???NSAIDs??? are non-steroidal anti-inflammatory drugs that provide pain relief. Advil and Motrin are popular NSAIDs that are currently available as an OTC pill. However, in order to get topical NSAID creams or gels in the United States you need a prescription.
The primary advantage of administering a drug topically is that the drug can bypass the stomach, and thus is more concentrated on the problem area. This is because the drug does not enter the bloodstream to the extent it does when administered orally so the pain relieving effects go only (or at least mostly) where they are needed. Also, by bypassing the stomach and the much of the bloodstream, the patient will likely experience significantly less adverse side effects of a drug.
This lessening of side effects allows a drug to be administered at higher concentrations as a topical agent. In fact, the skin creams were noted to deliver very high doses of NSAIDs when compared with standard dose for oral NSAIDs. However, the level of the topical NSAID that reached the bloodstream was very low ??? about 5 percent of the levels found with orally administered NSAIDs. This is not to suggest that topical NSAIDs are without adverse effects. Studies have shown that the skin creams are associated with a higher rate of irritation, redness, and rash.
Though the first topical NSAID was approved in the U.S. in 2007, many people are not aware of their availability. This is unfortunate as there are certain patient populations where these drugs may provide great benefit. For example, elderly patients taking multiple drugs for various conditions, who, because of the potential for an adverse drug reaction, cannot take oral NSAIDs but still need pain relief. Of course, if the NSAID is applied topically, there is much less chance for a harmful drug interaction. Ask your physician if a topical NSAID may be right for you.