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Long-term use of NSAIDs can cause gastric erosions, which can become stomach ulcers and in extreme cases can cause severe haemorrhage, resulting in death. The risk of death as a result of GI bleeding caused by the use of NSAIDs is 1 in 12,000 for adults aged 16–45. [5] The risk increases almost twentyfold for those over 75. [5]
Regarding adverse effects, selective COX-2 inhibitors have lower risk of gastrointestinal bleeding. [153] With the exception of naproxen, nonselective NSAIDs increase the risk of having a heart attack. [153] Some data also supports that the partially selective nabumetone is less likely to cause gastrointestinal events. [153]
NSAIDs (such as indomethacin) and calcium channel blockers (such as nifedipine) are the most likely to delay delivery for 48 hours, with the least amount of maternal and neonatal side effects. [46] Otherwise, tocolysis is rarely successful beyond 24 to 48 hours because current medications do not alter the fundamentals of labor activation. [47]
Gastrointestinal bleeding from the upper tract occurs in 50 to 150 per 100,000 adults per year. [8] It is more common than lower gastrointestinal bleeding which is estimated to occur at the rate of 20 to 30 per 100,000 per year. [2] Risk of bleeding is more common in males and increases with age. [2]
Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, vagina or anus, or through a puncture in the skin. Hypovolemia is a massive decrease in blood volume, and death by excessive loss of blood is referred to as exsanguination . [ 2 ]
Severe side effects include an increased risk of heart disease, stroke, gastrointestinal bleeding, and stomach ulcers. [8] The heart disease risk may be lower than with other NSAIDs. [8] It is not recommended in people with kidney problems. [8] Use is not recommended in the third trimester of pregnancy. [8] Naproxen is a nonselective COX ...
The preference for labor pain management is also influenced by cultural and religious beliefs, a lack of prenatal patient education, language barriers, fears and for some Black Americans ...
As with other NSAIDs, potential side effects include gastrointestinal bleeding. [10] Long-term use has been associated with kidney failure, and rarely liver failure, and it can exacerbate the condition of patients with heart failure. [8] At low doses, it does not appear to increase the risk of heart attack; however, at higher doses it may. [10]