NSAIDs may be grouped according to their preference for COX-1 and COX-2 enzymes. Those that favor COX-1 are more likely to cause gastrointestinal side effects. Those that favor COX-2 have a higher risk of cardiovascular effects but less gastrointestinal effects. Higher dosages of NSAIDs tend to result in more COX-2 enzyme inhibition (and more cardiovascular side effects), even in those NSAIDs traditionally seen as low risk (such as ibuprofen). NSAIDs with higher activity against COX-2 enzymes should be used with caution in people with cardiovascular disease or at increased risk of cardiovascular disease.
Ibuprofen which is also known as : Advil, Advil Childrens, Advil Junior Strength, Advil Liquigel, Advil Migraine, Advil Pediatric, Childrens Ibuprofen Berry, Genpril, IBU, Midol IB, Midol Maximum Strength Cramp Formula, Dolgesic, Motrin Childrens, Motrin IB, Motrin Infant Drops, Motrin Junior Strength, Motrin Migraine Pain, Nuprin, Migraine Liqui-gels, Ibu-Tab 200, Cap-Profen, Tab-Profen, Profen, Ibuprohm, Children’s Elixsure, IB Pro, Vicoprofen, Combunox, A-G Profen, Actiprofen, Addaprin, Advil Infants Concentrated Drops, Caldolor, Haltran, Q-Profen, Ibifon 600, Ibren, Menadol, Midol Cramps & Bodyaches, Rufen, Saleto-200, Samson, Ultraprin, Uni-Pro, Wal-Profen.
At every step of the analgesic ladder non-opioid analgesics form the basis of pain management. As long as they are not contraindicated, paracetamol, aspirin or an NSAID should also be prescribed with opioid analgesia (weak or strong). This is the concept that pain is best managed not by a single drug or therapy, but in combinations which maximise efficacy whilst keeping side-effects low. Research has demonstrated that when this happens, the synergistic effect on pain relief is improved, smaller amounts of pain killers are required and less side effects occur.