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Nonsteroidal anti-inflammatory drugs abbreviated NSAIDs, is a group of non-hormonal medications that have inflammation-eliminating, anti-fever, and pain-reducing effects. The use of the term “non-steroidal” in the name emphasizes their difference from glucocorticoids, which have not only inflammation-eliminating action, but also other, sometimes undesirable, properties of steroids.


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Nonsteroidal anti-inflammatory drugs abbreviated NSAIDs, is a group of non-hormonal medications that have inflammation-eliminating, anti-fever, and pain-reducing effects. The use of the term “non-steroidal” in the name emphasizes their difference from glucocorticoids, which have not only inflammation-eliminating action, but also other, sometimes undesirable, properties of steroids. The most known and widely used representatives of NSAIDs are acetylsalicylic acid (aspirin), ibuprofen, and diclofenac.

Another medication that is widely used to reduce fever and pain, Paracetamol does not have an anti-inflammatory effect since it belongs to the COX-3 selective blockers, due to which it has a pronounced antipyretic effect, so it does not belong to this group.

Painkillers from this group are used for acute and chronic diseases, accompanied by pain and inflammation. Currently, studies are being conducted aimed at the possibility of influencing intestinal cancer and their effect in the therapy of cardiovascular diseases.

Most often, painkillers from this class are appointed for:

- Various types of arthritis

- Osteoarthritis

- Inflammatory arthropathies (ankylosing spondylitis, Reiter syndrome)

- Gout

- Dysmenorrhea (painful period)

- Bone metastases accompanied by pain

- Headache and migraine

- Post-surgery pain

- Mild or moderate pain syndrome with inflammatory changes or trauma

- Fever

- Kidney colic

The most commonly used drugs in children's practice are: Aspirin, analgin, diclofenac, ibuprofen, ketoprofen, napraxen, piroxicam, meloxicam, and nimesulide.

The medicines from the class are available in the form of tablets, capsules, injectable solutions, ointments, gels, and rectal suppositories.

Types of NSAID painkiller medications

NSAIDs with pronounced anti-inflammatory activity

Acetylsalicylic acid (aspirin)



Pyrazolone derivatives Phenylbutazone
Indole acetic acid derivatives




Phenylacetic Acid Derivatives Diclofenac





Propionic Acid Derivatives





Thiaprofenic acid

Non Acid Derivatives
Alkanones Nabumeton
Sulfonamide derivatives




NSAIDs with low anti-inflammatory activity
Anthranilic Acid Derivatives

Mefenamic acid






Para-aminophenol derivative



Heteroaryl Acetic Acid Derivatives Ketorolac

What are NSAIDs and how do they work?

NSAIDs have inflammation-suppressing, painkiller and fever-lowering effects. The main principle of effect is the suppression of the formation of prostaglandins. Prostaglandins are tissue hormones that promote inflammation and the accompanying pain as a response to any external or internal damage.

For what purpose NSAID pain medications are used?

The drugs are intended to relieve pain of various kinds.

NSAIDs are appointed for inflammatory joint diseases, degenerative diseases (deforming osteoarthrosis, osteochondrosis), lumbago, sciatica, neuralgia, myalgia, and others), post-traumatic pain syndrome, accompanied by inflammation, post-surgery pain, acute attack of gout, migraine attacks, kidney and liver colic, infections of ENT organs, residual effects of pneumonia. Locally - injuries of tendons, ligaments, muscles, and joints (to cope with pain in sprains, dislocations, bruises), localized forms of soft tissue rheumatism.

What should I tell my doctor before starting treatment with NSAIDs?

Even if you have the indications for the use of these medicines and want to buy painkiller online, you should talk to your healthcare provider about the conditions that you have in:

- Stomach ulcer and/or duodenal ulcer,

- Chronic kidney or liver disease,

- Ever had a severe adverse reaction to salicylates or any other NSAID,

- Use of any other medicines, including over-the-counter medicines, vitamins,

- Pregnancy or breastfeeding.

What are the rules for taking NSAIDs?

Take the drug as prescribed by your doctor.

NSAIDs are taken 1-2 hours after meals with a large amount of water.

Never take NSAIDs at a dose higher than appointed by your healthcare provider. If you have taken an excessive dose, consult a doctor immediately or seek emergency help if you have developed severe adverse effects.

During treatment, carry a package of medicine with you, maintain a constant supply of the drug.

This medicine is only for you. Never give it to other people, even if it seems to you that they have a similar disease.

In prolonged use of nonsteroidal painkillers, regular monitoring of parameters reflecting the function of the liver, kidneys, and peripheral blood parameters should be carried out.

Can painkillers be used with other medicines?

Classification of NSAIDs by activity and chemical structure

Painkiller from the NSAIDs class
Indirect anticoagulants
Phenylbutazone Oxyphenbutazone
Avoid these NSAIDs, if possible, or have strict controls.
Indirect anticoagulants
All, especially aspirin
Avoid these NSAIDs, if possible, or have strict controls.
Oral hypoglycemic drugs (sulfonylureas)
Phenylbutazone Oxyphenbutazone
Avoid NSAIDs, if possible, or strictly monitor blood glucose
Avoid NSAIDs, if possible, or strictly monitor creatinine clearance and digoxin concentration in the blood
Antibiotics - Aminoglycosides
Strict control of the concentration of aminoglycosides in the blood
Methotrexate (high non-rheumatologic doses)
Concomitant use is contraindicated. Acceptable use of NSAIDs during chemotherapy intervals
Lithium salts
All (to a lesser extent - aspirin, sulindac)
Use aspirin or sulindac if prescribing NSAIDs is necessary. Strict control of lithium concentration in the blood
Phenylbutazone Oxyphenbutazone
Avoid these NSAIDs, if possible, or strictly monitor blood
Antihypertensive drugs Beta blockers Diuretics ACE inhibitors
To the greatest extent - indomethacin, Phenylbutazone; the lesser - sulindak
Use sulindac and, if possible, avoid other NSAIDs for hypertension. Strict blood pressure control. Increased antihypertensive therapy may be required.
To the greatest extent - indomethacin, phenylbutazone. In the smallest - sulindak
Avoid NSAIDs (except sulindac) for heart failure, strictly monitor the patient's condition
Indirect anticoagulants
Avoid NSAIDs if possible
High risk combinations
All diuretics
All (to a lesser extent - sulindak)
The combination is contraindicated
The combination is contraindicated
All potassium-sparing medicines
Avoid such combinations or strictly control plasma potassium levels.

What to do if you missed an intake of a painkiller drug?

Take the missed dose right as soon as you remembered. If you missed the medication, and the time has come for the next dosage, continue taking the medication as before without recouping the dosage. Do not take a double or additional dose of the medication.

What should you do for the treatment to be effective and safe?

Visit your doctor regularly to evaluate treatment effectiveness. If you do not feel improvement while taking the drug, discuss this with your doctor. If you need to take nonsteroidal pain medication, along with other drugs, discuss this with your healthcare provider.

What problems can cause the use of NSAIDs?

- Disorders of the gastrointestinal tract function (abdominal pain, constipation, heartburn, nausea) may appear, but often they are not so pronounced as to interrupt treatment.

- Long-term therapy with large doses increases the risk of side effects from the digestive tract (as an exception, peptic ulcer or bleeding may occur).

- Rashes, itching, swelling, feeling tired, and dizziness rarely appear.

- Possible increase in the activity of liver enzymes.

- The gel and ointment sometimes cause redness, itching and a burning sensation at the site of application.

How to store NSAIDs?

The drug should be stored in a dry place inaccessible to children at a temperature of no higher than 25 degrees. Never use the drug after the expiration date.

What NSAID painkillers can you buy at our online drugstore?

In this section you can find and buy painkillers made by reputable generics makers, i.e. the companies that make medicines identical to the branded ones but sell them cheaper due to less advertised names.

- Celebrex (Celecoxib) by Cipla is used for various forms of arthritis. It is used for maximum two weeks.

- Deltasone (Prednisolone) is used for different forms of arthritis, systemic diseases of the connective tissue (lupus, scleroderma, and others), multiple sclerosis, still's syndrome in adults, asthma, interstitial lung diseases, lung cancer (with chemotherapy), tuberculosis, primary and secondary adrenal insufficiency, allergy, hepatitis, hypoglycemic conditions, autoimmune diseases, nephrotic syndrome, inflammatory diseases of the digestive tract (ulcerative colitis, crohn's disease, etc.), diseases of the blood and hemopoietic organs, autoimmune and other skin diseases, cerebral edema, eye diseases, prevention of transplant rejection, hypercalcemia on due to cancer, prophylaxis and elimination of nausea in chemotherapy. It is a hormonal medication which must be used only under doctoral supervision.

- Diclofenac (Voltaren) by German Remedies in the form of tablets is used for inflammatory joint extra-articular soft tissues diseases, rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, pain syndromes from the spine, gout, pain due to injury or after surgery (including dental), menstrual cramps, toothache, headache, fever, and others.

- Diclofenac gel (Jonac) by Cipla is used for topical treatment of pain and inflammation of joints, muscles, ligaments and tendons of rheumatic or traumatic origin.

- Emulgel (Dicloflam) is used for inflammatory and degenerative diseases of the muscle system, rheumatoid arthritis, spondylitis, pain due to injury or in a postoperative period, spine diseases (lumbago, sciatica, and others), joint pain, muscle pain (due to sprains, overstrain, bruises, injuries), inflammation and swelling of soft tissues due to injuries.

- Feldene (Piroxicam) by Abbott is used for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis.

- Indocin (Indomethacin) by IPCA is used for pain in inflammatory and degenerative diseases, rheumatoid arthritis, ankylosing spondylitis, gout, osteoarthritis, diseases of the tissues around joints, tendonitis, acute painful shoulder, tendon bursitis, pain and inflammation after injuries and surgeries, dysmenorrhea (painful period).

- Mobic (Meloxicam) by Sun Pharma is used for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, pain in joints due to inflammation.

- Motrin (Ibuprofen) by Abbott is used for headaches, migraine attacks, period pains, toothache, neuralgia, muscle pains, rheumatoid arthritis, osteoarthritis, psoriatic arthritis, exacerbation of gout, ankylosing spondylitis, cervical migraine, vertebral artery syndrome, lumbago, sciatica, thoracic radiculopathy, myalgia, neuralgic amyotrophy, neuralgia, arthralgia, bursitis, tendonitis, ligament sprain, hematoma, traumatic inflammation of the soft tissues, postoperative pain syndrome.

- Naprosyn (Naproxen) is appointed for degenerative diseases of the muscle system, different forms of arthritis, ankylosing spondylitis, gout, neuralgia, myalgia, sciatica, headache, toothache, tendonitis, pain in cancer, postoperative pain, injuries of the musculoskeletal system and soft tissues, primary dysmenorrhea, pain and fever in infectious and inflammatory diseases of the upper respiratory tract (as part of complex therapy).

- Paracetamol (Paracip) by Cipla is used for headache, migraine, toothache, back pain, rheumatic pain, muscle pain, period cramps, arthritis pain, and flu. It renders only painkiller and fever-reducing effect but doesn’t reduce inflammation.

- Ponstel (Mefenamic Acid) by Blue Cross Pharma Industry is appointed for inflammatory diseases of the musculoskeletal system, rheumatoid arthritis, rheumatism, ankylosing spondylitis, acute respiratory viral infections and flu, primary dysmenorrhea, dysfunctional menorrhagia, muscle pain, joint pain, traumatic pain, toothache, headache of various origin, postoperative pain, and postpartum pain.

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