Drug Interaction:
NSAIDs include-
Propionic acid- Fenoprofen, Flurbiprofen, Ibuprofen, Ketoprofen, Naproxen, Naproxen Sodium,Oxaprozin
Acetic acids- Diclofenac sodium, Etodolac, Indomethicin, Ketorolac, Nabumetone, Sulindac, Tolmetin
Fenamates (anthralic acids) - Meclofenamate, Mefenamic acxid
Oxicams- Piroxicam
Refer- Ibuprofen
Anticoagulants, sulphonylureas
Hydantoins, NSAIDs Aspirin
Probenecid, metoclopramide
Colestyramine, busulphan,Quinolone
Plasma protein bound drugs.
Lithium, antihypertensives, diuretics,
Cardiac glycosides, methotrexate, cyclosporin
Miferistone, corticosteroids,
Magnesium containing antacids
ACE inhibitors or CYP2C6
Indication:
Moderate to severe pain
Adverse Reaction:
GI disturbances, (e.g abdominal pain, constipation, diarrheoa, nausea, dyspepsia, flatulance,
g-i ulceration or bleeding )
Skin rash (discontinue )
Headache, pruritus, dizziness, oedema
Tinnitus, drowsiness, photosensitivity
CNS effects, alopecia, blurred vision
Renal, hepatic impairment, anaemia,
Thrombocytopenia
Raised liver enzymes
Allergic glomerulonephritis
Risk of cardiovascular events
Risk of hepatotoxicity among chronic heavy users
Hepatotoxicity (overdosages only )
Blood dyscrasias ( rare )
Contra-Indications:
GI tract inflammation,
Glaucoma, peptic or gastric ulceration
Renal or hepatic impairment
Asprin/ NSAID allergy
Severe heart failure
Coronary artery bypass graft , surgery
Pregnancy lactation
Special precautions-
May exacerbate chronic urticaria or asthma
Dehydration
Haemoglobin and blood counts recommended
Elderly
Mild to moderate heart failure, epilepsy, asthma
Bleeding disorders,
Debilated , fliud retention,
Hypertension
Monitor for G-I ulcer bleed ( risk is increased if patient is otherwise at high risk ),
extended drug treatment, high doses, smokers, alcoholics, history of GI bleed or ulcer)
Blood , renal ,hepatic and ocular function in chronic use
Labour and delivery
Dosages/ Overdosage Etc:
Moderate to severe pain
1 tablet thrice daily
Patient Information:
NSAIDS INFORMATION INCLUDES-
DICLOFENAC, DIFUNISAL, ETODAC, FENOPROFEN, FLOCTAFENINE, FLURBIPROFEN, IBUPROFEN,
INDOMETHICIN, KETOPROFEN, MECLOFENAMATE, MEFENAMIC ACID, NABUMETONE, NAPROXEN,
OXAPROZIN,PHENYLBUTAZONE, PIROXICAM, SULINDAC, TENOXICAM, TIAPROFENIC, TOLMETIN
REFER - IBUPROFEN
Mefanamic acid
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1. NSAIDs can cause discomfort and rarely more serious side effects such as GI bleeding which
may result in hospitalisation and even fatalities.
2.Avoid aspirin and alcoholic beverages while taking medication.
3. If GI upset occurs, take with food, milk or antacids. For GI upset with tolmetin, use antacids other than sodium bicarbonate.
4. Notify physician, if skin rash, itching, visual disturbances, weight gain, edema occurs
5. Mefanamic acid and metclofenate: if rash, diarrhoea, or digestive problem occur discontinue use and consult physician
6. Ibuprofen- Do not take for more than 3 days for fever or 10 days for pain. If these symptoms persists,consult a physican.
Pregnancy and lactation:
Contraindicated for use during pregnancy and lactation
Observe caution if requried to be used