The use of prescription nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs) increases the risk of serious upper gastrointestinal toxicity.
Less is known about over-the-counter nonaspirin nonsteroidal anti-inflammatory drugs, which are typically used at lower doses and for shorter durations.
Dr James Lewis and colleagues from Pennsylvania assessed toxicity risk with over-the-counter nonaspirin nonsteroidal anti-inflammatory drugs.
The team recruited 359 case subjects hospitalized for upper gastrointestinal bleeding, perforation, or benign gastric outlet obstruction from 28 hospitals.
A total of 1889 control subjects were recruited by random digit dialing from the same region.
|High-dose over-the-counter nonaspirin NSAIDs had an adjusted odds ratio of 5|
Data on medication use were collected via structured telephone interview.
The team found that the use of over-the-counter nonaspirin NSAIDs 4 days or more during the most recent week had an adjusted odds ratio of 1.8.
The researchers noted that use of high-dose over-the-counter nonaspirin NSAIDs during the index week had an adjusted odds ratio of 5.
In contrast, the use of these drugs less than 4 times or at very low doses of prescription during the index week were not associated with an increased risk.
The team did not observe a significant difference between the risk of toxicity with over-the-counter naproxen versus about over-the-counter ibuprofen.
Dr Lewis' team conclude, “The use of over-the-counter nonaspirin nonsteroidal anti-inflammatory drugs at recommended doses has a relatively good safety profile compared with prescription nonaspirin nonsteroidal anti-inflammatory drugs.”
“However, the use of high-dose over-the-counter nonaspirin nonsteroidal anti-inflammatory drugs is associated with serious gastrointestinal toxicity.”