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Key takeaways
There isn’t one “strongest” anti-inflammatory. The anti-inflammatory that’s most effective for you depends on what health condition you are treating.
Most of the time, prescription-strength anti-inflammatories are strongest. These include prescriptions NSAIDs, corticosteroids, and biologic therapies.
Prescription-strength anti-inflammatories are best when you are experiencing severe or chronic inflammation.
Anti-inflammatories are medications used to reduce inflammation (swelling) in the body. Symptoms associated with inflammation may include swelling, fever, joint or muscle aches, and various types of pain, such as arthritis or chronic pain. There are many different conditions that cause inflammation, and there are also various types of anti-inflammatory medications. The most common anti-inflammatories are nonsteroidal anti-inflammatory drugs (NSAIDs), but corticosteroids and biologic therapies are also anti-inflammatory medications.
If you are experiencing pain or inflammation, you might want to know: What is the strongest anti-inflammatory medication? The answer is that the best or strongest anti-inflammatory medication for you depends on which medical condition you are treating and your overall health profile.
What is the strongest anti-inflammatory medication?
If you are experiencing serious inflammation, you are probably looking for an anti-inflammatory that will decrease your symptoms quickly and effectively. However, it’s not possible to zero in on one anti-inflammatory in particular as the “strongest”—it varies from one person to another.
“There is no single anti-inflammatory that is considered the strongest, because the most effective option depends on the type, cause, and severity of inflammation being treated,” explains Erika Gray, Pharm.D., founder and chief medical officer at MyToolBox Genomics. “Medications vary based on how they work in the body, and the conditions they are best suited to treat, so the right choice must be individualized.”
Anti-inflammatories work by decreasing inflammation in the body. How they do this varies based on the different types of anti-inflammatory medication. For example, the most common anti-inflammatory medications are NSAIDs like ibuprofen (Advil, Motrin) and naproxen (Aleve). “They work by inhibiting enzymes called cyclooxygenase (COX-1 and COX-2), which are involved in producing inflammatory chemicals,” explains Taher Saifullah, MD, pain management specialist and founder of Spine & Pain Institute Los Angeles.
Anti-inflammatories like corticosteroids work by suppressing the immune system, which decreases inflammation. Biologic therapies also suppress parts of the immune system, including proteins that produce inflammation.
Which type of anti-inflammatory will work best for you depends on your particular condition, whether chronic or acute, and how severe your symptoms are. Here’s what to know.
NSAIDs
NSAIDs are best for short-lived, acute conditions and symptoms. “I usually recommend them for short-term issues, like back pain, a sports injury, or even menstrual cramps,” says Raj Dasgupta, MD, who is quadruple-board certified in pulmonary, sleep, internal, and critical care medicine and chief medical adviser for Sleepopolis.
Corticosteroids
Corticosteroids like prednisone and methylprednisolone are used to treat inflammatory conditions like arthritis and asthma, Dr. Gray says. They are often prescribed when symptoms of these conditions have become severe.
Biologics
Biologic therapies like tumor necrosis factor-α (TNF) inhibitors and interleukin inhibitors are often used for severe and chronic inflammatory conditions. “For chronic inflammatory conditions like rheumatoid arthritis, biologics are often considered the strongest and most targeted long-term solutions, specifically designed to interrupt particular inflammatory cascades,” says Dr. Saifullah. Biologics are sometimes used when other drugs are not effective enough or cannot be tolerated.
Over-the-counter anti-inflammatory options
The most common over-the-counter anti-inflammatory options are NSAIDs. “Over-the-counter NSAIDs are best suited for short-term use in mild to moderate conditions,” Dr. Gray says. “If symptoms do not improve after several days, a medical evaluation is recommended.”
According to Dr. Saifullah, over-the-counter options like ibuprofen (Advil, Motrin) or naproxen (Aleve) are typically most effective. “I often recommend over-the-counter NSAIDs for mild to moderate pain relief and inflammation, such as muscle strains, minor sprains, headaches, or menstrual cramps,” says Dr. Saifullah. “They’re a good first-line approach for self-care when symptoms aren’t severe or debilitating, providing a convenient and generally safe option for short-term relief.”
Aspirin is another anti-inflammatory medication that can be purchased over the counter. “Aspirin has anti-inflammatory properties but is more commonly used in low doses for heart protection, as higher doses can irritate the stomach,” Dr. Gray says.
Prescription-strength anti-inflammatories
Sometimes, a prescription-strength anti-inflammatory is called for. What are some instances when your healthcare provider might prescribe one for you?
“A prescription anti-inflammatory is typically better when OTC options haven’t provided sufficient relief, or when a more potent or longer-acting anti-inflammatory effect is needed, especially for chronic conditions or more significant acute injuries under medical supervision,” Dr. Saifullah says.
When it comes to chronic inflammatory conditions, like asthma or rheumatoid arthritis, your healthcare provider may prescribe a corticosteroid or biologic therapy. But in most cases, “we are usually still talking about NSAIDs, but at higher dosages than what’s available over-the-counter,” Dr. Saifullah explains.
Examples of prescription-strength NSAIDS include:
- Nabumetone
- Celebrex (celecoxib)
- Mobic (meloxicam)
- High-dose ibuprofen or naproxen
Both over-the-counter and prescription-strength NSAIDs mainly target COX-1 and COX-2 enzymes. “The main difference lies in the dosage and sometimes the selectivity for COX-2,” Dr. Saifullah describes. “Prescription NSAIDs, particularly COX-2 selective inhibitors like celecoxib, aim to reduce some of the gastrointestinal side effects associated with non-selective NSAIDs, which can inhibit both COX-1 (important for stomach lining protection) and COX-2 (involved in inflammation).”
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Potential side effects and risks
Anti-inflammatory drugs are typically quite effective, but that doesn’t mean they don’t have side effects. Common side effects of NSAIDs include:
- Gastrointestinal issues like upset stomach, stomach pain, heartburn, gas, nausea, vomiting, and diarrhea
- Dizziness
Serious side effects, which are less common, require immediate or urgent medical attention and may include:
- Heart problems
- Kidney or liver problems
- Bleeding and ulcers in the stomach or intestines
- Low red blood cells
- Allergic or skin reactions
Still, NSAIDs are widely considered safe, especially when taken for temporary problems. However, they aren’t meant to be taken on a long-term basis, especially if you have underlying health conditions, so check with a healthcare provider before using an NSAID, even if it is over the counter. “They’re generally safe if you don’t take too much or use them for too long, but if you have stomach problems, high blood pressure, or kidney issues, it’s worth checking with a doctor first,” Dr. Dasgupta says.
Popular corticosteroids like prednisone also shouldn’t routinely be taken on a long-term basis, unless under the close watch of a healthcare provider. “These drugs reduce inflammation quickly but can lead to serious side effects with long-term use, including weight gain, elevated blood sugar, weakened bones, and increased infection risk,” Dr. Gray shares.
Making informed choices with healthcare providers
What is considered the “strongest” anti-inflammatory varies from one person to another. “While medications like ibuprofen and naproxen are highly effective for common aches and pains, stronger options such as corticosteroids or prescription NSAIDs may be needed for more serious inflammation,” Dr. Gray says.
The “best” anti-inflammatory is one that addresses your symptoms as effectively as possible, while ensuring that you minimize unwanted long- and short-term side effects, Dr. Gray notes. That’s why it’s vital to seek medical advice from a trusted healthcare provider and work with them to decide the best anti-inflammatory for you.
“Selecting the right anti-inflammatory should involve working with a healthcare provider who can assess your symptoms, overall health, and other medications you are taking,” Dr. Gray says. Factors to consider include the cause of your inflammation, any chronic health conditions you have, potential drug interactions, and the medication’s increased risks and possible side effects.
You and your provider can work together to decide which anti-inflammatory is right for you, weighing the risks and benefits of the medication.
- Anti-inflammatory agent, National Cancer Institute
- Nonsteroidal anti-inflammatory drugs (NSAIDs), StatPearls (2023)
- Corticosteroids, StatPearls (2023)
- Biologics, Arthritis Foundation (2022)
- NSAIDs (nonsteroidal anti-inflammatory drugs), American College of Rheumatology (2024)