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 medicines

- in people who have heart disease

NSAID medicines should never be used right before or after a heart surgery called a “coronary 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 symptoms

- may cause death

The chance of a person getting an ulcer or bleeding increases with:
- taking medicines called “corticosteroids” and “anticoagulants”

- longer use

- smoking

- drinking alcohol

- older age

- having poor health

NSAID medicines should only be used:

- exactly as prescribed

- at the lowest dose possible for your treatment

- for the shortest time needed

What 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 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	stomach pain
stroke	constipation
high blood pressure	diarrhea
heart failure from body swelling (fluid retention)	gas
kidney problems including kidney failure	heartburn
bleeding and ulcers in the stomach and intestine	nausea
low red blood cells (anemia)	vomiting
life-threatening skin reactions	dizziness
life-threatening allergic reactions
liver problems including liver failure
asthma attacks in people who have asthma

Get emergency help right away if you have any of the following symptoms:
- shortness of breath or trouble breathing

- slurred speech

- chest pain

- swelling of the face or throat

- weakness in one part or side of your body

Stop your NSAID medicine and call your healthcare provider right away if you have any of the following symptoms:
- nausea

- there is blood in your bowel movement or it is black and sticky like tar

- more tired or weaker than usual

- itching

- your skin or eyes look yellow

- unusual weight gain

- stomach pain

- skin rash or blisters with fever

- flu-like symptoms

- swelling of the arms and legs, hands and feet

- vomit blood

These are not all the side effects with NSAID medicines. Talk to your healthcare provider or pharmacist for more information about NSAID medicines.

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 ccause ulcers in the stomach and intestines.

- Some of these NSAID medicines are sold in lower doses without a prescription (over- the-counter). Talk to your healthcare provider before using over-the- counter NSAIDs for more than 10 days.

NSAID medicines that need a prescription

Generic Name	Tradename
Celecoxib	Celebrex®
Diclofenac	Cataflam®, Voltaren®, Arthrotec™ (combined with misoprostol)
Diflunisal	Dolobid®
Etodolac	Lodine®, Lodine® XL
Fenoprofen	Nalfon®, Nalfon® 200
Flurbirofen	Ansaid®
Ibuprofen	Motrin®, Tab-Profen®, Vicoprofen** (combined with hydrocodone), CombunoxTM (combined with oxycodone)
Indomethacin	Indocin®, Indocin® SR, Indo-Lemmon™, Indomethagan™
Ketoprofen	Oruvail®
Ketorolac	Toradol®
Mefenamic Acid	Ponstel®
Meloxicam	Mobic®
Nabumetone	Relafen®
Naproxen	Naprosyn®, Anaprox®, Anaprox® DS, EC-Naproxyn®, Naprelan®, Naprapac ® (copackaged with lansoprazole)
Oxaprozin	Daypro®
Piroxicam	Feldene®
Sulindac	Clinoril®
Tolmetin	Tolectin®, Tolectin DS®, Tolectin® 600
* Vicoprofen contains the same dose of ibuprofen as over-the-counter (OTC) NSAID, 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	* Vicoprofen contains the same dose of ibuprofen as over-the-counter (OTC) NSAID, 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.
Manufactured by:
Glenmark Generics Ltd
Colvale-Bardez, Goa 403 513
India
Manufactured for:

Glenmark

Glenmark Generics Inc., USA
Mahwah, NJ 07430
Questions? 1 (888)721-7115
www.glenmarkgenerics.com
November 2008