Adverse effects include nausea, dyspepsia, diarrhea, constipation, gastrointestinal ulceration/bleeding, headache, dizziness, rash, salt and fluid retention, and high blood pressure. Infrequent adverse effects include esophageal ulceration, heart failure, high blood levels of potassium, kidney impairment, confusion, and bronchospasm.<unk>  can exacerbate asthma, sometimes fatally. Allergic reactions, including anaphylaxis and anaphylactic shock, may occur.<unk>  may be quantified in blood, plasma, or serum to demonstrate the presence of the drug in a person having experienced an anaphylactic reaction, confirm a diagnosis of poisoning in people who are hospitalized, or assist in a medicolegal death investigation. A monograph relating<unk>  plasma concentration, time since ingestion, and risk of developing renal toxicity in people who have overdosed has been published. In October 2020, the U.S. Food and Drug Administration (FDA) required the drug label to be updated for all nonsteroidal anti-inflammatory medications to describe the risk of kidney problems in unborn babies that result in low amniotic fluid. They recommend avoiding NSAIDs in pregnant women at 20 weeks or later in pregnancy. Cardiovascular risk Along with several other NSAIDs, chronic<unk>  use has been found correlated with risk of progression to hypertension in women, though less than for acetaminophen, and myocardial infarction (heart attack), particularly among those chronically using higher doses. On 9 July 2015, the U.S. Food and Drug Administration (FDA) toughened warnings of increased heart attack and stroke risk associated with<unk>  and related NSAIDs; the NSAID aspirin is not included in this warning. The European Medicines Agency (EMA) issued similar warnings in 2015. Skin Along with other NSAIDs,<unk>  has been associated with the onset of bullous pemphigoid or pemphigoid-like blistering. As with other NSAIDs,<unk>  has been reported to be a photosensitising agent, but it is considered a weak photosensitising agent compared to other members of the 2-arylpropionic acid class. Like other NSAIDs,<unk>  is an extremely rare cause of the autoimmune disease Stevens–Johnson syndrome (SJS).<unk>  is also an extremely rare cause of toxic epidermal necrolysis. Interactions Alcohol Drinking alcohol when taking<unk>  may increase the risk of stomach bleeding. Aspirin According to the Food and Drug Administration (FDA),<unk>  can interfere with the antiplatelet effect of low-dose aspirin, potentially rendering aspirin less effective when used for cardioprotection and stroke prevention". Allowing sufficient time between doses of<unk>  and immediate-release (IR) aspirin can avoid this problem. The recommended elapsed time between a dose of<unk>  and a dose of aspirin depends on which is taken first. It would be 30 minutes or more for<unk>  taken after IR aspirin, and 8 hours or more for<unk>  taken before IR aspirin. However, this timing cannot be recommended for enteric-coated aspirin. But, if<unk>  is taken only occasionally without the recommended timing, the reduction of the cardioprotection and stroke prevention of a daily aspirin regimen is minimal. Paracetamol<unk>  combined with paracetamol is considered generally safe in children for short-term usage. Overdose<unk>  overdose has become common since it was licensed for OTC use. Many overdose experiences are reported in the medical literature, although the frequency of life-threatening complications from<unk>  overdose is low. Human response in cases of overdose ranges from an absence of symptoms to a fatal outcome despite intensive-care treatment. Most symptoms are an excess of the pharmacological action of<unk> , and include abdominal pain, nausea, vomiting, drowsiness, dizziness, headache, ear ringing, and nystagmus. Rarely, more severe symptoms, such as gastrointestinal bleeding, seizures, metabolic acidosis, high blood levels of potassium, low blood pressure, slow heart rate, fast heart rate, atrial fibrillation, coma, liver dysfunction, acute kidney failure, cyanosis, respiratory depression, and cardiac arrest have been reported. The severity of symptoms varies with the ingested dose and the time elapsed; however, individual sensitivity also plays an important role. Generally, the symptoms observed with an overdose of<unk>  are similar to the symptoms caused by overdoses of other NSAIDs. Correlation between severity of symptoms and measured<unk>  plasma levels is weak. Toxic effects are unlikely at doses below 100mg/kg, but can be severe above 400mg/kg (around 150 tablets of 200mg units for an average man); however, large doses do not indicate the clinical course is likely to be lethal. A precise lethal dose is difficult to determine, as it may vary with age, weight, and concomitant conditions of the individual person. Treatment to address an<unk>  overdose is based on how the symptoms present. In cases presenting early, decontamination of the stomach is recommended. This is achieved using activated charcoal; charcoal adsorbs the drug before it can enter the bloodstream. Gastric lavage is now rarely used, but can be considered if the amount ingested is potentially life-threatening, and it can be performed within 60 minutes of ingestion. Purposeful vomiting is not recommended. The majority of<unk>  ingestions produce only mild effects, and the management of overdose is straightforward. Standard measures to maintain normal urine output should be instituted and kidney function monitored. Since<unk>  has acidic properties and is also excreted in the urine, forced alkaline diuresis is theoretically beneficial. However, because<unk>  is highly protein-bound in the blood, the kidneys' excretion of unchanged drug is minimal. Forced alkaline diuresis is, therefore, of limited benefit. Miscarriage A study of pregnant women suggests that those taking any type or amount of NSAIDs (including<unk> , diclofenac and naproxen) were 2.4 times more likely to miscarry than those not taking the medications. However, an Israeli study found no increased risk of miscarriage in the group of mothers using NSAIDs.
Ibuprofen
Ketoprofen
Fenoprofen
Indoprofen
Loxoprofen
Meloxicam
Lornoxicam
Celecoxib