Nonsteroidal Anti-Inflammatory Drug (NSAIDs)

Common side effects

1. Dizziness
   
2. Nausea
   
3. Gastric irritation
   
4. High blood pressure
5. Fluid retention

Uncommon side effects

1. Raised liver enzymes / liver damage (if used on long term at high doses)
   
2. Kidney damage
   
3. Worsen heart failure
   
4. Increase risk of heart attacks and strokes in people with existing heart disease or other risk factors for stroke
5. Asthma exacerbation
6. Gastric ulcer or bleeding

• ​Keep to the dose as prescribed by your rheumatologist. If there is persistent or unbearable pain, make an earlier appointment with you rheumatologist.
• Come back to the hospital for regular blood test as instructed by your rheumatologist.
• Because adverse effects can happen at any time during the course of treatment, and some side effects may not cause symptoms, it is important to have your regular blood tests.​

• ​Maintain  adequate  hydration  (2-3  liters  of  fluid  a  day,  unless otherwise advised by your rheumatologist) and nutrition (small, frequent meals are preferred).
  
• Alcohol  should  be  avoided if  possible or  kept  to  a  minimum as suggested by your rheumatologist because alcohol may increase the risk of liver toxicity associated with NSAIDs.
  

• ​​It is usually given orally, either regularly or when needed. Some NSAIDs are available as suppositories or injections, although these are seldom used in the treatment of rheumatologic conditions.
  
• If   you   are   taking   NSAIDs   for   spondyloarthritis   (SpA),   your rheumatologist may advise you to take NSAIDs regularly to control the inflammation.
  
• Doses   of   NSAIDs   may   vary   from   person   to   person.   Your rheumatologist will prescribe a suitable dose for you. It is important that you DO NOT exceed the recommended dose, as this could make the side effects much more likely.
  
• Most NSAIDs should be swallowed whole with a glass of water, after food to prevent stomach upset, usually once or twice a day. The tablets/ capsules should not be crushed or chewed unless otherwise stated.

• ​NSAIDs are generally taken as needed and not regularly, except when directed by the rheumatologist.
  
•  If you forget to take a dose, take it as soon as you remember.
  
•  If it is almost time for next dose, skip the missed dose and continue with your regular dosing schedule.
  
• Do not double the dose to make up for the missed dose.

Keep away from children;#Keep in a cool, dry place, away from direct sunlight;#Store at room temperature;#

SUMMARY… what you need to know about NSAIDs?​​

• Beware of the SIDE EFFECTS​ and when to seek immediate medical attention.
• In people who already have kidney disease, using NSAIDs, even for a short time, can harm the kidneys. Never take OVER-THE-COUNTER medication, supplements or herbal treatment without checking with your rheumatologist or pharmacist first.
• If you (female) intent to start a family, please inform your rheumatologist as NSAIDs may affect your fetus and fertility.
If you have any questions about your NSAID treatment, please discuss with your doctor or Advanced Practice Nurse at 65762418 or pharmacist at 63265077.

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