What is the difference between NSAIDs and paracetamol?

NSAIDs work against pain, fever and additionally against inflammation. Paracetamol relieves pain and fever but does not reduce inflammation — however, it is gentler on the stomach. Which medication is more suitable depends on the cause and your health.

Will taking them harm my stomach?

NSAIDs can irritate the gastric mucosa, particularly with prolonged use, at an older age or in cases of previous stomach problems. Your doctor weighs up the risk and prescribes gastric protection in addition if necessary.

How long may I take such painkillers?

The basic principle is: for as short a time as possible. If you are dependent on them for longer than a few days without medical supervision, the cause of the pain should be investigated rather than continuously masking it.

Are pain gels an alternative to tablets?

For localized complaints such as tendon irritation or a sprain, gels can work well, and significantly less active ingredient enters the body. For deeper or more extensive pain, the effect is often insufficient.

May I combine NSAIDs with blood thinners?

This combination significantly increases the risk of bleeding and should only be undertaken after consulting your doctor. Therefore mention your blood thinner every time painkillers are prescribed — also at the pharmacy.

Anti-inflammatory Painkillers (NSAIDs) — Procedure, Preparation & Cost

Anti-inflammatory painkillers — medical professionals refer to them as non-steroidal anti-inflammatory drugs, or NSAIDs for short — relieve pain, reduce inflammation and lower fever. They are among the most frequently used medications of all, for example in cases of joint, back or headaches. Whether and for how long they are suitable for you depends on your health — particularly your stomach, kidneys and heart play a role in this.

Typical Areas of Use

Joint and osteoarthritis pain
Back and neck pain
Tendon and muscle inflammation
Headaches and migraines
Menstrual complaints
Pain following injuries

How It Works

1Your doctor will investigate the cause of the pain and assess whether an anti-inflammatory painkiller is suitable for it — or whether a different treatment would be more appropriate.
2In doing so, she takes your medical history into account: stomach problems, kidney or heart disease, blood thinners and other medications may contraindicate NSAIDs or make protective measures necessary.
3You will receive the appropriate preparation in the form of a tablet, gel or suppository — if you have a sensitive stomach, gastric protection is sometimes prescribed in addition.
4In the case of longer-term use, your doctor monitors the progress and regularly checks whether the medication is still necessary or can be reduced.

How to Prepare

Inform your doctor about any previous gastric or intestinal ulcers as well as kidney or heart disease.
Mention all medications you are taking — particularly blood thinners and cortisone.
Please tell us if you are pregnant or could be pregnant: NSAIDs may only be used during pregnancy after consultation with a doctor; in the last third of pregnancy they are contraindicated.

Side Effects & Risks

Stomach complaints extending to gastritis or ulcers, especially with prolonged use.
Strain on the kidneys, particularly in cases of pre-existing renal insufficiency, fluid deficiency or in combination with certain blood pressure medications.
Increased risk of cardiovascular events with long-term, high-dose use.
Increased tendency to bleed, especially in combination with blood thinners.
Allergic reactions, and in sensitive individuals also asthma attacks.

Afterwards — and When to Seek Help

For short-term use, no special monitoring is usually needed. Black, tar-like stools or vomiting blood can indicate gastrointestinal bleeding and must be assessed medically without delay — in case of heavier bleeding, circulatory problems, weakness, shortness of breath, or impaired consciousness, call 144 immediately. Also contact your medical practice if you experience stomach pain, skin rash, shortness of breath, markedly reduced urine output, or fluid retention. If you need the medication for longer than a few days in order to get through daily life, the cause of the pain needs to be medically assessed.

Cost & Insurance

NSAIDs prescribed by a doctor from the Specialty List are usually covered by the mandatory basic insurance, minus the Franchise and retention fee. Pain relievers bought over the counter at the pharmacy without a prescription, on the other hand, are usually paid for by you. This is for guidance only, without guarantee; your health insurer can provide information.

Frequently Asked Questions

What is the difference between NSAIDs and paracetamol?: NSAIDs work against pain, fever and additionally against inflammation. Paracetamol relieves pain and fever but does not reduce inflammation — however, it is gentler on the stomach. Which medication is more suitable depends on the cause and your health.
Will taking them harm my stomach?: NSAIDs can irritate the gastric mucosa, particularly with prolonged use, at an older age or in cases of previous stomach problems. Your doctor weighs up the risk and prescribes gastric protection in addition if necessary.
How long may I take such painkillers?: The basic principle is: for as short a time as possible. If you are dependent on them for longer than a few days without medical supervision, the cause of the pain should be investigated rather than continuously masking it.
Are pain gels an alternative to tablets?: For localized complaints such as tendon irritation or a sprain, gels can work well, and significantly less active ingredient enters the body. For deeper or more extensive pain, the effect is often insufficient.
May I combine NSAIDs with blood thinners?: This combination significantly increases the risk of bleeding and should only be undertaken after consulting your doctor. Therefore mention your blood thinner every time painkillers are prescribed — also at the pharmacy.