Side
Effects
of
NSAIDs

  Common side effects of NSAIDs include: Stomach pain and heartburn. Stomach ulcers. A tendency to bleed more, especially when taking aspirin. Headaches and dizziness. Ringing in the ears. Allergic reactions such as rashes, wheezing, and throat swelling. Liver or kidney problems. High blood pressure.
This page is a continuation from "The Basic's of NSAIDs"

 Side Effects
of  NSAIDs

    Some individuals are allergic to NSAID's. This may lead to a shortness of breath when taken. A classic example would be people who suffer from Asthma. The potential to experience an allergic reaction from NSAID's would be higher. Individuals with a serious allergy to one NSAID are likely to experience a similar reaction to other types of NSAID's.

     The use of Aspirin in children, and teenagers with Chickenpox or Influenza has been linked with the development of Reye's Syndrome. This is a serious and sometimes extremely fatal Liver Disease. It also has the potential to affect the brain. Salicylates also cause Ulceration and Hemorrhagic Lesions of the Gastric Mucosa; the same mechanisms involved in the anti-inflammatory effects increase the production of stomach acid, decrease the secretion of protective mucus and increase bleeding. Salsalate is used to relieve pain, tenderness, swelling, and stiffness caused by Rheumatoid Arthritis. It's also a Non-Acetylated dimer of Salicylic Acid that is used in the treatment of Chronic Arthritis, and Osteoarthritis as an Analgesic and Antipyretic.
Common Side Effects
  • Nausea

  • Vomiting

  • Diarrhea

  • Constipation
  • Rash

  • Dizziness

  • Headache

  • Drowsiness
  • Fluid retention, leading to edema, most commonly manifest by swelling of the ankles.
  • Kidney failure (primarily with chronic use). 
  • Liver failure, ulcers and prolonged bleeding  after an injury or surgery.
 
     NSAID's have the potential to affect and harm the stomach and intestinal areas. Such as bleeding, ulcers, and perforation of the stomach & intestines. These symptoms can occur at any time during treatment, without warning. Elderly patients have a greater risk of these symptoms. NSAID's may escalate the risk of having fatal heart attacks, strokes, and similar disorders. An exception to this is Aspirin. The risk may grow with the duration of using NSAID's. This can possibly affect patients who have fundamental risk factors for Heart, and Blood Vessel Disease. Because of these possibilities, NSAID's should not be used for the treatment of pain resulting from Coronary Artery Bypass Graft (CABG) surgery.

Variances
of NSAIDs

     NSAID's vary in their potency, duration of action, how they are eliminated from the body, how strongly they inhibit COX-1 versus COX-2 and their tendency to cause ulcers and create bleeding. The more an NSAID blocks COX-1, the greater its tendency to cause ulcers and create bleeding. One NSAID, celecoxib (Celebrex), blocks COX-2 but has little effect on COX-1, and is therefore further classified as a selective COX-2 inhibitor. Selective COX-2 inhibitors cause less bleeding and fewer ulcers than other NSAIDs, but still pose a serious threat..

     Most NSAID's inhibit the clotting of blood for only a few hours. Ketorolac (Toradol) is a very potent NSAID. It is used for moderately severe acute pains. Pains such as this usually require narcotics. Ketorolac causes ulcers more frequently than other NSAID's. Because of this, it is not used for no more than five days. NSAID's have similar traits, and similar functions. Individuals who do not respond to certain forms, or features from a particular NSAID, may respond to another type of NSAID.
    NSAID's reduce blood flow to the kidneys and therefore reduce the action of Diuretics (water pills), and decrease the elimination of Lithium, (Eskalith, Lithobid) and Methotrexate (Rheumatrex). As a result, the blood levels of these drugs may increase as may their side effects.
     NSAID's also decrease the ability of the blood to clot, thus increasing the hazard of  bleeding. Especially when used with other drugs that also increase bleeding. Such as Warfarin or (Coumadin). The increased possibility of severe bleeding or complications of bleeding. People who take drugs that reduce the ability of blood to clot should avoid prolonged use of NSAID's.
NSAIDs
Classes

NSAIDs
Med Guide
Medical Uses

NSAID identification on label of generic ibuprofen, an OTC NSAID NSAIDs are usually used for the treatment of acute or chronic conditions where pain and inflammation are present.

NSAIDs are generally used for the symptomatic relief of the following conditions:
  • Osteoarthritis
  • Rheumatoid arthritis
  • Mild-to-moderate pain due to inflammation and tissue injury
  • Low back pain
  • Inflammatory arthropathies (e.g., ankylosing spondylitis, psoriatic arthritis, reactive arthritis)
  • Tennis elbow
  • Headache
  • Migraine
  • Acute gout
  • Dysmenorrhoea (menstrual pain)
  • Metastatic bone pain
  • Postoperative pain
  • Muscle stiffness and pain due to Parkinson's disease
  • Pyrexia (fever)
  • Ileus
  • Renal colic
  • They are also given to neonate infants whose ductus arteriosus is not closed within 24 hours of birth
  • Macular edema

Contraindications

NSAIDs may be used with caution by people with the following conditions:
  • Irritable bowel syndrome
  • Persons who are over age 50, and who have a family history of GI (gastrointestinal) problems
  • Persons who have had past GI problems from NSAID use

NSAIDs should usually be avoided by people with the following conditions:
  • Peptic ulcer or stomach bleeding
  • Uncontrolled hypertension
  • Kidney disease
  • People that suffer with inflammatory bowel disease (Crohn's disease or ulcerative colitis)
  • Past transient ischemic attack (excluding aspirin)
  • Past stroke (excluding aspirin)
  • Past myocardial infarction (excluding aspirin)
  • Coronary artery disease (excluding aspirin)
  • Undergoing coronary artery bypass surgery
  • Taking ibuprofen for heart
  • Congestive heart failure (excluding low-dose aspirin)
  • In third trimester of pregnancy
  • Persons who have undergone gastric bypass surgery
  • Persons who have a history of allergic or allergic-type NSAID hypersensitivity reactions, e.g. aspirin-induced asthma

Adverse Effects

The widespread use of NSAIDs has meant that the adverse effects of these drugs have become increasingly common. Use of NSAIDs increases risk of having a range of gastrointestinal (GI) problems. When NSAIDs are used for pain management after surgery they cause increased risk of kidney problems.

An estimated 10–20% of NSAID patients experience dyspepsia. In the 1990s high doses of prescription NSAIDs were associated with serious upper gastrointestinal adverse events, including bleeding. Over the past decade, deaths associated with gastric bleeding have declined.

NSAIDs, like all drugs, may interact with other medications. For example, concurrent use of NSAIDs and quinolones may increase the risk of quinolones' adverse central nervous system effects, including seizure.

There is an argument over the benefits and risks of NSAIDs for treating chronic musculoskeletal pain. Each drug has a benefit-risk profile and balancing the risk of no treatment with the competing potential risks of various therapies is the clinician's responsibility.
The modification date for all health, and medical content on this page was last updated, and checked on April 12th, 2018 PST U.S.A.
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