d stools.
COX-2 inhibitors may carry an increased risk of heart attacks and stroke when compared to placebo (no treatment). If you have risk factors for heart disease or stroke, such as diabetes, high cholesterol or smoking, your doctor will need to assess the overall benefits and risks before deciding if this medicine is suitable for you. In general, if this medicine is suitable, your doctor will prescribe the lowest effective dose for as short a time as possible to control your symptoms, because the risks may increase with higher doses and the longer the medicine is taken. Do not exceed the prescribed dose. Tell your doctor if you experience shortness of breath, chest pains or ankle swelling while taking the medicine. Ask your doctor or pharmacist for further information.
It is recommended that your blood pressure is regularly monitored while you are taking this medicine.
If you have any existing problems with your kidneys, liver or heart function, your kidney function should be regularly monitored while you are taking this medicine.
Some cases of severe liver reactions have been reported in people taking this medicine. Most of these developed within one month of starting treatment. For this reason, while you are taking this medicine you should let your doctor know straight away if you notice any symptoms that could indicate a problem with your liver. These may include yellowing of the skin or whites of the eyes (jaundice), unusually dark urine, nausea and vomiting, loss of appetite or flu-like symptoms.
Very rarely, NSAIDS may cause serious blistering or peeling skin reactions (eg Stevens-Johnson syndrome, toxic epidermal necrolysis, exfoliative dermatitis). For this reason, you should stop taking this medicine and consult your doctor if you get a skin rash or sores inside your mouth while taking this medicine. This side effect is very rare, but if it occurs, is most likely to happen in the first month of treatment.
Use with caution in
Elderly people.
Decreased liver function.
Decreased kidney function.
People with a decreased volume of fluid in the body, eg due to dehydration, high doses of diuretics, severe vomiting or diarrhoea.
History of heart failure.
Swelling due to excess fluid retention (oedema).
History of disorders affecting the stomach or intestines, such as ulceration or bleeding.
High blood pressure (hypertension).
Raised levels of fats such as cholesterol in the blood (hyperlipidaemia).
Diabetes.
Smokers.
People who may be poor metabolisers of this medicine, due to reduced activity of an enzyme in the liver known as CYP2C9 (your doctor may be aware of this based on your previous response to certain other medicines).
People with a history of allergic reactions to medicines.
Not to be used in
Children.
Allergy to medicines from the sulphonamide group, eg the antibiotic sulfamethoxazole.
People in whom aspirin or other NSAIDs, eg ibuprofen, cause allergic reactions such as asthma attacks, itchy rash (urticaria), nasal polyps, nasal inflammation (rhinitis) or swelling of the lips, tongue and throat (angioedema).
People with an active peptic ulcer or bleeding from the gut.
Inflammatory bowel disease such as Crohn's disease or ulcerative colitis.
Severe liver disease.
Moderate to severely decreased kidney function.
Heart failure.
Heart disease caused by inadequate blood flow to the heart (ischaemic heart disease), eg angina or history of heart attack.
Disease of the blood vessel |
