→Appendix 1: NSAIDs
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GENERAL SIDE-EFFECTS
▶Uncommon Diarrhoea. paraesthesia. skin reactions
▶Rare or very rare Hypersensitivity. photosensitivity
reaction. renal impairment
▶Frequency not known Angioedema
SPECIFIC SIDE-EFFECTS
▶Common or very common
▶With oral use Gastrointestinal discomfort. nausea.
vomiting
▶Uncommon
▶With oral use Constipation. dizziness. drowsiness. fatigue.
gastrointestinal disorders. headache. oedema. rash
(discontinue)
▶With topical use Increased risk of infection
▶Rare or very rare
▶With oral use Asthma. haemorrhagic anaemia. hepatic
disorders. pancreatitis. shock. stomatitis. tinnitus. vision
disorders. weight increased
▶Frequency not known
▶With oral use Acute kidney injury (more common in
patients with pre-existing renal impairment).
Musculoskeletal system
agranulocytosis. alopecia. appetite decreased. bone
marrow failure. bronchospasm. confusion. Crohn’s
disease aggravated. depression. dyspnoea. fertility
decreased female. haemorrhage. hallucination. hearing
impairment. heart failure. hypertension. increased risk of
arterial thromboembolism. increased risk of ischaemic
stroke. increased risk of myocardial infarction. malaise.
meningitis aseptic (patients with connective-tissue
disorders such as systemic lupus erythematosus may be
especially susceptible). menometrorrhagia. mood altered.
nephritic syndrome. nephritis tubulointerstitial.
nephrotic syndrome. neutropenia. optic neuritis. rhinitis
. seizure. severe cutaneous adverse reactions (SCARs).
taste altered. thrombocytopenia. vasodilation. vertigo
▶With topical use Eosinophilia. eyelid oedema. fever.
gastrointestinal haemorrhage. lip swelling. peptic ulcer.
vasculitis. wound complications
SIDE-EFFECTS, FURTHER INFORMATION Topical application
of large amounts can result in systemic effects, including
hypersensitivity and asthma (renal disease has also been
reported).
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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▶With systemic use Caution—long-term use of some NSAIDs
is associated with reduced female fertility, which is
reversible on stopping treatment.
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▶With systemic use Avoid unless the potential benefit
outweighs the risk. 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.
▶With topical use Patient packs for topical preparations carry
a warning to avoid during pregnancy.
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▶With systemic use Use with caution during breast-feeding.
Amount probably too small to be harmful but
manufacturers advise avoid.
▶With topical use Patient packs for topical preparations carry
a warning to avoid during breast-feeding.
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▶With systemic use Manufacturer advises caution in mild to
moderate impairment; avoid in severe impairment.
▶With topical use Manufacturer advises caution.
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▶With systemic use Avoid if possible or use with caution.
Avoid in severe impairment.
▶With topical use Deterioration in renal function has also
been reported after topical use.
Dose adjustments ▶With systemic use The lowest effective
dose should be used for the shortest possible duration.
Monitoring ▶With systemic use 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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