, nonsteroidal anti-inflammatory drugs, or NSAIDs, are the first choice. Several familiar over-the-counter (OTC) medicines are NSAIDs, including the old standby—aspirin. Motrin and Advil (ibuprofen), as well as Aleve (naproxen sodium) also fall into this class of drugs. If you need something stronger or have certain health problems, your doctor may suggest a prescription-strength NSAID. Prescription NSAIDs include Ansaid (flurbiprofen), Celebrex (celecoxib), Clinoril (sulindac), Daypro (oxaprozin), Feldene (piroxicam), Indocin (indomethacin), Mobic (meloxicam), Naprosyn (naproxen), and Voltaren (diclofenate), as well as several others. Some prescription NSAIDs have more than one brand name. Risks Include Stomach Bleeding, Ulcers Prescription NSAIDs come with a medication guide to let you know about possible risks, side effects, and when to get emergency care. OTC products must be clearly labeled as an NSAID and carry a warning about known risks and side effects. The longer you take one of these drugs, the more likely you are to experience side effects. That's one reason you need to talk with your doctor before using any NSAID longer than 10 days. Prescription and OTC NSAIDs can cause stomach irritation that may result in bleeding, ulcers, or perforation of the stomach or intestines. As many as 25 percent of frequent NSAID users develop ulcers. While these problems can occur at any time during treatment, they're more likely to occur the longer you take the drugs. Risk is also higher in people: Older than 60 Taking blood-thinning medicines or steroid drugs like cortisone In poor health Who smoke or drink alcohol Who have previously had ulcers, gastrointestinal bleeding, or other bleeding problems, or an infection with the bacteria H. Pylori Stomach Discomfort Is Common Side effects from NSAIDs may also include constipation, diarrhea, gas, heartburn, nausea, vomiting, and dizziness. Between 10 and 20 percent of people taking NSAIDs have stomach upset or discomfort. That doesn't mean the drugs are causing serious problems, but tell your doctor about any troublesome side effects. Never take an NSAID on an empty stomach. Taking the medications with milk or food and staying away from stomach irritants like alcohol, tobacco, and caffeine may help. You can also ask your doctor about using medicine to coat the stomach or block stomach acids. If you are having serious stomach problems from an NSAID, your doctor may switch you to another one or ask you to stop taking NSAIDs. Or he or she may prescribe an additional medication to help protect your stomach and intestines. Take Steps to Prevent Problems If you use NSAID medicines, take them exactly as prescribed by your doctor or the package label. Use the lowest dose possible and take them for the shortest time needed. Don't take aspirin or any other NSAID if you've ever experienced asthma, hives, or another allergic reaction due to such drugs. If you have asthma along with nasal polyps or chronic sinus problems, you may be even more likely to react to aspirin or other NSAIDs. Tell your doctor and pharmacist about any nonprescription or prescription medications you take. NSAIDs can interact with other medicines and cause serious side effects. NSAIDs may also affect the way your body uses other drugs. For example, if you take aspirin to protect your heart, taking another NSAID like Motrin or Advil at the same time can reduce aspirin's beneficial effect. Other Conditions Can Lead to Other Side Effects If you have congestive heart failure or liver disease, NSAIDS can spell trouble. Certain NSAIDs may increase chances of having a heart attack. Using NSAIDs can damage kidneys as well. People with kidney disease or high blood pressure, or those older than 60, are more likely to experience such problems. Taking NSAIDs along with other medications like diuretics or common blood pressure or heart drugs also increases risk for kidney damage. That's why it's key to make sure all your healthcare providers know about any health conditions you have besides arthritis. Finally, be sure to always review the prescribing information (medication guide) before beginning any new medication.