Difference Between NSAIDs and Steroids

Main Difference

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

NSAIDS vs. Steroids

NSAIDs are anti-inflammatory and reduce fever while Steroids are anti-inflammatory and immune modulators. NASIDS inhibit COX enzyme while Steroids act as hormones. NASIDS are not commonly abused, whereas Steroids are abused commonly. NASIDS does not have any effect on weight when they are used for a prolonged period, while Steroids cause obesity when they are used for a prolonged period. NASIDS does not cause adrenal necrosis of hip joint; on the other hand, Steroids cause adrenal necrosis of the hip joint. NSAIDs are contraindicated in ulcers whereas Steroids treat ulcers.

Comparison Chart

NSAIDSSteroids
NSAIDs are nonsteroidal anti-inflammatory drugs which are used for the treatment of pain and inflammation in different ailments.Steroid belongs to a class of organic compounds which are clinically important as potent anti-inflammatory agents and immune modulators.
Mechanism of Action
Act by inhibiting the cyclooxygenases abbreviated as COXDifferent steroids have different MOA Anti-inflammatory action is by inhibiting phospholipase A2
Types
COX Non-Selective, COX-1 Selective, COX-2 SelectiveCatabolic steroids, Anabolic steroids
Route of administration
Oral
Parenteral
Topical but cannot be inhaled.
Oral
Parenteral
Topical but can be inhaled.
Therapeutic Uses
Relive pain and inflammation in different types of diseases, Reduce FeverRelive pain and inflammation in different ailments, Have different therapeutic uses depending upon the type of the steroid e.g. anabolic or catabolic.
Adverse effects
Nausea and vomiting
Decrease appetite
Drowsiness
Ulcers
Kidney and liver failure
Salt and fluid retention
Loss of potassium
Muscle weakness
Easy bruising of body
Glaucoma
Contraindications
Peptic ulcers, Inflammatory bowel diseases, Kidney Failure, Uncontrolled hypertensionEvery class of steroids has its own contraindication, e.g. glucocorticoids are contraindicated in systemic fungal infections.

What is NSAIDS?

NSAIDs are non-steroidal anti-inflammatory drugs which reduce the pain and inflammation and are used to treat different ailments, especially gout and hyperuricemia. NSAIDS show their therapeutic effect when they inhibit the prostaglandin G/H synthase enzymes called cyclooxygenase(COX) so ultimately inhibit prostaglandins production, 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 which inhibit the COX-2 are antipyretic, anti-inflammatory, and analgesic and simultaneous inhibition of COX-1 lead to different unwanted effects in the gastrointestinal tract. NSAIDs are a heterogeneous group of compounds which are different chemically, unrelated to each other in structure and possess different therapeutic effects, e.g. Aspirin inhibits COX reversibly, and Acetaminophen lacks anti-inflammatory activity, but it possesses the antipyretic and pain relieving activity. Some important classes of the NSAIDs are salicylates, para-aminophenol derivatives, acetic acid derivatives, propionic acid derivatives, cox inhibitors, NSAIDs are also used to treat the barter’s syndrome, systemic mastocytosis, cancer chemoprevention. NSAIDS are rapidly absorbed through GIT, and their peak plasma concentration is reached in 1-4 hrs. The time of absorption of NSAIDs is affected by the presence of food. NSAIDS are extensively protein bound and undergo hepatic metabolism, so they are not recommended in patients of impaired hepatic function. The main adverse effects of the 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 like ACE inhibitors, corticosteroids, warfarin, sulfonylurea hypoglycemic agents, and methotrexate.

What is Steroid?

Steroid belongs to a class of organic compounds which possess a characteristics molecular structure having four rings of carbon atoms and are important for their important clinical roles as potent anti-inflammatory agents and immune modulators. The word steroids are used for a wide range of molecules. Steroids have different physiological effects. Corticosteroids, mineralocorticoid, and glucocorticoid are steroids. Corticosteroids are chemicals which are synthesized naturally as hormones, and some are synthesized in the laboratory. Mineralocorticoids regulate the level of water and sodium. Glucocorticoid regulates metabolism and inflammation. Glucocorticoids are taken by the patients of rheumatoid arthritis, systemic lupus erythematous, inflammatory bowel disease, chronic obstructive pulmonary disease, and asthma, and they take it orally. Steroids have severe 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 leads to psychiatric side effects like mood disorders, panic disorder, delirium, and anxiety. Commonly recommended corticosteroids are dexamethasone, prednisolone, and prednisone; these are taken orally or parentally for the treatment of diseases where inflammation is involved like asthma, etc. Steroids are also used topically in the form of creams and ointments for the treatment of skin diseases. Anabolic and androgenic steroids are recommended to those patients who lack normal physiological hormones. Steroids abuse is too much in a young generation if it is diagnosed, proper treatment should be taken.

Key Differences

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

Conclusion

The conclusion of the above discussion is that NSAIDs and Steroids belong to different therapeutic classes and have significant therapeutic roles.

Janet White

Janet White is a writer and blogger for Difference Wiki since 2015. She has a master's degree in science and medical journalism from Boston University. Apart from work, she enjoys exercising, reading, and spending time with her friends and family. Connect with her on Twitter @Janet__White

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