Medication Guide for Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

What is the most important information I should know about medicines called Nonsteroidal Anti-inflammatory Drugs (NSAIDs)?

NSAIDs can cause serious side effects, including:

• • Increased risk of a heart attack or stroke that can lead to death. This risk may happen early in treatment and may increase:
  • owith increasing doses of NSAIDs
  • owith longer use of NSAIDs
• Do not take NSAIDs right before or after a heart surgery called a “coronary artery bypass graft (CABG)."
• Avoid taking NSAIDs after a recent heart attack, unless your healthcare provider tells you to. You may have an increased risk of another heart attack if you take NSAIDs after a recent heart attack.
• • Increased risk of bleeding, ulcers, and tears (perforation) of the esophagus (tube leading from the mouth to the stomach), stomach and intestines:
  • oanytime during use
  • owithout warning symptoms
  • othat may cause death
• The risk of getting an ulcer or bleeding increases with:
  1. opast history of stomach ulcers, or stomach or intestinal bleeding with use of NSAIDs
  2. otaking medicines called “corticosteroids”, “anticoagulants”, “SSRIs”, or “SNRIs”

• oincreasing doses of NSAIDs
• olonger use of NSAIDs
• osmoking
• odrinking alcohol

• oolder age
• opoor health
• oadvanced liver disease
• obleeding problems

NSAIDs should only be used:

• oexactly as prescribed
• oat the lowest dose possible for your treatment
• ofor the shortest time needed

What are NSAIDs?

NSAIDs are used to treat pain and redness, swelling, and heat (inflammation) from medical conditions such as different types of arthritis, menstrual cramps, and other types of short-term pain.

Who should not take NSAIDs?

Do not take NSAIDs:

• •if you have had an asthma attack, hives, or other allergic reaction with aspirin or any other NSAIDs.
• •right before or after heart bypass surgery.

Before taking NSAIDs, tell your healthcare provider about all of your medical conditions, including if you:

• •have liver or kidney problems
• •have high blood pressure
• •have asthma
• •are pregnant or plan to become pregnant. Taking NSAIDs at about 20 weeks of pregnancy or later may harm your unborn baby. If you need to take NSAIDs for more than 2 days when you are between 20 and 30 weeks of pregnancy, your healthcare provider may need to monitor the amount of fluid in your womb around your baby. You should not take NSAIDs after about 30 weeks of pregnancy.
• •are breastfeeding or plan to breast feed.

Tell your healthcare provider about all of the medicines you take, including prescription or over-the-counter medicines, vitamins or herbal supplements. NSAIDs and some other medicines can interact with each other and cause serious side effects. Do not start taking any new medicine without talking to your healthcare provider first.

What are the possible side effects of NSAIDs?

NSAIDs can cause serious side effects, including:

See “What is the most important information I should know about medicines called Nonsteroidal Anti-inflammatory Drugs (NSAIDs)?”

• •new or worse high blood pressure
• •heart failure
• •liver problems including liver failure
• •kidney problems including kidney failure
• •low red blood cells (anemia)
• •life-threatening skin reactions
• •life threatening allergic reactions
• • Other side effects of NSAIDs include: stomach pain, constipation, diarrhea, gas, heartburn, nausea, vomiting, and dizziness.

Get emergency help right away if you get any of the following symptoms:

• •shortness of breath or trouble breathing
• •chest pain
• •weakness in one part or side of your body

• •slurred speech
• •swelling of the face or throat

Stop taking your NSAID and call your healthcare provider right away if you get any of the following symptoms:

• •nausea
• •more tired or weaker than usual
• •diarrhea
• •itching
• •your skin or eyes look yellow
• •indigestion or stomach pain
• •flu-like symptoms

• •vomit blood
• •there is blood in your bowel movement or it is black and sticky like tar
• •unusual weight gain
• •skin rash or blisters with fever
• •swelling of the arms, legs, hands and feet

If you take too much of your NSAID, call your healthcare provider or get medical help right away.

These are not all the possible side effects of NSAIDs. For more information, ask your healthcare provider or pharmacist about NSAIDs.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Other information about NSAIDs

• •Aspirin is an NSAID but it does not increase the chance of a heart attack. Aspirin can cause bleeding in the brain, stomach, and intestines. Aspirin can also cause ulcers in the stomach and intestines.
• •Some NSAIDs are sold in lower doses without a prescription (over-the-counter). Talk to your healthcare provider before using over-the-counter NSAIDs for more than 10 days.

General information about the safe and effective use of NSAIDs

Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use NSAIDs for a condition for which they were not prescribed. Do not give NSAIDs to other people, even if they have the same symptoms that you have. They may harm them.

If you would like more information about NSAIDs, talk with your healthcare provider. You can ask your pharmacist or healthcare provider for information about NSAIDs that is written for health professionals.

Manufactured for: Mylan Pharmaceuticals Inc., Morgantown, WV 26505 U.S.A.

For more information, call Mylan at 1-877-446-3679 (1-877-4-INFO-RX).

Manufactured for:
Mylan Pharmaceuticals Inc.
Morgantown, WV 26505 U.S.A.

Manufactured by:
Mylan Laboratories Limited
Hyderabad — 500 096, India

75107848