Difference Between NSAIDs and Steroids

Main difference

The main difference between NSAIDs and steroids is that NSAIDs reduce inflammation, pain, and fever, and steroids reduce inflammation and have several other pharmacological actions.

NSAIDs versus steroids

NSAIDs are anti-inflammatory and reduce fever, while steroids are anti-inflammatory and immunomodulatory. NASIDS inhibit the COX enzyme while steroids act like hormones. NASIDS are not abused, exclusively while steroids are abused NASIDS have no effect on weight when used for a long time, while steroids cause obesity when used for a long time. NASIDS does not cause adrenal necrosis of the hip joint; on the other hand, steroids cause adrenal necrosis of the hip joint. NSAIDs are contraindicated in ulcers, while steroids treat ulcers.

Comparison chart

NSAIDs steroids
NSAIDs are non-steroidal anti-inflammatory drugs used to treat pain and inflammation in a variety of conditions. The steroid belongs to a class of organic compounds that are clinically important as potent anti-inflammatory and immunomodulatory agents.
Mechanism of action
Act by inhibiting cyclooxygenases abbreviated as COX Different steroids have different MOAs Anti-inflammatory action is by inhibiting phospholipase A2
COX non-selective, COX-1 selective, COX-2 selective Catabolic steroids, Anabolic steroids
Administration route
Topical but cannot be inhaled.
Topical but can be inhaled.
therapeutic uses
Relives pain and inflammation in different types of diseases, reduces fever. Relives pain and inflammation in different ailments. It has different therapeutic uses depending on the type of steroid, for example, anabolic or catabolic.
Adverse effects
nausea and vomiting
Decrease appetite.
Kidney and liver failure
Salt and fluid retention
potassium loss
Muscular weakness
Easy bruising on the body
Peptic ulcers, Inflammatory bowel diseases, Kidney failure, Uncontrolled hypertension Each class of steroids has its own contraindications, for example, glucocorticoids are contraindicated in systemic fungal infections.

What are NSAIDs?

NSAIDs are nonsteroidal anti-inflammatory drugs that reduce pain and inflammation and are used to treat a variety of conditions, especially gout and hyperuricemia. NSAIDs show their therapeutic effect when they inhibit prostaglandin G/H synthase enzymes called cyclooxygenase (COX), thereby ultimately inhibiting the production of prostaglandins, the main cause of pain and inflammation. Based on the type of cyclooxygenase, NSAIDs are classified as COX non-selective NSAIDs, COX-1 selective NSAIDs, COX-2 selective NSAIDs. NSAIDs that inhibit COX-2 are antipyretic, anti-inflammatory and analgesic, and the simultaneous inhibition of COX-1 produces different undesirable effects in the gastrointestinal tract. NSAIDs are a heterogeneous group of compounds that are different chemically, they are not related to each other in structure and have different therapeutic effects, e.g. Eg Aspirin inhibits COX reversibly and acetaminophen lacks anti-inflammatory activity, but has antipyretic and analgesic activity. Some important classes of NSAIDs are salicylates, para-aminophenol derivatives, acetic acid derivatives, propionic acid derivatives, cox inhibitors, NSAIDs are also used to treat barter syndrome, systemic mastocytosis, cancer chemoprevention. NSAIDs are rapidly absorbed through the GIT and their maximum plasma concentration is reached in 1-4 hours. The absorption time of NSAIDs is affected by the presence of food. NSAIDs are highly protein bound and undergo hepatic metabolism. therefore, they are not recommended in patients with hepatic insufficiency. The main adverse effects of NSAIDs are observed in the gastrointestinal tract, renal system, CNS, platelets, uterus and vascular system. NSAIDs also show hypersensitivity reactions. NSAIDs show drug interactions with different classes of drugs such as ACE inhibitors, corticosteroids, warfarin, sulfonylurea hypoglycemic agents, and methotrexate.

What is steroid?

The steroid belongs to a class of organic compounds that possess a characteristic molecular structure having four rings of carbon atoms and are important for their important clinical functions as potent anti-inflammatory and immunomodulatory agents. The word steroids is used for a wide range of molecules. Steroids have different physiological effects. Corticosteroids, mineralocorticoids, and glucocorticoids are steroids. Corticosteroids are chemicals that are naturally synthesized as hormones, and some are synthesized in the laboratory. Mineralocorticoids regulate the level of water and sodium. The glucocorticoid regulates metabolism and inflammation. Patients with rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease, chronic obstructive pulmonary disease and asthma take glucocorticoids, and take it orally. Steroids have serious side effects and that is the limiting factor in their use. Chronic use of glucocorticoids causes bruising, muscle weakness, skin changes, sleep disturbances, weight gain, and cataracts. Glucocorticoid administration also produces psychiatric side effects such as mood disorders, panic disorder, delirium, and anxiety. Commonly recommended corticosteroids are dexamethasone, prednisolone, and prednisone; these are taken orally or parenterally for the treatment of diseases where there is inflammation like asthma etc. Steroids are also used topically in the form of creams and ointments to treat skin conditions. Anabolic and androgenic steroids are recommended for those patients who lack normal physiological hormones. Steroid abuse is too much in a young generation if diagnosed proper treatment should be taken.

Key differences

  1. NSAIDs are non-narcotic pain relievers, while steroids are hormones.
  2. NSAIDs are therapeutically important in reducing pain and fever. On the other hand; Steroids are used therapeutically in various disorders for their various pharmacological actions.
  3. NSAIDs act as COX enzyme inhibitors, while steroids act as hormones.
  4. NSAID abuse is not common, while steroid abuse is common
  5. NSAIDs do not suppress the immune system, while steroids suppress the immune system.
  6. Long-term use of NSAIDs does not cause obesity. On the other hand, the use of steroids for a long period of time leads to obesity.
  7. NSAIDs are available as oral, parenteral, and topical dosage forms, excluding sprays, while steroids are available as oral, parenteral, and topical dosage forms, including sprays.
  8. NSAIDs do not cause hip joint adrenal necrosis, on the other hand, steroids cause hip joint adrenal necrosis with prolonged use.

Final Thought

The conclusion from the above discussion is that NSAIDs and steroids belong to different therapeutic classes and have important therapeutic functions.

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