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Strong Opioids +/- adjuvant therapy - page 5 / 38

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(rashes, angioedema, bronchospasm)

headache

dizziness

nervousness

depression

drowsiness

insomnia

vertigo

hearing disturbance such as tinnitus

photosensitivity

haematuria

Blood disorders

Fluid retention (leading to heart failure in elderly patients)

Rarely papillary necroisis or interstitial fibrosis leading to renal failure

Hepatic damage

Alveolitis

Pulmonary eosinophilia

Eye changes

Stevens-Johnson syndrome

TEN

Reversible reduced female fertility

Overdose – nausea vomiting and tinnitus, serious toxicity is rare

Contraindications:

Pregnancy

Breastfeeding

Allergy to ibuprofen or hypsersensitivity to aspirin or NSAID

Coagulation defects

Previous active peptic ulceration

Relative contraindications/Cautions:

Active gout

Elderly

Renal failure

Cardiac failure

Left ventricular dysfunction

Hypertension

Oedema

Hepatic failure

Interactions:

Drug

Effect of interaction

ACEi

Renal impairment and hypotensive effect antagonised

Alpha blockers

hypotensive effect antagonised

Aspirin

Ibuprofen reduces antiplatelet effect of aspirin, increasing side effects and haemorrhage

AR2 inhibitors

hypotensive effect antagonised

5

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