SEVERE CYSTITIS ASSOCIATED WITH TIAPROFENIC ACID

Objective To review the UK spontaneous reports of urinary disorders as sociated with tiaprofenic acid and other non-steroidal anti-inflammato ry drugs (NSAIDs) and put them into context of the usage of these prep arations in the UK. Methods Suspected adverse drug reaction (ADR) repo rts of urinary disorders associated with tiaprofenic acid and other NS AIDs received by the UKs spontaneous ADR reporting scheme were analyse d. Results Between 1982, when tiaprofenic acid was introduced in the U K, and August 1994, 69 cases of cystitis were reported, with a further 32 reports describing related urinary symptoms including frequency, d ysuria and haematuria. Only eight cases of cystitis were reported for all other NSAIDs. The duration of treatment with tiaprofenic acid befo re the onset of urinary symptoms varied markedly (range 2 days to >3 y ears). In patients in whom a drug-induced cause was suspected and the drug was stopped promptly, recovery usually occurred within weeks. How ever, many patients continued on long-term treatment with tiaprofenic acid and underwent extensive investigations to determine the cause of their urinary symptoms. On cystoscopy and biopsy, the findings were si milar to interstitial cystitis. Most patients with chronic cystitis re covered after withdrawal of tiaprofenic acid, but some patients had su rgery before the drug was stopped. Conclusion Tiaprofenic acid can cau se severe cystitis. These reports highlight the importance of taking a full drug history in patients with unexplained chronic cystitis. Tiap rofenic acid should be stopped immediately in all patients developing urinary symptoms.