NSAIDs have anti-inflammatory, analgesic, and antipyretic activities largely related to inhibition of prostaglandin synthesis; exact mechanisms of action are not known.

Indications

Relief of signs and symptoms of rheumatoid arthritis, osteoarthritis, and juvenile arthritisRelief of mild to moderate painTreatment of primary dysmenorrheaFever reductionReduction of number of adenomatous colorectal polyps in adults with familial adenomatous polyposis

Contraindications and cautions

Contraindicated with allergy to salicylates or other NSAIDs (more common in patients with rhinitis, asthma, chronic urticaria, nasal polyps); CV dysfunction, hypertension; peptic ulceration, GI bleeding; pregnancy or lactation.Use cautiously with impaired hepatic function, impaired renal function, heart failure.

Adverse effects

CNS: Headache, dizziness, somnolence, insomnia,fatigue, tiredness, tinnitus, ophthalmologic effects

Dermatologic: Rash,pruritus, sweating, dry mucous membranes, stomatitis

GI: Nausea, dyspepsia, GI pain,diarrhea, vomiting, constipation, flatulence

GU: Dysuria, renal impairment

Hematologic: Bleeding, platelet inhibition with higher doses, neutropenia, eosinophilia, leukopenia, pancytopenia, thrombocytopenia, agranulocytosis, granulocytopenia, aplastic anemia, decreased Hgb or Hct, bone marrow depression, menorrhagia

Respiratory: Dyspnea, hemoptysis, pharyngitis, bronchospasm, rhinitis

Other: Peripheral edema, anaphylactoid reactions to anaphylactic shock

Interactions

Drug-drug

Increased toxic effects of lithium with NSAIDs

Decreased diuretic effect with loop diuretics: bumetanide, furosemide, ethacrynic acid

Potential decrease in antihypertensive effect of beta-adrenergic blockers