Non Steroidal Anti Inflammatory Agent


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More Specific Terms




  • Cautions:


  • (administration)
  • see specific NSAID
  • Guidelines for use [17] {based on expert opinion}




  • hepatic
  • manifestations:




More General Terms

Additional Terms


  1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 792
  2. Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 14, 598, 853
  3. Medical Knowledge Self Assessment Program (MKSAP) 11, 16, 17. American College of Physicians, Philadelphia 1998, 2012, 2015
  4. Prescriber's Letter 8(3):14 2001
  5. Prescriber's Letter 9(5):29 2002
  6. Journal Watch 23(8):63, 2003 Fiorucci S et al Gastrointestinal safety of NO-aspirin (NCX-4016) in healthy human volunteers: a proof of concept endoscopic study. Gastroenterology 124:600, 2003 PMID: [1]
    - Peura DA Mandate to modify a medicinal mantra: maybe not yet? Gastroenterology 124:842, 2003 PMID: [2]
  7. Prescriber's Letter 10(10):58 2003
  8. Journal Watch 24(14):109, 2004 Mamdani M, Juurlink DN, Lee DS, Rochon PA, Kopp A, Naglie G, Austin PC, Laupacis A, Stukel TA. Cyclo-oxygenase-2 inhibitors versus non-selective non-steroidal anti-inflammatory drugs and congestive heart failure outcomes in elderly patients: a population-based cohort study. Lancet. 2004 May 29;363(9423):1751-6. PMID: [3]
  9. Prescriber's Letter 12(2): 2005 Update on the Safety and Use of COX-2 Inhibitors and Traditional NSAIDs Detail-Document#: [4] (subscription needed) [5]
  10. Prescriber's Letter 12(5): 2005 FDA Announces Important Changes and Additional Warnings for COX-2s and NSAIDs Detail-Document#: [6] (subscription needed) [7]
  11. FDA MedWatch COX-2 Selective (includes Bextra, Celebrex, and Vioxx) and Non-Selective Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) [8]
  12. Journal Watch 25(13):102, 2005 Maiden L, Thjodleifsson B, Theodors A, Gonzalez J, Bjarnason I. A quantitative analysis of NSAID-induced small bowel pathology by capsule enteroscopy. Gastroenterology. 2005 May;128(5):1172-8. PMID: [9]
  13. Journal Watch 25(13):102, 2005 Hawkey C, Talley NJ, Yeomans ND, Jones R, Sung JJ, Langstrom G, Naesdal J, Scheiman JM; NASA1 SPACE1 Study Group. Improvements with esomeprazole in patients with upper gastrointestinal symptoms taking non-steroidal antiinflammatory drugs, including selective COX-2 inhibitors. Am J Gastroenterol. 2005 May;100(5):1028-36. PMID: [10]
  14. Journal Watch 25(16):126, 2005
    - Hippisley-Cox J, Coupland C. Risk of myocardial infarction in patients taking cyclo- oxygenase-2 inhibitors or conventional non-steroidal anti- inflammatory drugs: population based nested case-control analysis. BMJ. 2005 Jun 11;330(7504):1366. <PubMed> PMID: [11] <Internet> [12]
  15. Prescriber's Letter 12(9): 2005 Non-narcotic Analgesics and the Risk of Hypertension in Women Detail-Document#: [13] (subscription needed) [14]
  16. Gislason GH et al Increased mortality and cardiovascular morbidity associated with the use of nonsteroidal anti-inflammatory drugs in chronic heart failure. Arch Intern Med 2009 Jan 26; 169:141. PMID: [15]
  17. Rostom A et al. Canadian consensus guidelines on long-term nonsteroidal anti-inflammatory drug therapy and the need for gastroprotection: Benefits versus risks. Aliment Pharmacol Ther 2009 Mar 1; 29:481. PMID: [16]
  18. Prescriber's Letter 17(8): 2010 Managing NSAID Risks Detail-Document#: [17] (subscription needed) [18]
  19. Prescriber's Letter 18(12): 2011 NSAIDs and Hypertension Detail-Document#: [19] (subscription needed) [20]
  20. Johannesdottir SA et al Nonsteroidal anti-inflammatory drugs and the risk of skin cancer Cancer, May 29, 2012 <PubMed> PMID: [21] <Internet> [22]
  21. Burmester G, Lanas A, Biasucci L et al The appropriate use of non-steroidal anti-inflammatory drugs in rheumatic disease: opinions of a multidisciplinary European expert panel. Ann Rheum Dis. 2011 May;70(5):818-22 PMID: [23]
  22. Farkouh ME, Greenberg BP. An evidence-based review of the cardiovascular risks of nonsteroidal anti-inflammatory drugs. Am J Cardiol. 2009 May 1;103(9):1227-37. PMID: [24]
  23. Prescriber's Letter 21(3): 2014 NSAID Safety in Patients with Heart Disease Detail-Document#: [25] (subscription needed) [26]
  24. Antman EM, Bennett JS, Daugherty A et al Use of nonsteroidal antiinflammatory drugs: an update for clinicians: a scientific statement from the American Heart Association. Circulation. 2007 Mar 27;115(12):1634-42. Epub 2007 Feb 26. PMID: [27]
  25. Masclee GMC et al. Risk of upper gastrointestinal bleeding from different drug combinations. Gastroenterology 2014 Oct; 147:784 PMID: [28]
    - Laine L. NSAID-associated gastrointestinal bleeding: Assessing the role of concomitant medications. Gastroenterology 2014 Oct; 147:730. PMID: [29]
  26. FDA Drug Safety Alert. July 9, 2014 Non-aspirin Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Drug Safety Communication - FDA Strengthens Warning of Increased Chance of Heart Attack or Stroke [30] [31]
  27. Yuan JQ et al. Systematic review with network meta-analysis: Comparative effectiveness and safety of strategies for preventing NSAID- associated gastrointestinal toxicity. Aliment Pharmacol Ther 2016 Jun; 43:1262 PMID: [32]
  28. Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
  29. Arfe A et al Non-steroidal anti-inflammatory drugs and risk of heart failure in four European countries: nested case-control study. BMJ 2016;354:i4857 <PubMed> PMID: [33] <Internet> [34]
    - Gislason GH, Torp-Pedersen C NSAIDs and the failing heart BMJ 2016;354:i5163 <PubMed> PMID: [35] <Internet> [36]
  30. Lin B, Curhan SG, Wang M et al Duration of Analgesic Use and Risk of Hearing Loss in Women. Am J Epidemiol (2016) 1-8. Published 14 December 2016 PMID: [37] [38]
  31. Bally M, Dendukuri N, Rich B et al Risk of acute myocardial infarction with NSAIDs in real world use: bayesian meta-analysis of individual patient data. BMJ 2017;357:j1909 <PubMed> PMID: [39] <Internet> [40]
  32. Therapeutics Letter #108. Therapeutics Initiative Drugs to Avoid. [41]
  33. NSAIDs and Peptic Ulcers [42]
  34. National Guideline Clearinghouse Guidelines for prevention of NSAID-related ulcer complications. American College of Gastroenterology ngc-guideline: [43]

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