What is a major contraindication for using NSAIDs?

A significant contraindication for using NSAIDs is active peptic ulcer disease. NSAIDs, or non-steroidal anti-inflammatory drugs, can inhibit the production of prostaglandins, which are substances that help protect the stomach lining. By reducing prostaglandin levels, NSAIDs can exacerbate gastric mucosal injury, leading to increased risk of bleeding, ulceration, and complications in individuals with active peptic ulcer disease. Therefore, it is critical to avoid NSAIDs in patients who have this condition to prevent further irritation of the gastrointestinal tract.

While other conditions like heart failure may warrant caution due to the potential for fluid retention and worsening of heart function, and chronic obstructive pulmonary disease may present risks related to respiratory effects, the direct and acute risks associated with NSAID use in the context of active peptic ulcer disease make it a major contraindication. Hypotension is not a direct contraindication for NSAIDs, although care should always be taken in patients with any hemodynamic concerns.