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NSAIDs for Rheumatoid Arthritis


What Are the Side Effects of NSAIDs?

Most people take NSAIDs with few to no side effects. However, some people do have stomach pain, and NSAIDs may cause stomach ulcers.

Side effects vary from one NSAID to another. The most common side effects include:

  • Stomach problems, including pain, constipation, diarrhea, gas, nausea, and stomach ulcers
  • Abnormal kidney function
  • Anemia
  • Dizziness
  • Swelling in the legs
  • Abnormal liver tests (blood tests)
  • Headaches
  • Easy bruising
  • Ringing in the ears
  • Rash

NSAIDs may also increase blood pressure. If you have hypertension, be sure to keep a close eye on your blood pressure. Let your doctor know if your blood pressure goes up.


Is There a Serious Risk of Stomach Ulcers With NSAIDs?

It is estimated that more than 100,000 Americans are hospitalized each year from ulcers and stomach bleeding linked to NSAID use.

The chance of getting an ulcer or stomach bleeding increases even more if you also take corticosteroids (often called "steroids" for RA) and/or blood thinners, or anticoagulants. Also, the longer you use NSAIDs, the greater the risk of stomach bleeding and ulcers. Older adults, especially over 65, have an increased risk of stomach bleeding and ulcers, as do those who drink alcohol and smoke cigarettes.

There are ways to reduce the risk of stomach irritation when taking NSAIDs for rheumatoid arthritis. People at high risk of stomach bleeding may need a strong stomach acid blocker to help prevent ulcers.

If you take NSAIDs to ease the inflammation, pain, and stiffness of RA, be sure to talk with your doctor about ways to protect your stomach.

Can I Take NSAIDs if I Have High Blood Pressure?

If you have high blood pressure or kidney disease, talk to your doctor. NSAIDs can reduce blood flow to the kidneys, which may cause your kidneys not to work as well. This causes fluid to build up in your body. The more fluid in your bloodstream, the higher your blood pressure.

Since NSAIDs can affect the kidneys, your doctor will likely check your kidney function from time to time. This is a simple blood test.

Can I Be Allergic to NSAIDs?

NSAIDs can cause allergies. This is most worrisome in people with asthma. Experts aren't sure why, but some people with asthma are sensitive to some NSAIDs. The drugs may worsen breathing, and many specialists recommend that people who have asthma stay away from certain NSAIDs. The risk may be even greater in people with sinus problems or nasal polyps.

If you have asthma, make sure your arthritis doctor knows. Certain NSAIDs may be safer for you. You and your doctor can determine if NSAIDs are right for you.

Are There Special Precautions for Using NSAIDs for Rheumatoid Arthritis?

NSAIDs should be used with caution if you have kidney or liver disease, heart failure, high blood pressure, diabetes, lupus, asthma, or ulcers.

Be sure your doctor is aware of all drugs and supplements you are taking. NSAIDs may interact with blood thinners, cyclosporine, lithium, or methotrexate. Be sure to let your doctor know if you are sensitive to aspirin.




WebMD Medical Reference

Reviewed by David Zelman, MD on June 10, 2013
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