NSAIDs Side Effects

What are NSAIDs?

NSAIDs are a broad category of common medications. It includes several different categories of similar drugs, but all of them share certain characteristics. For more specific information about NSAIDs, click here: What are NSAIDs?

NSAID (pronounced EN-sed) is an acronym for Non-Steroidal Anti-Inflammatory Drug. They are generally used as painkillers (analgesics), fever reducers (antipyretics) and anti-inflammatory medications (reducing swelling).  For more about what NSAIDs are used to treat, click here: Common Uses of NSAIDs.

Side-Effects of NSAIDs

Though NSAIDs are generally safe, as many as 30% of NSAIDs users suffer from various side effects. “Side effect” is a bit over-used, however, and can also describe POSITIVE unexpected results.  Instead, we will mostly use the medical term here: adverse drug reactions (ADRs).  Though most NSAIDs share these ADRs, the various drugs will affect different people in different ways.

Gastrointestinal Problems (Stomach and Intestines)

The most common side effects of NSAIDs are digestive problems.  Most of the time, the reactions are mild, but can result in very serious complications. The following adverse drug reactions are most frequent:

  • nausea
  • vomiting
  • indigestion/upset stomach (dyspepsia)
  • stomach bleeding
  • stomach ulcers

These digestive problems are a direct result of NSAIDs effects on hormones called prostaglandins.  Prostaglandins have many functions in a healthy body, such as increasing body temperature and producing the protective lining of the stomach and intestines. Larger amounts of prostaglandin are responsible for fever, however, so NSAIDs’ effects on the hormone are a major part of their ability to reduce fever.

Many commercially produced NSAIDs are given a special coating meant to relieve the gastrointestinal problems caused by the drugs, but there is no evidence of this being effective. These stomach and intestine problems occur regardless of how the medicine is taken as it is interference with a system-wide hormone (prostaglandins) that makes the drug effective.

Cardiovascular Problems (Heart Attack and Stroke)

With the exception of aspirin (which is heart-healthy in certain situations), NSAIDs carry an increased risk of cardiovascular disease.  Some research implies that the occurrence of serious cardiovascular disease such as heart attacks and stroke can be twice as likely in people using NSAIDs, even if there is no pre-existing heart disease.

Low-dose aspirin is an exception to this ADR, and it is often used to reduce the risk of further heart attack and stroke among those who have a pre-existing condition.  Researchers are still unsure whether or not it is helpful for a healthy individual to take low-dose aspirin as a preventative treatment.  Besides aspirin, naproxen is considered the least likely to cause cardiovascular disease.

Renal Failure (Kidney Problems)

This is another fairly common side effect of NSAIDs, especially when the drugs are mixed with other drugs such as ACE inhibitors (common blood pressure medications).  NSAIDs’ effects on the prostaglandin hormones also effect the kidneys, making them less efficient at filtering and eliminating wastes from the body.

Some common signs of an NSAID’s adverse drug reaction on the kidneys may include salt and water retention (bloating) or hypertension (high blood pressure). More serious conditions may result in pain of the kidneys, a reduction in the amount of urine, or changes in the urine.  If these symptoms sound non-specific, it’s because they are often very general, so it’s best to see a doctor immediately if there are any issues related to urination.

Erectile Dysfunction Risk

Use of NSAIDs has been linked to erectile dysfunction, though it’s currently not understood exactly why this is the case. Middle-aged men regularly taking NSAIDs are up to 2.4 times more likely to suffer from erectile dysfunction. Researchers are surprised by the findings, and they are looking into it further.

Photosensitivity (Sun Allergy)

Photosensitivity is also commonly called “sun allergy.” It describes an event when the skin has an allergic reaction the sun, in this case because NSAIDs are reacting with the sunlight in the skin itself. The result is typically a rash, though how severe a rash will vary between people.

NSAIDs During Pregnancy

NSAIDs are not considered safe during pregnancy.  Though NSAIDs aren’t known to cause birth defects among infants, they can affect both the kidneys and the heart, especially late in the pregnancy. They are also suspected to cause premature birth and miscarriage.

In specific situations, however, NSAIDs are used to treat specific conditions in an unborn or newborn child. This is always according to the directions of a doctor, however.

Combining with Other Drugs

As with any medication, it’s very important to NEVER mix NSAIDs with other medications without first consulting a doctor. Many NSAIDs react badly with alcohol, increasing the chances of stomach bleeding and other digestive problems.

NSAIDs can interfere with the effects of some kidney and blood pressure medications.

Also, many NSAIDs have anti-platelet effects (preventing the normal clotting of blood).  Aspirin is especially well known for this. The effect can be compounded if NSAIDs are mixed with another anti-clotting medication such as warfarin.

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