Patients may be advised by their physician against taking nonsteroidal anti-inflammatory drugs (NSAIDs) if they have been diagnosed with any of the following conditions:

• Asthma. Some people with asthma are extremely sensitive to NSAIDs. Using the drugs triggers an asthma attack in these individuals. Because of this sensitivity, physicians recommend that patients with asthma use acetaminophen in place of NSAIDs. However, patients sensitive to NSAIDs may also have reactions to acetaminophen and should discuss use of these medications with a physician. People with this condition often also have problems with chronic sinusitis or nasal polyps. A physician may determine that an individual with asthma is able to tolerate the COX-2 inhibitor class of NSAIDs (including celecoxib).
  
  
• Aspirin sensitivity or allergic reactions to other NSAIDs. People who have an allergic reaction to aspirin (or another NSAID) often have sensitivity to other NSAIDs as well. An allergic reaction to NSAIDs can be very serious and result in life-threatening anaphylactic shock. Individuals who have an allergic reaction to NSAIDs should avoid all drugs in the class and seek immediate medical attention whenever they believe they are having a reaction to a drug. Symptoms of aspirin sensitivity (e.g., difficulty breathing, runny nose, hives) usually occur within an hour of taking the drug, but can occur later.
  
  To avoid accidental exposure to aspirin/NSAIDs, patients with allergies to the drugs should inform their pharmacist and all of their physicians about the condition. Because aspirin is found in many over-the-counter pain killers, patients with aspirin sensitivity should carefully read drug labels and discuss the use of pain killers with a physician or pharmacist before taking the drug. 
  
  
• Hives (red, swollen patches of skin). Using NSAIDs can worsen this condition.
  

  

• Swelling. Using NSAIDs can worsen this condition.
  
  
• Heart problems. COX-2 inhibitors, a subclass of NSAIDs, have been linked to increased stroke and heart attack risk. For this reason, two of these medications (rofecoxib and valdecoxib) have been withdrawn from the market. In addition, NSAIDs may worsen heart failure, increase blood pressure and reduce the effectiveness of some heart medications. People with heart problems should consult their physician about taking NSAIDs regularly. Some patients are advised by a cardiologist to take small doses of aspirin daily to reduce their risk of heart attack or stroke. Aspirin is the only NSAID that can be used for this purpose.
  
  
• Stomach problems. NSAIDs can alter stomach chemistry and enzymes, causing irritation. Serious problems can develop (e.g., gastric ulcers, stomach bleeding) if this alteration is prolonged.
  
  
• Kidney or liver problems. NSAIDs are potentially damaging to the kidneys and liver if taken in high doses or for extended periods of time.
  
  
• Inflammatory bowel disease (inflammatory disease of the colon). NSAIDs can trigger this condition. 
  
  
• Nasal polyps (round piece of tissue that extends into the nasal cavity). The use of NSAIDS can complicate this condition in certain populations.
  
  

  
  

• Ulcers, sores or white spots in the mouth. Developing sores in the mouth while taking NSAIDs often indicates the medicine is causing serious side effects. If sores are present before the medication is started, it can be harder to detect serious side effects.
  
  
• Gout or bleeding disorders. Patients with these conditions may be advised by their physician to avoid taking NSAIDs.
  
  
• Parkinson’s disease. NSAIDs should not be used in conjunction with several of the medications commonly prescribed to treat Parkinson’s disease, unless prescribed by a physician.
  
  
• Mental illness. Because NSAID use may cause some psychiatric medications to become toxic in the body, they should be used only with a physician’s prescription.

Patients should generally not take NSAIDs before undergoing surgery. These medications prevent blood clotting, which is necessary for healing wounds.