K. Ghose, CYSTITIS AND NONSTERIODAL ANTIINFLAMMATORY DRUGS - AN INCIDENTAL ASSOCIATION OR AN ADVERSE EFFECT, New Zealand medical journal, 106(968), 1993, pp. 501-503
Aims. Cystits, a rare adverse effect of systematically administered dr
ugs, was first reported to be associated with a nonsteroidal antiinfla
mmatory drug, tiaprofenic acid, in 1991. Similar reports of adverse ef
fect of tiaprofenic acid were received by a number of national drug mo
nitoring centres. It was therefore deceided to investigate the frequen
cy of cystitis associated with tiaprofenic acid and to see whether thi
s association is typical of tiaprofenic acid or also occurs with other
nonsteroidal antiinflammatory drugs. Methods. The Medicines Adverse R
eaction Monitoring Centre has been monitoring drug related events/reac
tions since 1965. An analysis of the spontaneous adverse reaction repo
rts received at this centre during the period 1965-92 was carried out.
Results. Haemorrhagic cystitis was reported to be associated with tia
profenic acid (n=3) and indomethacion (n=3). In addition 11 other repo
rts of haematuria (not associated with any coagulopathy and/or hepatic
disorders) in relation to other nonsteroidal antiinflammatory drugs,
such as diclofenac, ketoprofen, naproxen and piroxicam were received.
Five patients who were rechallenged with the suspect drug, suffered fr
om recurrence of cystitis/ haematuria. Conclusions. In addition to tia
profenic acid, cystitis appears to be associated with indomethacin and
possibly also with other nonsteroidal antiinflammatory drugs. An alle
rgic or immunological mechanism is probably responsible for this react
ion. Although our centre received the first report of cystitis in rela
tion to indomethacin in 1966, judging by the number of reports receive
d, this association appears to be poorly recognised.