Anti-inflammatory (Systemic and local)

Active GI Bleeding or Ulceration or history of either Cerebrovascular disease History of NSAID related GI bleeding Ischaemic Heart Disease Mild or Severe Heart Failure Peripheral Arterial Disease

GI Ulcers Worsening Asthma Impaired Renal Function

Inflammatory pain

Oral - Exacerbation of COPD REctal - Ulcerative Colitis

Avoid injections containing benzyl alcohol in neonates Live vaccines (immune suppressive doses) Systemic Infection Avoid along in the presence of untreated ear infection (combine with suitable ant-infective) Bowel Perforation (Rectal) Extensive Fistulas Recent intestinal anastamoses

Osteoporosis Diabetes Avascular necrosis of the femoral head (high doses) Muscle wasting Psychiatric reactions

Not for certain patient groups as can lead to renal insufficiency If disease is unlikely to relapse and t/ment received for less than 3 weeks and not part of specific patient groups mentioned in BNF then abrupt withdrawal is ok

Asthma - improve control/reduce frequency of exacerbations Severe/very severe COPD - reduce frequency of exacerbations

No

Oropharyngeal candiadis headache hoarseness (Dysphonia) sore throat

Usually need to reduce dose gradually

Kidneys Some prostaglandins in COX-1 pathway effects pressure of blood flow through Kidneys