Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) inhibit COX-1 and COX-2 enzymes involved with inflammation. There are many agents including naproxen, ibuprofen, acetylsalicylic acid, meloxicam, indomethacin, celecoxib (COX-2 selective) and more!
Dosing varies with each agent, but these must be taken with food to reduce stomach irritation and bleed risk.
Adverse Effects: Many!
Gastric Irritation: lowest risk is with COX-2 selective NSAIDs (diclofenac and celecoxib). Choose enteric coated versions, or use proton pump inhibitors for high risk patients or long-term NSAID use.
Cardiovascular: Increased events such as hypertension and myocardial infaction (especially celecoxib)
Renal: Altered renal perfusion, leading to kidney dysfunction and impairment
-Caution in pregnancy due to malformations and interference with closure of ductus arteriosus
-May exacerbate heart failure through fluid retention
-Antihypertensives: loss of effect
-Blood thinners, SSRIs: increased risk of bleed
-Lithium: leads to increased lithium levels