Sickle cell disease is a serious genetic disease affecting the protein that carries oxygen in red blood cells, called hemoglobin. The faulty protein causes red blood cells to become rigid and sickle-shaped. which means they have trouble reaching the different tissues and organs in the body.

These sickle-shaped cells can also stick together and block blood vessels, leading to pain and inflammation. One of the treatments for mild chronic pain in sickle cell disease is nonsteroidal anti-inflammatory drugs, or NSAIDs.

What are NSAIDs?

NSAIDs are treatments that reduce pain, fever, and inflammation. Some are available only by prescription, but many are over-the-counter medications. They work by inhibiting an enzyme called cyclooxygenase (COX), which has two forms, COX-1 and COX-2.

COX-1 works to maintain kidney function, as well as protect the stomach lining from both stomach acid and digestive enzymes. It is also responsible for stimulating blood clotting at sites of injury.

COX-2 is produced in areas that are injured or inflamed as part of the inflammatory response.

NSAIDs fall into two categories: those that affect both COX-1 and COX-2 and those that primarily affect COX-2. It is important for people to consult a healthcare professional to determine the appropriate NSAID because it can differ from patient to patient.

NSAIDs affecting both COX-1 and COX-2

NSAIDs that act on both COX-1 and COX-2 include aspirin, ibuprofen, diclofenacacetaminophen, naproxen, and nabumetone. Diclofenac and ibuprofen are frequently used to treat mild chronic pain in sickle cell disease.

NSAIDs affecting COX-2 only

NSAIDs that affect primarily COX-2 include Celebrex (celecoxib), Prexige (lumiracoxib), and Arcoxia (etoricoxib). Prexige and Arcoxia are available by prescription in some European countries but have not been approved by the U.S. Food and Drug Administration due to liver toxicity. Research has also shown that COX-2 inhibitors are not more effective in managing pain and do not have tangibly fewer gastrointestinal side effects than NSAIDs that inhibit both COX-1 and COX-2.

Other information

Side effects of NSAIDs may include upset stomach, stomach ulcers, vomiting, and diarrhea. There is also an increased risk of bleeding after injury, so it is important in these cases to inform the doctor if a patient has been taking any of these medications.


Sickle Cell Disease News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.