Severe cystitis associated with tiaprofenic acid

• Published in: British Journal of Urology Vol. 79; no. 4; pp. 578 - 584
• Main Authors: CRAWFORD, M.L.A., WALLER, P.C., WOOD, S.M.
• Format: Journal Article
• Language: English
• Published: Oxford UK Blackwell Science Ltd 01-04-1997; Blackwell
• Subjects: Adverse Drug Reaction Reporting Systems; Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal - adverse effects; Biological and medical sciences; Chronic Disease; Cystitis; Cystitis - chemically induced; Cystitis, Interstitial - chemically induced; Drug toxicity and drugs side effects treatment; Female; Humans; interstitial cystitis; Male; Medical sciences; Middle Aged; non‐steroidal anti‐inflammatory drugs; Pharmacology. Drug treatments; Propionates - adverse effects; tiaprofenic acid; Toxicity: urogenital system; United Kingdom; Europe; Non steroidal antiinflammatory agent; Case study; Human; Thiophene derivatives; Urinary system disease; Clinical management; Toxicity; Bladder disease; Tiaprofenic acid; Urinary tract disease; Cystitis; Bibliographic review
• ISSN: 0007-1331; 1464-410X
• DOI: 10.1046/j.1464-410X.1997.00094.x

Objective
 To review the UK spontaneous reports of urinary disorders associated with tiaprofenic acid and other non‐steroidal anti‐inflammatory drugs (NSAIDs) and put them into context of the usage of these preparations in the UK.
Methods
 Suspected adverse drug reaction (ADR) reports of urinary disorders associated with tiaprofenic acid and other NSAIDs received by the UKs spontaneous ADR reporting scheme were analysed.
Results
 Between 1982, when tiaprofenic acid was introduced in the UK, and August 1994, 69 cases of cystitis were reported, with a further 32 reports describing related urinary symptoms including frequency, dysuria and haematuria. Only eight cases of cystitis were reported for all other NSAIDs. The duration of treatment with tiaprofenic acid before the onset of urinary symptoms varied markedly (range 2 days to >3 years). In patients in whom a drug‐induced cause was suspected and the drug was stopped promptly, recovery usually occurred within weeks. However, 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 similar to interstitial cystitis. Most patients with chronic cystitis recovered after withdrawal of tiaprofenic acid, but some patients had surgery before the drug was stopped.
Conclusion
 Tiaprofenic acid can cause severe cystitis. These reports highlight the importance of taking a full drug history in patients with unexplained chronic cystitis. Tiaprofenic acid should be stopped immediately in all patients developing urinary symptoms.