Fatal asthmatic and anaphylactoid reactions have occurred in «aspirin triad». NSAIDs are associated with increased risk of adverse cardiovascular events, including MI, stroke, and new onset or worsening of pre-existing hypertension (risk may be increased with duration of use or pre-existing cardiovascular risk factors or disease). Use caution with fluid retention, heart failure, or hypertension. Severe cases of cystitis (bladder pain, dysuria, urinary frequency, hematuria) reported. Avoid use in prior history of urinary symptoms. GI bleeding may occur without prior symptoms of GI irritation. Use with caution in history of GI disease. When used concomitantly with ≤325 mg of aspirin, substantial increase in risk of GI complications occurs. Do not administer with asthma (severe bronchospasm may occur). Patients with autoimmune disorders may be at greater risk of developing aseptic meningitis, as rare adverse reaction associated with some NSAIDs. Use with caution in decreased hepatic function. 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, and ACEIs, and the elderly are at greater risk of renal toxicity. Contraindicated in deteriorating function or severe impairment (CrCl <30 mL/minute). Long-term NSAID use may result in renal papillary necrosis. Withhold for at least 4-6 half-lives prior to surgical or dental procedures.