Non Steroidal Anti Inflammatory Drugs (NSAIDs) are commonly prescribed in conditions with inflammation and pain such as joint pains, rheumatoid arthritis, urinary stones and muscle pains. Some NSAIDs are prescribed for congenital heart diseases (Indocid in PDA) and in heart attacks (Aspirin). Some medications are available over the counter E.g. Naprosyn®. Main side effects are gastritis and gastric ulceration.
These medications are effective in reducing fever as well. But some viral fevers can reduce platelet counts. In this scenario inhibition of platelet function by NSAID can cause life threatening bleeding. Due to this reason doctors do not prescribe this medication to control undiagnosed fevers or viral fever.
Two main problems common to all the NSAIDs are inhibition of blood clot formation by the platelets and increased gastric acid secretion. Increased gastric acid secretion causes gastritis and gastric irritation.
These medications are available as tablets, suppositories, and in injections. Suppositories are used in the patients who cannot take tablets orally. But NSAIDs do not reduce the gastric side effects. Injections are used to treat congenital heart diseases (Patent ductus arteriosus).
How side effects can be minimized?
As with any medication NSAIDs should be taken as a whole with full glass of water. It should be used in recommended dosage. It should not be crushed before use. Adverse effects like stomach irritation and ulceration can be minimized by taking these medications with milk or aluminum hydroxide and magnesium hydroxide tablets.
If you have bleeding disorder, kidney disease, liver disease, heart disease, history of NSAID allergy (including aspirin) or bronchial asthma, you should discuss that with your doctor. If you have a history of troublesome gastritis, bleeding from the gastro intestinal tract, and passing dark color stools then you should tell that to your doctor as well. If you have fever for more than two days doctor will do several blood tests to identify a cause before starting NSAIDs.
What are the Common side effects?
Burning stomach pain, gastro intestinal discomfort, nausea, bleeding and gastric ulceration are common. Patients who have a history of stomach ulceration and bleeding should not use NSAIDs. These problems are more common in elderly patients. While on this medication, if you happen to pass dark color stools, developed severe abdominal pain then you should consult your doctor immediately.
What are the Long term side effects?
Long term regular use of NSAIDs can cause irreversible kidney failure. These medications can aggravate bronchial asthma as well. Some medications like COX2 inhibitors (Celebrex®) can cause heart problems.
These medications (NSAIDs) are known to cause fetal harm. So your doctor may not use them in pregnancy. Amount secreted to breast milk is too small to be harmful to the baby. But they are usually not used in breast feeding.
NSAIDs are widely prescribed to kill pain. However it can cause gastric and duodenal ulcers. In addition they can cause renal failure on long term use.
British National Formulary