Nonsteroidal anti-inflammatory drugs (NSAIDs), or aspirin-like medications, reduce inflammation (and hence pain) arising from injured tissue. Such medications have analgesic, anti-inflammatory, and antipyretic effects, and they inhibit platelet aggregation by inhibiting the cyclooxygenase (COX) enzyme. NSAIDs are associated with adverse gastrointestinal effects, particularly with long-term use.  Most NSAIDs are taken by mouth. NSAIDs are also available for topical use, although topical effects are unknown.