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NSAIDs (Selective COX-2 inhibitor (CI (IHD, Cerebrovascular disease, L/R…
NSAIDs
Selective COX-2 inhibitor
Celecoxib
Interactions
↓s effects of ACEis and ARBs
↑ toxicity of methotrexate
CI
IHD
Cerebrovascular disease
L/R failure
Assess CV risk before use
SE
↑ cardiovascular events
Renal SEs as above
Only used for short periods
in young pts. with intolerance
of other NSAID
Non-selective COX inhibitors
Analgesic
Antipyretic
Anti-inflammatory
Eg
from least to most toxic
Ibuprofen
Diclofenac
Aspirin
Naproxen
Indomethacin
Ketoprofen
CI
Renal or cardiac failure
PUD
Severe hepatic impairment
Caution
asthma
elderly
interactions
↑ bleeding with warfarin
↓ effects of ACEis and ARBs
↑ toxicity of methotrexate
SE
↓ GFR
Interstitial nephritis
Papillary necrosis
↑ K
Peripheral oedema
Bronchospasm
Hypersensitivity
EM → SJS
Gastritis and PUD
Give with other agents for gastro protection
PPI
H2RAs
mioprostol