anti-inflammatory agents (NSAIDs) are a group of medicines that relieve pain
and fever and reduce inflammation. There are nearly two dozen different NSAIDs
available, but they all work in the same way, and that is by blocking a
specific group of enzymes called cyclo-oxygenase enzymes, often abbreviated to
COX enzymes. These enzymes are responsible for the production of
prostaglandins. Prostaglandins are a group of compounds with hormone-like
effects that control many different processes such as inflammation, blood flow,
and the formation of blood clots.
are one of the most widely prescribed group of medicines; however, they are
associated with some serious side effects.
can increase your risk of a fatal heart attack or stroke. The risk increases
the higher the dosage and the longer the length of time you remain on an NSAID
for. People with pre-existing heart disease are more at risk and certain
NSAIDs, such as diclofenac and celecoxib, have been linked to more
heart-related side effects than others. NSAIDs should never be used just before
or after heart bypass surgery (coronary artery bypass graft, or CABG).
(GI) side effects are also common, and usually related to dosage and duration
of treatment although some NSAIDs, such as ketorolac, aspirin and indomethacin,
are associated with a higher risk. Elderly people or those taking other
medicines that irritate the stomach are more likely to experience
life-threatening GI side effects, such as stomach or intestinal bleeding.
NSAIDs are not suitable for children or adolescents under the age of 18 years.
Ibuprofen is the only NSAID approved for children aged three months and older.
NSAIDs should not be taken during the last three months of pregnancy or while
breastfeeding except on a doctor’s advice.
NSAIDs can potentially cause a range of
side effects, especially when used at higher than recommended dosages for long
periods of time.
Gastrointestinal side effects that may
occur include bloating, diarrhea, constipation, irritation of the lining of the
stomach, nausea or vomiting.
NSAIDs may also affect kidney function and
reduce how quickly blood flows through the kidneys. They may cause retention of
sodium and water which can lead to edema and high potassium levels.
Occasionally, they may cause more serious damage to the kidneys.
Some NSAIDs, particularly diclofenac and
those that are selective for COX-2 enzymes, have a high risk of cardiovascular
thrombotic events such as a heart attack or stroke. Other heart-related side
effects such as high blood pressure, congestive heart failure, and palpitations
have also been reported.
In addition, some people taking NSAIDs have
experienced asthma attacks, bleeding, fatigue, headache, insomnia, low
neutrophil levels, urticaria (hives), vertigo and seizures. Reye’s syndrome, a
life-threatening condition that causes swelling in the liver and brain and is
mostly associated with aspirin use in young children has also been reported.
Always consult your healthcare provider to
ensure the information displayed on this page applies to your personal
Keywords: nonsteroidal anti-inflammatory drugs; NSAIDs.