Abstract
<jats:p>NSAIDs are among the most powerful analgesics and often outperform opioids in safety and efficacy. Our patients should benefit from them wherever possible. The well-known renal, gastrointestinal (GI), cardiovascular, and bleeding risks have led to reluctance and potential underutilisation. These risks are acceptable for most patients, so long as we follow some essential “rules”, which have been distilled into an easy-to-use flowchart in this article. Nuance in patient response and NSAID pharmacokinetics means individuals may benefit from specific NSAID types, formulations or doses. Taking NSAIDs on an empty stomach allows a rapid rise in plasma concentrations and earlier analgesia, yet outdated “take with food” advice diminishes these benefits without reducing GI risks.</jats:p>