What are the side effect of corticosteroids and NSAIDs?

Corticosteroids

Corticosteroids have many side effects that can be mild or serious. These side effects are more apparent when corticosteroids are used at higher doses or for extended periods of time. This section lists only some of these side effects of corticosteroids.
Corticosteroids can cause:

The prolonged use of corticosteroids can cause obesity, growth retardation in children, and even lead to convulsions and psychiatric disturbances. Reported psychiatric disturbances include depression, euphoria, insomnia, mood swings, and personality changes. Psychotic behaviors also have been reported.

Corticosteroids, since they suppress the immune system, can lead to an increase in the rate of infections and reduce the effectiveness of vaccines and antibiotics.
The long term use of corticosteroids may cause osteoporosis which can result in bone fractures.

Shrinking (atrophy) of the adrenal glands can be caused by the long term use of corticosteroids resulting in the body’s inability to produce cortisol, the body’s natural corticosteroid, when the systemic corticosteroids are discontinued.

Another condition which can result from the long term use of corticosteroids is adrenal necrosis of the hip joints, a very painful and serious condition that may require surgery. Any symptoms of hip or knee pain in people taking corticosteroids require prompt medical attention.

Corticosteroids should not be stopped suddenly after prolonged use as this can result in adrenal crisis because of the body’s inability to secrete enough cortisol to make up for the withdrawal. Nausea, vomiting, and shock are the reported side effects of adrenal crisis.

NSAIDs

NSAIDs are associated with several side effects. The frequency of side effects varies among NSAIDs.
Common side effects are

Other important side effects are:

  • kidney failure (primarily with chronic use),
  • liver failure,
  • ulcers, and
  • prolonged bleeding after injury or surgery.

NSAIDs can cause fluid retention which can lead to edema, which is most commonly manifested by swelling of the ankles.

WARNING: Some individuals are allergic to NSAIDs and may develop shortness of breath when an NSAID is taken. People with asthma are at a higher risk for experiencing serious allergic reaction to NSAIDs. Individuals with a serious allergy to one NSAID are likely to experience a similar reaction to a different NSAID.
Use of aspirin in children and teenagers with chickenpox or influenza has been associated with the development of Reye’s syndrome, a serious and sometimes fatal liver disease. Therefore, aspirin and non-aspirin salicylates (for example, salsalate [Amigesic]) should not be used in children and teenagers with suspected or confirmed chickenpox or influenza.

NSAIDs increase the risk of potentially fatal, stomach and intestinal adverse reactions (for example, bleeding, ulcers, and perforation of the stomach or intestines). These events can occur at any time during treatment and without warning symptoms. Elderly patients are at greater risk for these adverse events. NSAIDs (except low dose aspirin) may increase the risk of potentially fatal heart attacks, stroke, and related conditions. This risk may increase with duration of use and in patients who have underlying risk factors for heart and blood vessel disease. Therefore, NSAIDs should not be used for the treatment of pain resulting from coronary artery bypass graft (CABG) surgery.