General information
Non-steroidal anti-inflammatory drugs or non-steroidal anti-inflammatory drugs (NSAIDs) are drugs that relieve the symptoms of inflammatory processes such as pain, reduce swelling and, to varying degrees, lower fever. As painkillers, NSAIDs are initially counted in the group of non-opioid analgesics. This means that non-steroidal anti-inflammatory drugs (NSAIDs) exert their analgesic effect by suppressing biochemical processes and do not, like the group of opioids, inhibit pain at the opioid receptors in the body.
NSAIDs not only have an analgesic effect but also an anti-inflammatory effect (antiphlogistic). They are therefore often used in rheumatism therapy (antirheumatic drugs) and belong to the group of non-steroidal anti-inflammatory drugs. In contrast, cortisol and cortisol-like active ingredients are called steroidal antirheumatic drugs.
The mechanism of action of non-opioid analgesics is not uniform. Most non-opioid analgesics act through the blockade of the synthesis of pro-inflammatory tissue hormones (prostaglandins), which are formed when tissue is damaged. These tissue hormones are produced by certain enzymes, the so-called cyclooxygenases (COX), which are divided into COX-1 and COX-2.
The substances classically known as non-steroidal anti-inflammatory drugs (NSAIDs) are acids that accumulate and act particularly in inflamed tissue. Acetylsalicylic acid (e.g. Aspirin®, ASS-ratiopharm®), diclofenac (e.g.
Voltaren®, Diclofenac-ratiopharm®) and ibuprofen (e.g. Nurofen®, Ibu-Hexal®) belong to these acidic antiphlogistic analgesics. Novalgin® with the active ingredient metamizole belongs to the group of non-acidic anti-inflammatory analgesics. In contrast to acidic NSAIDs, these are distributed largely evenly throughout the body and hardly accumulate in inflamed tissue.
Therefore, the non-acidic anti-inflammatory analgesics are well suited for the treatment of pain that is independent of inflammation (e.g. after surgery, injuries or tumor pain). These analgesics are also very good against pain and fever, but an anti-inflammatory effect is not expected in therapeutic doses. In addition, the undesirable effects of acidic analgesics (such as Asprin® and co.) on the kidney, such as acute and chronic kidney failure, are not expected to occur with non-acidic painkillers.
These non-acidic analgesics include Coxibe (e.g. Celebrex®), paracetamol (e.g. Perfalgan®) and also metamizole (Novalgin®). The exact mechanism of action of Novalgin® has not yet been conclusively clarified, but it appears to act like NSAIDs by inhibiting the enzymes COX-1 and COX-2 (cyclooxygenases).
In contrast to the NSAIDs in the central nervous system, Novalgin® appears to have a direct influence on the perception of pain, as the active ingredient can also partially penetrate the spinal cord and the brain. In contrast to the classical non-steroidal anti-inflammatory drugs (NSAIDs), the active ingredient metamizole in the drug Novalgin® has an additional antispasmodic (spasmolytic) effect. For this reason Novalgin® is frequently used for pain therapy in cases of colics of the bile and urinary tract.
