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Gastrointestinal and cardiovascular adverse events associated with NSAIDs.

Authors :
Domper Arnal MJ
Hijos-Mallada G
Lanas A
Source :
Expert opinion on drug safety [Expert Opin Drug Saf] 2022 Mar; Vol. 21 (3), pp. 373-384. Date of Electronic Publication: 2021 Aug 18.
Publication Year :
2022

Abstract

Introduction: Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most prescribed pharmacological groups, especially in elderly patients.<br />Areas Covered: The main GI and CV adverse events associated with NSAID use are reviewed. Risk factors and prophylactic strategies are also covered.<br />Expert Opinion: COX-2 selective agents are safer to the GI tract but have a worst CV profile. On the contrary, naproxen seems safer for CV system, but it is one of the NSAIDs with higher GI toxicity. Co-therapy with aspirin reduces the GI benefits of COX-2 selective agents, whereas ibuprofen and naproxen may neglect the antiplatelet effect of aspirin. NSAIDs increase the risk of both upper and lower GI complications. Co-therapy with PPI reduces the risk of upper but not lower GI complications, and seems to induce dysbiosis in the small bowel, which may be implicated in the damage induced by NSAIDs. Celecoxib, a COX-2 selective agent, seems safer for both the upper and the lower GI tract. Prescription of type and dose of NSAIDs must be individualized based on the stratification of the CV and GI risk of patients.

Details

Language :
English
ISSN :
1744-764X
Volume :
21
Issue :
3
Database :
MEDLINE
Journal :
Expert opinion on drug safety
Publication Type :
Academic Journal
Accession number :
34376069
Full Text :
https://doi.org/10.1080/14740338.2021.1965988