All
NSAIDs reduce sodium excretion by the kidneys, which raises blood pressure.
When a patient requires an
NSAID for muscle or joint pain associated with arthritis, finding an effective
NSAID can be a matter of trial and error.
"American College of Gastroenterology guidelines for management of IBD recognise
NSAIDs as potential triggers for disease exacerbation, highlighting the ongoing concern regarding the use of these medications in patients with established disease," wrote Oluwatoba Moninuola, MBBS, of Harvard University T.H.
NSAID SAFETY: Regarding
NSAID safety, the Arthritis, Rheumatism, and Aging Medical Information System estimates that adverse effects due to
NSAIDs are associated with more than 100,000 hospitalizations and more than 16,000 deaths in the U.S.
After multivariable analysis, first author Oscar Viteri, MD, and his colleagues reported that 70% of patients who received
NSAIDs had persistent postpartum hypertension, defined as a blood pressure of at least 150 mm Hg or a diastolic BP of at least 100 mm Hg obtained on two occasions at least 4 hours apart.
They found that taking any dose of
NSAIDs, including ibuprofen and naproxen, for a week, a month or more than a month was associated with a greater heart attack risk.
The primary endpoint was differences in gastrointestinal symptom scores and health-related QOL scores between users and nonusers of
NSAIDs and LDA at peptic ulcer onset, compared with the following patient groups: NSAID-only, LDA-only,
NSAIDs + LDA, and nonusing (neither
NSAIDs nor LDA).
The Proprietary Association of Great Britain, the trade association representing manufacturers of branded over-the-counter medicines, stressed the patients were given
NSAIDs on prescription.
The study by a team from Milano-Bicocca University in Italy showed increased risk in seven traditional
NSAIDs. These are diclofenac, ibuprofen, indomethacin, ketorolac, naproxen, nimesulide and piroxicam.
Each year, more than 15 per cent of the population in western countries are given a prescription for
NSAIDs. This figure increases with age.
Jones notes that the bleeding risk is especially high for patients taking
NSAIDs in combination with other blood-thinning agents; these include aspirin, warfarin (Coumadin), the newer anticoagulants used to treat atrial fibrillation (Pradaxa, Xarelto, Eliquis), and antiplatelet agents that are given after having a stent placed (Plavix, Effient).
After examining the data of over 30,000 patients with high blood pressure, researchers at the Institute of Population Health Sciences, National Health Research Institutes in Zhunan, Taiwan, found that those who'd been taking
NSAIDs for at least three months were 32% more likely to have chronic kidney disease than those who didn't take
NSAIDs.
Since discovery of an increased risk of cardiovascular (CV) events with nonsteroidal anti-inflammatory drugs (
NSAIDs) a decade ago, additional analyses have been conducted to provide further insight and assess if differences exist among the
NSAIDs regarding CV risk.
Another day, another achy joint, another dose of nonsteroidal anti-inflammatory drugs (
NSAIDs).
Non-steroidal anti-inflammatory drugs (
NSAIDs) comprise a group of medicines that exert their action by inhibiting cyclooxygenase (COX) isozymes.
