Tags

Type your tag names separated by a space and hit enter

Risk of serious upper gastrointestinal toxicity with over-the-counter nonaspirin nonsteroidal anti-inflammatory drugs.
Gastroenterology. 2005 Dec; 129(6):1865-74.G

Abstract

BACKGROUND & AIMS

Use of prescription nonaspirin nonsteroidal anti-inflammatory drugs (NANSAIDs) increases the risk of serious upper gastrointestinal toxicity. Less is known about over-the-counter (OTC) NANSAIDs, which are typically used at lower doses and for shorter durations. This study assessed the risk of toxicity with OTC NANSAIDs.

METHODS

A total of 359 case subjects hospitalized for upper gastrointestinal bleeding, perforation, or benign gastric outlet obstruction were recruited from 28 hospitals. A total of 1889 control subjects were recruited by random digit dialing from the same region. Data on medication use were collected via structured telephone interview.

RESULTS

Use of OTC NANSAIDs on > or = 4 days during the most recent week had an adjusted odds ratio (OR) of 1.83 (95% confidence interval [CI], 1.14-2.95). Use of high-dose OTC NANSAIDs during the index week had an adjusted OR of 5.21 (95% CI, 2.32-11.69). In contrast, use of OTC NANSAIDs <4 times during the index week (adjusted OR, 0.67; 95% CI, 0.43-1.06) and use of very low doses of prescription or OTC NANSAIDs during the index week (adjusted OR, 0.74; 95% CI, 0.49-1.12) were not significantly associated with an increased risk of serious gastrointestinal toxicity. We did not observe a significant difference between the risk of toxicity with OTC naproxen versus OTC ibuprofen (adjusted OR, 0.84; 95% CI, 0.26-2.70).

CONCLUSIONS

Use of OTC NANSAIDs at recommended doses has a relatively good safety profile compared with prescription NANSAIDs. However, use of high-dose OTC NANSAIDs (comparable to a prescription dose) is associated with serious gastrointestinal toxicity.

Authors+Show Affiliations

Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA. jlewis@cceb.med.upenn.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16344055

Citation

Lewis, James D., et al. "Risk of Serious Upper Gastrointestinal Toxicity With Over-the-counter Nonaspirin Nonsteroidal Anti-inflammatory Drugs." Gastroenterology, vol. 129, no. 6, 2005, pp. 1865-74.
Lewis JD, Kimmel SE, Localio AR, et al. Risk of serious upper gastrointestinal toxicity with over-the-counter nonaspirin nonsteroidal anti-inflammatory drugs. Gastroenterology. 2005;129(6):1865-74.
Lewis, J. D., Kimmel, S. E., Localio, A. R., Metz, D. C., Farrar, J. T., Nessel, L., Brensinger, C., McGibney, K., & Strom, B. L. (2005). Risk of serious upper gastrointestinal toxicity with over-the-counter nonaspirin nonsteroidal anti-inflammatory drugs. Gastroenterology, 129(6), 1865-74.
Lewis JD, et al. Risk of Serious Upper Gastrointestinal Toxicity With Over-the-counter Nonaspirin Nonsteroidal Anti-inflammatory Drugs. Gastroenterology. 2005;129(6):1865-74. PubMed PMID: 16344055.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of serious upper gastrointestinal toxicity with over-the-counter nonaspirin nonsteroidal anti-inflammatory drugs. AU - Lewis,James D, AU - Kimmel,Stephen E, AU - Localio,A Russell, AU - Metz,David C, AU - Farrar,John T, AU - Nessel,Lisa, AU - Brensinger,Colleen, AU - McGibney,Karen, AU - Strom,Brian L, PY - 2005/04/11/received PY - 2005/08/17/accepted PY - 2005/12/14/pubmed PY - 2006/2/4/medline PY - 2005/12/14/entrez SP - 1865 EP - 74 JF - Gastroenterology JO - Gastroenterology VL - 129 IS - 6 N2 - BACKGROUND & AIMS: Use of prescription nonaspirin nonsteroidal anti-inflammatory drugs (NANSAIDs) increases the risk of serious upper gastrointestinal toxicity. Less is known about over-the-counter (OTC) NANSAIDs, which are typically used at lower doses and for shorter durations. This study assessed the risk of toxicity with OTC NANSAIDs. METHODS: A total of 359 case subjects hospitalized for upper gastrointestinal bleeding, perforation, or benign gastric outlet obstruction were recruited from 28 hospitals. A total of 1889 control subjects were recruited by random digit dialing from the same region. Data on medication use were collected via structured telephone interview. RESULTS: Use of OTC NANSAIDs on > or = 4 days during the most recent week had an adjusted odds ratio (OR) of 1.83 (95% confidence interval [CI], 1.14-2.95). Use of high-dose OTC NANSAIDs during the index week had an adjusted OR of 5.21 (95% CI, 2.32-11.69). In contrast, use of OTC NANSAIDs <4 times during the index week (adjusted OR, 0.67; 95% CI, 0.43-1.06) and use of very low doses of prescription or OTC NANSAIDs during the index week (adjusted OR, 0.74; 95% CI, 0.49-1.12) were not significantly associated with an increased risk of serious gastrointestinal toxicity. We did not observe a significant difference between the risk of toxicity with OTC naproxen versus OTC ibuprofen (adjusted OR, 0.84; 95% CI, 0.26-2.70). CONCLUSIONS: Use of OTC NANSAIDs at recommended doses has a relatively good safety profile compared with prescription NANSAIDs. However, use of high-dose OTC NANSAIDs (comparable to a prescription dose) is associated with serious gastrointestinal toxicity. SN - 0016-5085 UR - https://www.unboundmedicine.com/medline/citation/16344055/Risk_of_serious_upper_gastrointestinal_toxicity_with_over_the_counter_nonaspirin_nonsteroidal_anti_inflammatory_drugs_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(05)01769-5 DB - PRIME DP - Unbound Medicine ER -