Paracetamol does not treat inflammation but can provide effective analgesia if taken at the maximum dose of eight tablets per day. Weak opioids (e.g. codeine or dihydrocodeine) may be taken in combination preparations with paracetamol but they do not have any anti-inflammatory effect. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen and diclofenac, relieve pain and reduce inflammation in the joint lining, as well as stiffness and swelling but do not modify the disease in RA. 

In addition to taking NSAIDs with food to avoid gastric side effects, patients may require a proton pump inhibitor, particularly if taking a NSAID regularly. Although the analgesic effect is usually optimised after a week of regular use, the anti-inflammatory effect can take up to three weeks to show full effect. In RA, NSAIDs are usually only recommended for short-term use or when required, to overcome flare-ups of disease activity. Specialist advice should be sought prior to commencing NSAIDs if the patient is on methotrexate and low-dose aspirin.