Upper Gastrointestinal Toxicity of Rofecoxib and Naproxen

To the Editor: In 1998, the American College of Gastroenterology recommended that patients at high risk for hemorrhage and perforation from ulcers induced by aspirin and other nonselective nonsteroidal antiinflammatory drugs (NSAIDs) should be considered for prophylaxis with misoprostol. In this sen...

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Bibliographic Details
Published inThe New England journal of medicine Vol. 344; no. 18; pp. 1398 - 1399
Main Authors Delgado Fernández, M, Zambrana García, J L, Diez García, F
Format Journal Article
LanguageEnglish
Published United States Massachusetts Medical Society 03.05.2001
Subjects
Anti-Inflammatory Agents, Non-Steroidal - adverse effects
Anti-Ulcer Agents - therapeutic use
Ethics, Medical
Gastrointestinal Hemorrhage - prevention & control
Histamine H2 Antagonists - therapeutic use
Humans
Lactones - adverse effects
Middle Aged
Misoprostol - therapeutic use
Naproxen - adverse effects
Proton Pump Inhibitors
Risk Factors
Sulfones
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Summary:To the Editor: In 1998, the American College of Gastroenterology recommended that patients at high risk for hemorrhage and perforation from ulcers induced by aspirin and other nonselective nonsteroidal antiinflammatory drugs (NSAIDs) should be considered for prophylaxis with misoprostol. In this sense, proton-pump inhibitors are an acceptable alternative for the prevention of NSAID-related complications. 1 Double doses of histamine H 2 –receptor antagonists and standard doses of proton-pump inhibitors are also effective in preventing endoscopically detectable duodenal and gastric ulcers. 2 Risk factors for NSAID-related complications include a history of gastrointestinal events (ulcer or hemorrhage), age over 60 years, use of a . . .
ISSN:0028-4793
1533-4406
DOI:10.1056/NEJM200105033441812