→Appendix 1: NSAIDs
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GENERAL SIDE-EFFECTS
▶Common or very common Constipation. Crohn’s disease
aggravated. diarrhoea. gastrointestinal discomfort.
gastrointestinal disorders. haemorrhage. headache.
nausea. vomiting
▶Uncommon Fatigue. oedema. skin reactions
▶Rare or very rare Asthma. bronchospasm. depression.
dyspnoea. hyperglycaemia. nervousness. palpitations.
pancreatitis. severe cutaneous adverse reactions (SCARs).
sleep disorders. vertigo. weight changes
▶Frequency not known Agranulocytosis. alopecia. anaemia.
angioedema. aplastic anaemia. confusion. eosinophilia.
fertility decreased female. haemolytic anaemia.
hallucination. heart failure. hepatic disorders.
hypersensitivity. hypertension. leucopenia. malaise. nail
disorder. nephritis tubulointerstitial. nephropathy.
paraesthesia. photosensitivity reaction. platelet
aggregation inhibition. purpura non-thrombocytopenic.
renal failure (more common in patients with pre-existing
renal impairment). thrombocytopenia. tinnitus. vasculitis
. vision disorders
SPECIFIC SIDE-EFFECTS
▶Common or very common
▶With oral use Dizziness. dry mouth. oral disorders
▶Rare or very rare
▶With oral use Embolism and thrombosis. metabolic
disorder
▶Frequency not known
▶With oral use Drowsiness. eye irritation. eye swelling
▶With parenteral use Appetite decreased. increased risk of
arterial thromboembolism. increased risk of ischaemic
stroke. increased risk of myocardial infarction. meningitis
aseptic (patients with connective-tissue disorders such as
systemic lupus erythematosus may be especially
susceptible). neutropenia. oral ulceration
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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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.
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Use with caution during breast-feeding.
Present in milk in animal studies.
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Manufacturer advises caution in
mild to moderate impairment; avoid in severe impairment.
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Avoid if possible or use with caution.
Avoid in severe impairment.
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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