Trade Name(s):
Available
Dose
Indications
To reduce inflammation and pain, most commonly pain associated with joints or soft tissues
Side Effects
Headache, dizziness, fluid retention (swelling in legs, e.g.), ringing of the ears, itching, and rash (including hives) are minor side effects. Side effects related to the stomach may be more serious and can include nausea, heartburn, stomach or intestinal ulcers, and bleeding. Less frequently, kidney function may be impaired. An increased bleeding time and anemia may result as well. Patients undergoing surgery in the near future may be asked to stop taking certain NSAIDs several days prior to avoid bleeding complications.
Monitoring
Baseline kidney and liver function tests, blood chemistry, and blood count are recommended. These studies should be repeated every 6-12 months. Blood pressure, heart rate, and weight should be monitored with each office visit.
Important Points to Know
Better absorption is achieved if these medications are taken with an empty stomach, but NSAIDs may be better tolerated if taken with meals. NSAIDs should be taken with a full glass of water to ensure that the medication has passed into the stomach. Follow-up is very important so that the provider can monitor for potential side effects. These medications should be taken as directed and over-the-counter NSAIDs should not be taken concurrently.
Special note: Celecoxib (Celebrex) is an NSAID that is selective for its effects on COX-2, an enzyme responsible for inflammation. The use of this medication results in less stomach-related side effects has no significant effect on bleeding time. Otherwise, all of the above side effects apply to this agent that apply to other NSAIDs. Some controversy has arisen about potential cardiac side effects after the withdrawal of rofecoxib (Vioxx), another COX-2 selective drug that demonstrated an increased rate of heart attacks in clinical studies. Thus far, the studies are inconsistent and inconclusive about potential cardiac risks of Celebrex. This drug remains an appropriate choice for patients needing an NSAID who would be at risk for stomach-related side effects from traditional NSAIDs.