Patients should consult their physicians before taking any additional prescriptions, over-the-counter medications, nutritional supplements or herbal medications. Interactions that can occur when taking nonsteroidal anti-inflammatory drugs (NSAIDs) are:

• Aspirin. Increases the chance of developing serious side effects (e.g., stomach bleeding, ulcers) if taken regularly with other NSAIDs.
  
  
• Zinc. Reduces the absorption and effectiveness of NSAIDs.
  
  
• Blood pressure medications. Taking NSAIDs may reduce the effectiveness of these drugs.
  
  
• Triamterene. This diuretic increases the chance of kidney problems when taken with NSAIDs.
  
  
• Cimetidine. This drug, used to treat gastrointestinal disorders, increases the chance of kidney problems when taken with NSAIDs.
  
  
• Chemotherapy drugs. Taking NSAIDs may increase the toxicity of some cancer-fighting drugs.
  
  
• Arthritis, gout or diabetes medication. These drugs can interact poorly with NSAIDs in some instances.
  
  
• Anticoagulants (medications that inhibit the blood’s ability to clot). Taking NSAIDs along with anticoagulants may increase the risk of excessive bleeding.
  
  
• Lithium carbonate. The effect and toxicity of this compound used to treat bipolar disorder may increase when taken along with NSAIDs.
  
  
• Immunosuppressants (medications that suppress the immune system). These may lessen the medicinal effects of NSAIDs.
  
  
• Corticosteroids (anti-inflammatory medications). NSAIDs taken in conjunction with corticosteroids may increase the risk of stomach ulcers.
  
  
• Anti-emetics (medications that prevent or stop vomiting). When used in conjunction with NSAIDs, anti-emetics may not be as effective.
  
  
• Cigarettes and alcohol. Smokers have an increased risk of developing stomach ulcers from NSAID use. When alcohol and NSAIDs interact, nausea and bleeding of the stomach may occur.
  
  
• Vitamin E supplements and omega-3 fatty acid supplements. Each of these increases the likelihood of bleeding when taken along with NSAIDs.

Supplements that help build cartilage in joints (e.g., chondroitin, glucosamine) may enhance the anti-inflammatory properties of NSAIDs. Copper supplements may bind to NSAIDs and increase their anti-inflammatory properties as well. NSAIDs should never be taken with other pain relievers (analgesics) or anti-inflammatory medications unless under the direction of a physician.