NSAIDs have anti-inflammatory (reduce inflammation), analgesic (relieve pain) and antipyretic (lower temperature) effects. Although different NSAIDs have different structures, they all work by blocking cyclooxygenase (COX) enzymes. There are two main types of COX enzymes: COX-1 and COX-2. Both types produce prostaglandins; however, the main function of COX-1 enzymes is to produce baseline levels of prostaglandins that activate platelets and protect the lining of the gastrointestinal tract, whereas COX-2 enzymes are responsible for releasing prostaglandins after infection or injury. Prostaglandins have a number of different effects, one of which is to regulate inflammation. Most NSAIDs inhibit both enzymes, although a few are available that mainly inhibit COX-2. The pain-relieving and anti-inflammatory effects of NSAIDs are mainly due to inhibition of COX-2, and their unwanted side effects are largely due to inhibition of COX-1.
Apply to the affected area and massage into the skin gently. Always wash your hands after you have finished rubbing the cream, gel or spray into the skin. This is to make sure that you avoid rubbing this medicine into sensitive areas of the body such as the eyes. Do not apply to skin that is broken, or near the eyes, nose, mouth, genital or bottom (anal) areas. Do not use plasters or bandages (dressings) on top of these medicines. Generally these medicines are applied to the skin 2-4 times a day. However, for specific advice for your medicine, see the leaflet that comes inside the packet.