NSAIDs Side Effects

Nonsteroidal anti-inflammatory drugs (NSAIDs) are most commonly used by adults to manage musculoskeletal pain. Lower doses and intermittent use of NSAIDs are often adequate for analgesia. NSAIDs' anti-inflammatory properties often make them a favorable option over acetaminophen. Prescribers typically offer higher doses with scheduled use when anti-inflammatory effects are desirable.

RENAL EFFECTS

In general, most NSAIDs (both nonselective and COX-2 selective) have relatively similar effects on kidney function. The most common clinical features of NSAID-associated kidney injury include hypertension, salt and water retention, and hyperkalemia. Despite widespread use of these drugs, these effects are relatively uncommon. The challenge is that some patients are at increased risk for kidney injury, and may be particularly susceptible to NSAID-induced renal toxicities.

CARDIOVASCULAR EFFECTS

NSAID-associated cardiovascular events include interference with antiplatelet therapies, worsening of heart failure, increased BP, and diminished effect of concurrent antihypertensive therapies such as ACE inhibitors or thiazide diuretics.