Cenex Special Precautions

Before the patient takes Cenex, the doctor must be told if the patient has: Previously had an ulcer or bleeding in his/her stomach or intestines (The patient must not take Cenex if he/she currently has an ulcer or bleeding in the stomach or intestine).
Medicine to reduce blood clotting.
Taking acetylsalicylic acid.
Medicine called corticosteroids.
Using Cenex at the same time as other non-acetylsalicylic NSAID such as ibuprofen or diclofenac. The use of these medicines together should be avoided.
Heart, liver or kidneys dysfunction.
Smoking, has diabetes, raised blood pressure or raised cholesterol.
Fluid retention.
Dehydration, for instance due to sickness, diarrhea or the use of diuretics.
A serious allergic reaction or a serious skin reaction to any medicines.
Illness due to infection or think the patient has an infection, as Cenex may mask a fever or other signs of infection and inflammation.
Age over 65 years the doctor will want to monitor the patient regularly.
The consumption of alcohol and NSAID may increase the risk of gastrointestinal problem.
Cardiovascular Risk: NSAIDs may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk.
Gastrointestinal Risk: NSAIDs cause an increased risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious gastrointestinal events.
Renal Effects: Long-term administration of NSAIDs has resulted in renal papillary necrosis and other renal injury. Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. In these patients, administration of an NSAID may cause a dose-dependent reduction in prostaglandin formation and, secondarily, in renal blood flow, which may precipitate overt renal decompensation. Patients at greatest risk of this reaction are those with impaired renal function, heart failure, liver dysfunction, those taking diuretic and ACE inhibitors, and the elderly.
Discontinuation of NSAID therapy is usually followed by recovery to the pretreatment state.
Advanced Renal Disease: No information is available from controlled clinical studies regarding the use of "Cenex" in patients with advanced renal disease. Therefore, treatment with "Cenex" is not recommended in these patients with advanced renal disease. If therapy must be initiated, close monitoring of the patient's renal function is advisable.
Driving and using machines: The patient should be aware of how he/she reacts to Cenex before driving or operating machinery. If the patient feels dizzy or drowsy after taking Cenex, he/she must not drive or operate machinery until these effects wear off.