Increased risk of salicylate toxicity with aspirin. May increase effects of oral anticoagulants. May reduce effects of β-blockers, diuretics and other antihypertensive agents. May increase risk of methotrexate and lithium toxicity.
Common side effects are depression, sedation, somnolence, confusion, disturbance of sleep, weakness, malaise; rash, prutitus, urticaria, photosensitivity; abdominal pain/distress, anorexia, flatulence, vomiting, constipation, diarrhoea, dyspepsia, nausea, peptic ulcer and/or GI bleeding, abnormalities in LFTs, stomatitis, haemorrhoidal or rectal bleeding; tinnitus; dysuria or frequency; oedema, BP changes; haematuria, renal insufficiency, decreased menstrual flow; anaemia, thrombocytopenia, leukopenia, ecchymoses; wt gain/loss; blurred vision, conjunctivitis.
The following adverse reactions may occur:
Cardiovascular Thrombotic Events
GI Bleeding, Ulceration and Perforation
Hepatotoxicity
Hypertension
Heart Failure and Edema
Renal Toxicity and Hyperkalemia
Anaphylactic Reactions
Serious Skin Reactions
Hematologic Toxicity
Pregnancy categaory: C, D (in 3rd trimester or near delivery)
Be alert for ulceration and bleeding in patients treated chronically. History of serious GI events, alcoholism, smoking, other factors known to be associated with peptic ulcer. Elderly or debilitated patients. Uncompensated cardiac failure, history of hypertension, cardiac decompensation, chronic diuretic therapy, conditions predisposing to fluid retention. Renal and hepatic impairment. Underlying coagulation defects or patients who are undergoing surgical procedures where a high degree of haemostasis is required. Pregnancy (avoid in 3rd trimester) and lactation.
Renal Impairment-
Osteoarthritis: Severe or on dialysis: 600 mg once daily. Increase to 1.2 g daily if needed.
Rheumatoid arthritis: Severe or on dialysis: 600 mg once daily. Increase to 1.2 g daily if needed.
Symptoms: Acute renal failure, vomiting, drowsiness, leukocytosis.
Management: Supportive and symptomatic. Multiple admin of charcoal may be required to reduce potential for delayed toxicities.
Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)
