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 25 May 2018

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News

Risk of GI symptoms with over-the-counter nonsteroidal anti-inflammatory drugs

Over-the-counter NSAIDs are not a benign medication even at low dosage, with NSAID users twice as likely as non-users to report GI symptoms, finds a study in the September issue of the American Journal of Gastroenterology.

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In this study, researchers sought to determine the use of over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs) and their GI side-effects, as well as to identify any professional or self-care for these side-effects.

The team, from the United States, surveyed an age-stratified random sample of over 1500 people using a telephone survey. All subjects were 40 years of age or over.

Subjects were divided into two groups, the first, contained 535 people who had used OTC NSAIDs for 4 of the previous 7 days. The second, 1068 people who had not used any NSAIDs within the previous 30 days.

The team measured each individual's current use of OTC NSAIDs, any GI symptoms, plus diagnoses and their treatment. They also measured any use of prescription or OTC GI medications.

The researchers identified the most commonly used OTC NSAID as aspirin, either alone or in combination compounds.

GI symptoms twice as likely in over-the-counter NSAID users.
American Journal of Gastroenterology

It was discovered that the majority of NSAIDs taken were for the prevention of myocardial infarction or stroke (43%). This was followed by pain relief and relief of arthritis symptoms.

The team also found that NSAID users (20%) were twice as likely as non-users (10%) to report GI side-effects.

When experiencing GI symptoms, they were more than twice as likely to use an OTC GI medication (47% compared to 21%).

Dr Joseph Thomas' team concluded, "OTC NSAIDs are not a benign medication, even at low dosages".

In addition, "Physicians may be unaware that patients self-medicate with OTC NSAIDs or with OTC GI medications".

In an editorial in the same publication, Drs Scheiman and Fendrick comment that, "Most regular NSAID users lack awareness of their potential side-effects".

"The sheer numbers of individuals exposed to OTC agents raise concern regarding their appropriate use", they state.

Am J Gastroenterol 2002; 97 (9): 2215-9, 2159-61
04 October 2002

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