Nonsteroidal Anti-Inflammatory Drug Leads from Plant Sources

Nonsteroidal anti-inflammatory drugs are FDA-approved for their anti-inflammatory, antipyretic (fever-reducing), and analgesic (pain-relieving) properties. These treat various diseases like rheumatoid arthritis, migraine, muscle pain, menstrual pain, fever, and gout. They can also reduce the need for opioids in acute trauma cases. These drugs are categorized into distinct groups based on their chemical structure and selectivity including COX-2 selective inhibitors (celecoxib and etoricoxib), acetylated salicylates (aspirin), non-acetylated salicylates (diflunisal and salsalate), propionic acids (naproxen and ibuprofen), enolic acid (meloxicam and piroxicam), acetic acids (diclofenac and indomethacin), naphthyl alanine (nabumetone), and anthranilic acids (meclofenamate and mefenamic acid). They can be used orally or topically like diclofenac gel and can be used for soft tissue injuries, acute tenosynovitis, and ankle sprains. However, due to high toxicity, the use of classical NSAIDs has been restricted. Therefore, new drugs with lower side effects and increased half-life should be developed. Multi-targeted inhibition can enhance efficacy or reduce side effects in treating inflammation and pain. This chapter focuses on existing NSAIDs, their mechanism of action, and drug leads from plant sources that may serve as anti-inflammatory compounds to combat classical NSAIDs.