Rare side effects to NSAIDs
- 1. Febrile reactions—ibuprofen.
- 2. Mediastinal lymphadenopathy—sulindac.
- 3. Hematologic effects: aplastic anemia, pure red cell aplasia, thrombocytopenia, neutropenia—rare; reported with most NSAIDs (phenylbutazone removed from the market due to its association with hematologic effects).
- 4. Stomatitis—most NSAIDs.
- 5. Cutaneous effects: photosensitivity, urticaria/angioedema, erythema multiform, toxic epidermal necrolysis—most NSAIDs, especially piroxicam.
- 6. Aseptic meningitis (especially SLE patients)—ibuprofen, other NSAIDs less commonly.
- Other NSAIDs have been associated with CNS effects without aseptic meningitis: headaches, dizziness, loss of concentration, depersonalization, tremor, and psychosis have been described in patients taking indomethacin and, to a lesser extent, tolmetin.
- 7. Small bowel webs—most NSAIDs, particularly piroxicam.
- 8. Sulfa allergy—celecoxib.
- 9. Kidney stones—sulindac.
- 10. Reversible infertility due to interference with ovulation and implantation.
- 11. Nonunion of fractures and bone grafts