Specific Concerns With NSAIDs

Specific NSAID Warnings and Precautions

Some precautions and warnings to be aware of prior to taking NSAIDs include the following:
 
To decrease the chances of these problems, people should take the smallest effective dose for the shortest period of time. Also, call 911 if you notice things such as:
    • Chest pain
    • Shortness of breath
    • Weakness
    • Slurring of speech.
 
  • All NSAIDs may cause high blood pressure or cause high blood pressure to become worse. These medications should be used with caution in people who have high blood pressure.
 
  • All NSAIDs may cause congestive heart failure or swelling. Make sure to contact your healthcare provider if you notice any unexplained weight gain or swelling during treatment with NSAIDs. Also, these medications should be used with caution in people who have heart failure.
 
  • All NSAIDs have been reported to cause problems in the stomach and intestines, including bleeding (known as gastrointestinal bleeding), stomach ulcers, or holes in the stomach or intestines. These problems can lead to serious complications or even loss of life. Extreme caution should be used if NSAIDs are prescribed to people with a history of ulcers or gastrointestinal bleeding.
To decrease the chances of these problems occurring, people should take the smallest effective dose for the shortest period of time. Make sure to contact your healthcare provider immediately if you experience any signs or symptoms of stomach ulcers or bleeding, including:
    • Abdominal pain (stomach pain)
    • Indigestion
    • Black, tarry stools
    • Vomiting blood.
 
  • People taking NSAIDs can suffer kidney damage. It is more common in the elderly and people with kidney disease, heart failure, or liver problems. It is also more common in those taking diuretics or ACE inhibitors.
 
  • Liver damage can occur in people taking NSAIDs. Contact your healthcare provider immediately if you notice things such as:
 
    • Nausea
    • Tiredness
    • Lethargy
    • Itchy or yellowing skin
    • Abdominal pain (stomach pain)
    • Flu-like symptoms.
 
  • NSAIDs have been reported to cause allergic reactions. Seek immediate emergency medical attention if you notice things such as hives, an unexplained rash, difficulty breathing, or swelling of the face and throat while taking NSAIDs.
 
  • In rare cases, people taking NSAIDs can develop a serious rash. If you notice an unexplained rash or blisters, fever, or itchy skin, stop taking the NSAID and call your healthcare provider.
 
  • If you are an alcoholic or drink alcohol frequently, discuss this with your healthcare provider prior to starting NSAIDs. Alcohol can affect the way the liver works, indirectly affecting NSAIDs.
 
  • NSAIDS have been known to cause an increase in liver enzymes. Therefore, it is recommended that you have a blood test to measure your liver function before starting NSAIDs and 12 weeks after treatment has started.
 
  • NSAIDs have been known to cause anemia. If you are taking these medications for an extended amount of time and show signs of anemia, talk with your healthcare provider.
 
  • You should not take more than one NSAID at one time, as this may increase your risk of any of the problems discussed previously. Many NSAIDs are available with or without a prescription. A brief list of NSAIDs include:
 
You can ask your doctor or pharmacist for a complete list of these medications.
  • NSAIDs are pregnancy Category C medications, meaning that they could potentially cause harm to your unborn child. If you are pregnant, you should take NSAIDs only if your healthcare provider believes that the benefits to you outweigh the possible risks to your unborn child. NSAIDs are not recommended for women in the third trimester of pregnancy, as they can cause injury and even death to the developing fetus. If you become pregnant while taking NSAIDs, contact your healthcare provider immediately (see NSAIDs and Pregnancy for more information).
 
  • If you are breastfeeding, you should not take NSAIDs. Talk with your healthcare provider about whether to stop breastfeeding or stop taking NSAIDs.
 
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