→Appendix 1: NSAIDs
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▶Common or very common Arrhythmias. asthenia.
bronchospasm. constipation. diarrhoea. dizziness. fluid
retention. gastrointestinal discomfort. gastrointestinal
disorders. headache. hypertension. increased risk of
infection. influenza like illness. nausea. oedema. oral
ulceration. palpitations. skin reactions. vomiting
▶Uncommon Alertness decreased. anaemia. angina pectoris
. anxiety. appetite abnormal. cerebrovascular
insufficiency. chest pain. congestive heart failure.
Musculoskeletal system
conjunctivitis. cough. depression. drowsiness. dry mouth
. dyspnoea. flushing. haemorrhage. hallucination.
hyperkalaemia. hypersensitivity. insomnia. irritable
bowel syndrome. leucopenia. myocardial infarction.
pancreatitis. proteinuria. renal failure (more common in
patients with pre-existing renal impairment). sensation
abnormal. taste altered. thrombocytopenia. tinnitus.
vasculitis. vertigo. vision blurred. weight increased
▶Rare or very rare Angioedema. confusion. hepatic
disorders. muscle complaints. severe cutaneous adverse
reactions (SCARs). shock
▶Frequency not known Nephritis tubulointerstitial.
nephropathy
SIDE-EFFECTS, FURTHER INFORMATION For information
about cardiovascular and gastrointestinal side-effects, and
a possible exacerbation of symptoms in asthma, see Non-
steroidal anti-inflammatory drugs p. 1193.
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Caution—long-term
use of some NSAIDs is associated with reduced female
fertility, which is reversible on stopping treatment.
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Manufacturer advises avoid (teratogenic in
animal studies). Avoid during the third trimester (risk of
closure of fetal ductus arteriosus in utero and possibly
persistent pulmonary hypertension of the newborn); onset
of labour may be delayed and duration may be increased.
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Use with caution during breast-feeding.
Manufacturer advises avoid—present in milk in animal
studies.
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Manufacturer advises caution in
mild to moderate impairment; avoid in severe impairment
(no information available).
Dose adjustments Manufacturer advises max. 60 mg once
daily in mild impairment; max. 30 mg once daily in
moderate impairment.
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Avoid if possible or use with caution.
▶In adults Avoid if eGFR less than 30 mL/minute/1.73 m2.
▶In children Avoid if estimated glomerular filtration rate less
than 30 mL/minute/1.73 m2.
Dose adjustments The lowest effective dose should be used
for the shortest possible duration.
Monitoring In renal impairment monitor renal function;
sodium and water retention may occur and renal function
may deteriorate, possibly leading to renal failure.
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Monitor blood pressure
before treatment, 2 weeks after initiation and periodically
during treatment.
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