MEDGUIDE

Medication Guide
for
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
(See the end of this Medication Guide for a list of prescription NSAID medicines.)
What is the most important information I should know about medicines called
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)?
NSAID medicines may increase the chance of a heart attack or stroke that can lead to death.This chance increases:
     with longer use of NSAID medicinesin people who have heart diseaseNSAID medicines should never be used right before or after a heart surgery called a
artery bypass graft (CABG).
NSAID medicines can cause ulcers and bleeding in the stomach and intestines at any
time during treatment. Ulcers and bleeding:
     can happen without warning symptomsmay cause deathThe chance of a person getting an ulcer or bleeding increases with:
     taking medicines called     
anddrinking alcohollonger useolder agesmokinghaving poor healthNSAID medicines should only be used:
     exactly as prescribedfor the shortest time neededat the lowest dose possible for your treatmentWhat are Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)?
NSAID medicines are used to treat pain and redness, swelling, and heat (inflammation) from medical conditions such as:
     different types of arthritis
     menstrual cramps and other types of short-term pain
Who should not take a Non-Steroidal Anti-Inflammatory Drug (NSAID)?
Do not take an NSAID medicine:
     if you had an asthma attack, hives, or other allergic reaction with aspirin or any other NSAID medicine
     for pain right before or after heart bypass surgery
Tell your healthcare provider:
     about all of your medical conditions.
     about all of the medicines you take. NSAIDs and some other medicines can interact with each other and cause serious side effects.Keep a list of your medicines to show to your healthcare provider and pharmacist.
     if you are pregnant.NSAID medicines should not be used by pregnant women late in their pregnancy.
     if you are breastfeeding.Talk to your doctor.
What are the possible side effects of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)?
Serious side effects include:Other side effects include:heart attack
     stroke
     high blood pressure
     heart failure from body swelling (fluid retention)
     kidney problems including kidney failure
     bleeding and ulcers in the stomach and intestine
     low red blood cells (anemia)
     life-threatening skin reactions
     life-threatening allergic reactions
     liver problems including liver failure
     asthma attacks in people who have asthmastomach pain
     constipation
     diarrhea
     gas
     heartburn
     nausea
     vomiting
     dizzinessGet emergency help right away if you have any of the following symptoms:
     shortness of breath or trouble breathingslurred speechchest painswelling of the face or throatweakness in one part or side of your bodyStop your NSAID medicine and call your healthcare provider right away if you have any of the following symptoms:
     nauseavomit bloodmore tired or weaker than usualthere is blood in your bowel movement or it is black and sticky like taritchingunusual weight gainyour skin or eyes look yellowskin rash or blisters with feverstomach painswelling of the arms and legs, hands and feetflu-like symptomsThese are not all the side effects with NSAID medicines. Talk to your healthcare provider or pharmacist for more information about NSAID medicines.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Other information about Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
     Aspirin is an NSAID medicine but it does not increase the chance of a heart attack. Aspirin can cause bleeding in the brain, stomach, and intestines. Aspirin can also cause ulcers in the stomach and intestines.
     Some of these NSAID medicines are sold in lower doses without a prescription (overthe-counter). Talk to your healthcare provider before using over-the-counter NSAIDs for more than 10 days.
NSAID medicines that need a prescription
Generic NameTradenameCelecoxibCelebrexDiclofenacCataflam, Voltaren, Arthrotec (combined with misoprostol)DiflunisalDolobidEtodolacLodine, Lodine XLFenoprofenNalfon, Nalfon 200FlurbiprofenAnsaidIbuprofenMotrin, Tab-Profen, Vicoprofen* (combined with hydrocodone), Combunox (combined with oxycodone)IndomethacinIndocin, Indocin SR, Indo-Lemmon, IndomethaganKetoprofenOruvailKetorolacToradolMefenamic AcidPonstelMeloxicamMobicNabumetoneRelafenNaproxenNaprosyn, Anaprox, Anaprox DS, EC-Naprosyn, Naprelan, Naprapac (copackaged with lansoprazole)OxaprozinDayproPiroxicamFeldeneSulindacClinorilTolmetinTolectin, Tolectin DS, Tolectin 600* Vicoprofen contains the same dose of ibuprofen as over-the-counter (OTC) NSAIDs, and is usually used for less than 10 days to treat pain. The OTC NSAID label warns that long term continuous use may increase the risk of heart attack or stroke.
This Medication Guide has been approved by the U.S. Food and Drug Administration.