Selective COX-2 inhibitors should be used judiciously in the presence of renal impairment
Bhowmik, D.; Tiwari, S.C.
Journal of the Indian Medical Association 102(4): 225
2004
ISSN/ISBN: 0019-5847 PMID: 15473294 Document Number: 9871
Wherever possible it is more prudent to avoid all NSAIDs or reduce their dosage in high risk cases. Use of paracetamol, and in severe cases dextropropoxyphene or tramadol (with due precautions to avoid addiction) may be safer from the renal point of view. In case NSAIDs have to be prescribed, one must observe the same precautions with the selective COX-2 inhibitors as for the conventional NSAIDs viz, minimum possible dose for a short duration with regular monitoring of renal functions. This would go a long way in the prevention of deterioration of renal functions in these patients and avoidance of life threatening situation needing dialysis or renal support.
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