Gastrointestinal adverse effects such as nausea and abdominal pain are common, and their frequency is similar to that of ibuprofen. Increase in risk-taking behavior is possible. According to the US Food and Drug Administration, the drug may cause rare and possibly fatal skin reactions such as Stevens–Johnson syndrome and toxic epidermal necrolysis, although an analysis of the French Pharmacovigilance Database indicated no obvious risk of these reactions. In clinical trials for osteoarthritis, the number of<unk> ticipants reporting adverse effects were similar for those on<unk>  and on placebo. However, the abnormal liver function tests (meaning there was some inflammation or damage to the liver) were almost four times more likely in those on<unk> , although the clinical importance of this effect is uncertain. After 13 weeks of<unk>  therapy for knee pain, a drop in hemoglobin level indicating gastrointestinal bleeding was observed in 20% of<unk> ticipants, this rate being similar to ibuprofen group. Due to the absence of controlled studies, most of the information about the long-term safety of<unk>  comes from observational studies. These indicate a consistent pattern of increased mortality as well as cardiovascular (stroke, myocardial infarction), gastrointestinal (ulcers, bleeding) and renal adverse effects with increased dose of<unk> . Use of<unk>  is associated with 1.9 times higher risk of peptic ulcer. Those who take it regularly at a higher dose (more than 23g daily) are at much higher risk (3.63.7 times) of gastrointestinal bleeding and other bleeding events. Meta-analyses suggest that<unk>  may increase the risk of kidney impairment by 23% and kidney cancer by 28%.<unk>  is<unk> ticularly dangerous to the liver in overdose, but even without overdose those who take this drug may develop acute liver failure requiring liver transplantation more frequently than the users of nonsteroidal anti-inflammatory drugs.<unk>  slightly but significantly increases blood pressure and heart rate. The majority of observational studies suggests that, used chronically, it may increase the risk of developing hypertension, as confirmed in a prospective randomized confirmed trial. The risk is higher with the higher dose. The association between<unk>  use and asthma in children has been a matter of controversy. However, the most recent research suggests that there is no association, and that the frequency of asthma exacerbations in children after<unk>  is the same as after another frequently used pain killer ibuprofen. Use in pregnancy<unk>  safety in pregnancy has been under increased scrutiny. There appears to be no link between<unk>  use in the first trimester and adverse pregnancy outcomes or birth defects. However, indications exist of a possible increase of asthma and developmental and reproductive disorders in the offspring of women with prolonged use of<unk>  during pregnancy.<unk>  use by the mother during pregnancy is associated with an increased risk of childhood asthma, but so are the maternal infections for which<unk>  may be used, and separating these influences is difficult.<unk> , in a small scale meta analysis was also associated with 2030% increase in autism spectrum disorder, attention deficit hyperactivity disorder, hyperactivity symptoms, and conduct disorder, with the association being lower in a meta analysis where a larger demographic was used, but it is unclear whether this is a causal relationship and there was potential bias in the findings. There is also an argument that the large number, consistency, and the robust designs of the studies provide a strong evidence in favor of<unk>  causing the increased risk of these neurodevelopmental disorders. In animal experiments,<unk>  disrupts fetal testosterone production, and several epidemiological studies linked cryptorchidism with mother's<unk>  use for more than two weeks in the second trimester. On the other hand, several studies did not find any association. The consensus recommendation appears to be to avoid prolonged use of<unk>  in pregnancy and use it only when necessary, at the lowest effective dosage and for the shortest time.
Paracetamol
Ketoprofen
Ibuprofen
Ketorolac
Meloxicam
Lornoxicam
Etodolac
Loxoprofen