NSAIDs and Voice Effects
NSAIDs do not directly affect voice quality or vocal function in typical clinical use. The evidence base focuses extensively on cardiovascular, gastrointestinal, and renal toxicities of NSAIDs, but voice-related effects are not documented as a recognized adverse effect in major guidelines or drug labels 1.
Direct Evidence on Voice
A comprehensive review of medications affecting vocal function from 2019 does not identify NSAIDs as a class of drugs known to cause alterations in vocal function 2.
A 2025 survey of singers found that NSAIDs were among the most commonly used over-the-counter medications, with users reporting both positive effects (reduced inflammation, improved voice recovery) and negative effects (vocal strain, hoarseness, dryness), though these appear to be individual experiences rather than established pharmacologic effects 3.
The mechanism by which NSAIDs could theoretically affect voice would be through their anti-inflammatory properties (potentially beneficial for laryngeal inflammation) or through mucosal drying effects, but this is not substantiated in the medical literature 2.
Established NSAID Toxicities (Not Voice-Related)
The well-documented adverse effects of NSAIDs include:
Gastrointestinal complications: ulceration, bleeding, and perforation, with 3-5 fold increased risk compared to non-users 1.
Cardiovascular risks: increased thrombotic events, myocardial infarction, and stroke, particularly with COX-2 selective agents and in patients with cardiovascular disease 1.
Renal toxicity: acute renal impairment, particularly in elderly patients, those with compromised fluid status, or on nephrotoxic drugs 1, 4.
Hematologic effects: thrombocytopenia and bleeding disorders, though non-acetylated salicylates and COX-2 inhibitors do not inhibit platelet aggregation 1.
Clinical Implications
If a patient reports voice changes while taking NSAIDs, consider alternative explanations such as underlying laryngeal pathology, gastroesophageal reflux (which NSAIDs can worsen), or coincidental upper respiratory conditions 1.
The anti-inflammatory properties of NSAIDs could theoretically benefit acute laryngitis or vocal fold inflammation, though this is not a standard indication 3.
Use NSAIDs at the lowest effective dose for the shortest duration necessary, as recommended by the American Heart Association, to minimize all toxicity risks 1.