OTC High-Dose NANSAID Use Has Fivefold Risk for GI Bleed

Recommended dosage for short duration appears safe

FRIDAY, Dec. 30 (HealthDay News) -- Nonaspirin nonsteroidal anti-inflammatory drugs (NANSAIDs) that are purchased over-the-counter (OTC) can be taken safely without the risk of gastrointestinal bleeding if the proper dosage recommendations are followed, according to a report in the December issue of Gastroenterology.

James D. Lewis, M.D., of the University of Pennsylvania, and colleagues interviewed 359 Philadelphia-area subjects recently hospitalized for upper gastrointestinal bleeding, perforation or benign gastric outlet obstruction. The researchers asked about the patients' use of OTC NANSAIDS in the week prior to admission. A total of 1,889 control subjects from the same area were recruited randomly by phone.

The investigators found that those who used OTC NANSAIDs at the proper dosage, or prescription NANSAIDS at low dosages less than four times in the week prior to admission had no significant risk of bleeding. In contrast, use of high-dose OTC NANSAIDs was associated with a 5.2 -fold risk of upper GI bleeding.

The authors found no difference in the risk of bleeding from OTC naproxen versus ibuprofen.

"Our data show that OTC NANSAIDs, when used at recommended doses and for short duration, exhibit a relatively good safety profile," the authors conclude.

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