NSAID-Induced Adverse Drug Reaction: Mechanism and Management
Keywords:NSAIDs, ADR, side effects, hypersensitivity
Non-steroidal anti-inflammatory drugs (NSAIDs) are drugs to reduce pain or swelling. The use of these drugs
in high doses or long-term can cause side effects or hypersensitivity problems, also known as Adverse Drug
Reaction (ADR). A literature review was carried out using the PubMed database by inserting the keywords
‘NSAID’, ‘adverse drug reaction’, and ‘hypersensitivity’. All studies related to NSAIDs and their adverse
drug reactions were included in this review, while genetic or pharmacogenomics studies and NSAIDs’
effectiveness were excluded. The results showed that gastrointestinal (GI) problems such as duodenal ulcers
or erosive gastritis are the most common diclofenac effects (2.05%). Cardiovascular issues, such as acute
myocardial infarction, were mostly caused by rofecoxib (2.12%). Hypersensitivity, both respiratory and
skin, is commonly caused by ibuprofen with prevalence 50% and 67%, respectively. The most frequent
kidney problem related to NSAIDs use is acute kidney injury. In comparison, the common hypersensitivity
problems are asthma, urticaria, and angioedema. Adverse drug reactions can be prevented or treated by
lowering the dose, reducing the duration of treatment, adding companion drugs, or changing the type of
NSAID. In conclusion, it can be seen that ibuprofen severely caused kidney problems and hypersensitivity.
On the other hand, diclofenac caused digestive issues, and rofecoxib caused cardiovascular problems.
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