Which side effect is most commonly associated with NSAIDs?

Gastrointestinal bleeding is the most commonly recognized side effect associated with nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs work by inhibiting cyclooxygenase (COX) enzymes, which play a crucial role in the production of prostaglandins. Prostaglandins are important for protecting the gastric mucosa by promoting the secretion of mucus and bicarbonate, and maintaining blood flow to the stomach lining. When NSAIDs inhibit these protective prostaglandins, they can lead to decreased gastric mucosal defenses, increasing the risk of ulcers and gastrointestinal bleeding.

Long-term use or high doses of NSAIDs significantly elevate this risk, often resulting in serious complications such as perforation or significant hemorrhage. Monitoring for signs of gastrointestinal discomfort, such as abdominal pain or black tarry stools, is critical in patients on NSAIDs. While other side effects, like hypertension or sleep disturbances, can occur with NSAID use, they are less commonly associated than gastrointestinal bleeding. Hypoglycemia is also generally unrelated to NSAID use, which further emphasizes why gastrointestinal bleeding is a key consideration in the management of patients taking these medications.