Tiaprofenic acid

How it works

It inhibits cyclo-oxygenase, reducing prostaglandin synthesis and producing anti-inflammatory and analgesic effects.

Prescribing in practice

• It can cause severe cystitis and urinary symptoms, and should be stopped immediately and not restarted if urinary frequency, pain, urgency or haematuria develops.
• As with all NSAIDs it carries gastrointestinal, cardiovascular and renal risks and should be used at the lowest effective dose for the shortest time.
• It interacts with anticoagulants, other NSAIDs, diuretics, ACE inhibitors and lithium; avoid in patients with active peptic ulceration or significant renal impairment.

Monitoring

Monitor for urinary symptoms, renal function and gastrointestinal tolerability, particularly during prolonged use.

Counselling the patient

• Stop the medicine and tell your doctor at once if you develop bladder symptoms such as needing to pass urine often, pain on passing urine, or blood in the urine.
• Take it with or after food and report indigestion or black stools.
• Avoid combining it with other anti-inflammatory painkillers unless advised.

Evidence & guidelines

The MHRA has highlighted the risk of severe cystitis with tiaprofenic acid, advising prompt discontinuation if urinary symptoms occur.