Nonsteroidal Anti-Inflammator... Health Article

Special conditions

People with certain medical conditions and people who are taking some other medicines can have problems if they take nonsteroidal anti-inflammatory drugs. Before taking these drugs, be sure to let the physician know about any of these conditions:

ALLERGIES. Let the physician know about any allergies to foods, dyes, preservatives, or other substances. Anyone who has had reactions to nonsteroidal antiinflammatory drugs in the past should also check with a physician before taking them again.

PREGNANCY. Women who are pregnant or who plan to become pregnant should check with their physicians before taking these medicines. Whether nonsteroidal antiinflammatory drugs cause birth defects in people is unknown, but some do cause birth defects in laboratory animals. If taken late in pregnancy, these drugs may prolong pregnancy, lengthen labor time, cause problems during delivery, or affect the heart or blood flow of the fetus.

BREASTFEEDING. Some nonsteroidal anti-inflammatory drugs pass into breast milk. Women who are breast-feeding should check with their physicians before taking these drugs.

OTHER MEDICAL CONDITIONS. A number of medical conditions may influence the effects of nonsteroidal anti-inflammatory drugs. Anyone who has any of the conditions listed below should tell his or her physician about the condition before taking nonsteroidal antiinflammatory drugs.

• stomach or intestinal problems, such as colitis or Crohn's disease
• liver disease
• current or past kidney disease; current or past kidney stones
• heart disease
• high blood pressure
• blood disorders, such as anemia, low platelet count, low white blood cell count
• bleeding problems
• diabetes mellitus
• hemorrhoids, rectal bleeding, or rectal irritation
• asthma
• parkinson's disease
• epilepsy
• systemic lupus erythematosus
• diseases of the blood vessels, such as polymyalgia rheumatica and temporal arteritis
• fluid retention
• alcohol abuse
• mental illness

People who have sores or white spots in the mouth should tell the physician about them before starting to take nonsteroidal anti-inflammatory drugs. Sores or white spots that appear while taking the drug can be a sign of serious side effects.

SPECIAL DIETS. Some nonsteroidal anti-inflammatory drugs contain sugar or sodium, so anyone on a low-sugar or low-sodium diet should be sure to tell his or her physician.

SMOKING. People who smoke cigarettes may be more likely to have unwanted side effects from this medicine.

USE OF CERTAIN MEDICINES. Taking nonsteroidal anti-inflammatory drugs with certain other drugs may affect the way the drugs work or increase the risk of unwanted side effects. (See Interactions.)

Side effects

The most common side effects are stomach pain or cramps, nausea, vomiting, indigestion, diarrhea, heart-burn, headache, dizziness or lightheadedness, and drowsiness. As the patient's body adjusts to the medicine, these symptoms usually disappear. If they do not, check with the physician who prescribed the medicine.

Serious side effects are rare, but do sometimes occur. If any of the following side effects occur, stop taking the medicine and get emergency medical care immediately:

• swelling or puffiness of the face
• swelling of the hands, feet, or lower legs
• rapid weight gain
• fainting
• breathing problems
• fast or irregular heartbeat
• tightness in the chest

Other side effects do not require emergency medical care, but should have medical attention. If any of the following side effects occur, stop taking the medicine and call the physician who prescribed the medicine as soon as possible:

• severe pain, cramps, or burning in the stomach or abdomen
• convulsions
• ever
• severe nausea, heartburn, or indigestion
• white spots or sores in the mouth or on the lips
• rashes or red spots on the skin
• any unusual bleeding, including nosebleeds, spitting up or vomiting blood or dark material
• black, tarry stool
• chest pain
• unusual bruising
• severe headaches

A number of less common, temporary side effects are also possible. They usually do not need medical attention and will disappear once the body adjusts to the medicine. If they continue or interfere with normal activity, check with the physician. Among these side effects are:

• gas, bloating, or constipation
• bitter taste or other taste changes
• sweating
• restlessness, irritability, anxiety
• trembling or twitching

Interactions

Nonsteroidal anti-inflammatory drugs may interact with a variety of other medicines. When this happens, the effects of the drugs may change, and the risk of side effects may be greater. Anyone who takes these drugs should let the physician know all other medicines he or she is taking. Among the drugs that may interact with nonsteroidal anti-inflammatory drugs are:

• blood thinning drugs, such as warfarin (Coumadin)
• other nonsteroidal anti-inflammatory drugs
• heparin
• tetracyclines
• cyclosprorine
• digitalis drugs
• lithium
• phenytoin (Dilantin)
• zidovudine (AZT, Retrovir)

Nancy Ross-Flanigan