Two isoforms of cyclooxygenases have been identified. COX-2 predominately, decreasing gastrointestinal adverse effects. Four deaths were reported. With acute ingestion, GI symptoms occur the most frequently, with dyspepsia being the most common. Peptic ulceration and its complications are relatively rare.
Renal effects are the second most common problem.
Typically, these include salt and water retention, hyperkalemia, and acute renal failure. Acute interstitial nephritis, nephrotic syndrome, and papillary necrosis occur much less often than other renal symptoms. Elderly persons and individuals with underlying kidney problems or decreased intravascular volume from salt loss or hypoalbuminemia are at particular risk. Dermatologic lesions include generalized exanthems, pruritus, and, rarely, Stevens-Johnson syndrome and toxic epidermal necrolysis. Time of ingestion Nomograms that correlate time and amount of drug ingested have not been reliable for predicting outcome.