Anaphylactoid reactions may occur; patients with «aspirin triad» (bronchial asthma, aspirin intolerance, rhinitis) may be at increased risk. Do not use in patients who experience bronchospasm, asthma, rhinitis, or urticaria with NSAID or aspirin therapy. May increase risk of aseptic meningitis, especially in systemic lupus erythematosus and mixed connective tissue disorders. Platelet adhesion and aggregation may be decreased (may prolong bleeding time). Anemia may occur. NSAIDs are associated with increased risk of adverse cardiovascular thrombotic events (myocardial infarction, stroke, and new onset or worsening of pre-existing hypertension). Use caution with fluid retention, heart failure, or hypertension. NSAIDs may increase risk of GI irritation, inflammation, ulceration, bleeding, and perforation. Use caution with history of GI disease, concurrent therapy with aspirin, anticoagulants and/or corticosteroids, smoking, use of alcohol, elderly or debilitated patients. When used concomitantly with ≤325 mg of aspirin, a substantial increase in risk of GI complications occurs. Pancreatitis reported. NSAIDs may cause serious skin adverse events including exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis. Use contraindicated for treatment of perioperative pain in setting of coronary artery bypass graft surgery (risk of MI and stroke). Use with caution in decreased hepatic function (severe hepatic reactions occurred). NSAID use may compromise existing renal function; dose-dependent decreases in prostaglandin synthesis may result from NSAID use, reducing renal blood flow which may cause renal decompensation. Patients with impaired renal function, dehydration, heart failure, liver dysfunction, those taking diuretics, ACEIs, and the elderly are at greater risk of renal toxicity. Not recommended for use in advanced renal disease. Long-term NSAID use may result in renal papillary necrosis. Use caution in renal lithiasis (sulindac metabolites reported as components of renal stones). Withhold prior to surgical or dental procedures. May cause increased chloride, increased sodium, increased bleeding time.