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

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

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

Serious 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 asthma

Other side effects include:

• stomach pain
• constipation
• diarrhea
• gas
• heartburn
• nausea
• vomiting
• dizziness

• Some 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.
• 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.

Talk to your doctor to learn more about possible side effects and NSAID risk.

Additional resources include:

• American College of Gastroenterology (ACG)
  ACG represents more than 8,500 digestive health specialists and is committed to providing accurate, unbiased and up-to-date health information to patients and the public.
  www.acg.gi.org/patients/women/asprin.asp
• American Gastroenterological Association (AGA)
  The AGA is a society of physicians, surgeons, scientists and other individuals within the healthcare community who have a demonstrated and continued interest in the functions and disorders of the digestive system.
  AGA Patient Center
  http://www.gastro.org/wmspage.cfm?parm1=478
  Reduce Your Risk Brochure
  http://www.2reduce.org/docs/REDUCE_Brochure_Final.pdf
• American Society for Gastrointestinal Endoscopy (ASGE)
  The ASGE, a society of gastroenterologists and surgeons with specialized training in gastrointestinal endoscopy and other medical specialists, serves the public by providing education and information, by promoting the highest standards for the training and practice of endoscopy (a procedure that allows the physician to view the inside of the digestive tract, as well as treat certain conditions), and by supporting research for better patient care.
  www.askasge.org
• U.S. Food and Drug Administration (FDA)
  The FDA is responsible for protecting the public health by assuring the safety, efficacy, and security of human and veterinary drugs, biological products, medical devices, our nation’s food supply, cosmetics, and products that emit radiation. The FDA is also responsible for advancing the public health by helping to speed innovations that make medicines and foods more effective, safer, and more affordable; and helping the public get the accurate, science-based information they need to use medicines and foods to improve their health.
  www.fda.gov/cder/drug/infopage/cox2/NSAIDmedguide.htm