Yes

Nonsteroidal Anti-Inflammatory Agent (NSAID)

Treatment of inflammatory disorders

B (D in 3rd trimester)

Active GI bleeding, ulcer disease, hypersensitivity to aspirin, meclofenamate, or other NSAIDs

May have adverse effects on fetus; use with caution with dehydration

>10%:

Central nervous system: Dizziness

Dermatologic: Rash

Gastrointestinal: Abdominal cramps, heartburn, indigestion, nausea

1% to 10%:

Central nervous system: Headache, nervousness

Dermatologic: Itching

Endocrine & metabolic: Fluid retention

Gastrointestinal: Vomiting

Otic: Tinnitus

<1%: Congestive heart failure, hypertension, arrhythmia, tachycardia, confusion, hallucinations, aseptic meningitis, mental depression, drowsiness, insomnia, urticaria, erythema multiforme, toxic epidermal necrolysis, Stevens-Johnson syndrome, angioedema, polydipsia, hot flashes, gastritis, GI ulceration, cystitis, polyuria, agranulocytosis, anemia, hemolytic anemia, bone marrow suppression, leukopenia, thrombocytopenia, hepatitis, peripheral neuropathy, toxic amblyopia, blurred vision, conjunctivitis, dry eyes, decreased hearing, acute renal failure, allergic rhinitis, shortness of breath, epistaxis

Symptoms of overdose include drowsiness, lethargy, nausea, vomiting, seizures, paresthesia, headache, dizziness, GI bleeding, cerebral edema, cardiac arrest, tinnitus

Management of a nonsteroidal anti-inflammatory drug (NSAID) intoxication is primarily supportive and symptomatic. Fluid therapy is commonly effective in managing the hypotension that may occur following an acute NSAID overdose, except when this is due to an acute blood loss. Seizures tend to be very short-lived and often do not require drug treatment. Although, recurrent seizures should be treated with I.V. diazepam. Since many of the NSAID undergo enterohepatic cycling, multiple doses of charcoal may be needed to reduce the potential for delayed toxicities.

Decreased effect with aspirin; decreased effect of diuretics, antihypertensives; ACE-inhibitor effects may be decreased by concurrent therapy with NSAIDs

Increased effect/toxicity of warfarin, methotrexate

Inhibits prostaglandin synthesis by decreasing the activity of the enzyme, cyclo-oxygenase, which results in decreased formation of prostaglandin precursors

Duration of action: 2-4 hours

Distribution: Crosses the placenta

Protein binding: 99%

Half-life: 2-3.3 hours

Time to peak serum concentration: Within 0.5-1.5 hours

Elimination: Principally in urine and in feces as glucuronide conjugates

Children >14 years and Adults: Oral:

Rheumatoid arthritis/osteoarthritis: 200-400 mg/day in 3-4 equal doses

May be administered with food, milk, or antacids

chloride (S), sodium (S)

Dizziness is common; may cause drowsiness, confusion, hallucinations, or depression

May rarely cause agranulocytosis; use caution with clozapine or carbamazepine; may decrease lithium clearance resulting in an increase in serum lithium levels and potential lithium toxicity; monitor serum lithium levels

No information available to require special precautions

NSAID formulations are known to reversibly decrease platelet aggregation via mechanisms different than observed with aspirin. The dentist should be aware of the potential of abnormal coagulation. Caution should also be exercised in the use of NSAIDs in patients already on anticoagulant therapy with drugs such as warfarin (Coumadin®). Recovery of platelet function usually occurs 1-2 days after discontinuation of NSAIDs.

Take with food, milk, or with antacids

Should be used for short-term only (<7 days); advise patient to report persistent GI discomfort, sore throat, fever, or malaise

Capsule, as sodium: 50 mg, 100 mg

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