In an attack of several days' duration prior to starting therapy, a longer course of treatment may be necessary. In such patients, added interventions to prevent NSAID gastropathy (eg, use of a proton pump inhibitor) may be of benefit, particularly in patients at increased risk due to advanced age or to a prior history of ulcer disease or gastrointestinal bleeding. (See "NSAIDs (including aspirin): Primary prevention of gastroduodenal toxicity" and "NSAIDs (including aspirin): Secondary prevention of gastroduodenal toxicity" .)
Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.
At times, there are no symptoms of this disease, but when they do occur they are widely varied and can occur rapidly or gradually.      When caused by an allergic reaction, the symptoms of acute tubulointerstitial nephritis are fever (27% of patients),  rash (15% of patients),  and enlarged kidneys. Some people experience dysuria , and lower back pain. In chronic tubulointerstitial nephritis the patient can experience symptoms such as nausea, vomiting, fatigue, and weight loss. Other conditions that may develop include hyperkalemia , metabolic acidosis , and kidney failure.