Blood Pressure Spikes Linked to NSAID Use, Experts Warn

A recent query to People’s Pharmacy highlights a troubling side effect associated with nonsteroidal anti-inflammatory drugs (NSAIDs). A patient reported a significant spike in blood pressure to 198/90 after starting an NSAID for back pain. Upon discontinuing the medication, their blood pressure returned to normal levels. Despite this experience, their doctor claimed he had never encountered such a reaction linked to NSAIDs.

While the physician’s reaction may be common, it does not reflect the broader evidence available. According to feedback from various sources, including readers of People’s Pharmacy, elevated blood pressure is a recognized adverse effect of NSAID use. This category of medication encompasses well-known drugs such as celecoxib, diclofenac, ibuprofen, meloxicam, and naproxen. A review published in the journal Cureus on September 15, 2025, confirms a clear association between these medications and increased blood pressure.

For those seeking alternatives or additional information, People’s Pharmacy offers an “eGuide to Blood Pressure Solutions.” This resource, available on their website, provides insights on managing blood pressure, including various non-drug approaches.

Nicotinamide’s Role in Skin Cancer Prevention

Another inquiry addressed by People’s Pharmacy involved the use of nicotinamide, a form of vitamin B3, for preventing skin cancer recurrence. An Australian reader sought clarity on whether a prescription is necessary for nicotinamide in the United States, especially after having undergone treatment for basal cell skin cancer and melanoma in situ.

While nicotinamide is not indicated for melanoma prevention, it is often recommended for reducing the risk of other skin cancers. The reader expressed concern over potential liver problems associated with high doses of certain B3 forms but noted that the referenced study in JAMA did not mention these risks.

In general, vitamin B3 exists in various forms, including niacin and nicotinamide. While high doses of niacin, particularly in the range of 1 to 3 grams daily, may cause liver damage, nicotinamide is considered safe up to doses of 3 grams per day. The recommended dosage for preventing skin cancer recurrence is 500 milligrams taken twice daily. It is available over the counter, but patients are advised to consult their doctor to monitor liver enzyme levels during treatment.

Joe and Teresa Graedon, the voices behind People’s Pharmacy, continue to engage with readers on health-related topics. They encourage individuals to reach out with questions via their website or through traditional mail.

As awareness of the side effects of medications increases, it remains crucial for patients to communicate openly with healthcare providers about their experiences, ensuring they receive informed and safe medical advice.