CONNECT TO PROTECT




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Managing the Risk

Understanding and reducing the gastrointestinal (GI) risks associated with the use of non-steroidal anti-inflammatory drugs, or NSAIDs, is becoming an increasingly important part of patient care for primary care physicians and rheumatologists. One of the first steps is for physicians to consider whether NSAID therapy is necessary at all and whether patients can be managed with non-NSAID analgesics such as acetaminophen. If NSAID therapy is necessary, physicians should start with the lowest NSAID dose which effectively manages patients’ pain or inflammation. In patients who require full-dose NSAID treatment, physicians may add a GI protective co-therapy to reduce the risk for upper GI complications. Physicians may prescribe high doses of the H2 antagonists, like famotidine (Pepcid®)1, a proton pump inhibitor (PPI), such as lansoprazole (Prevacid®)2, esomeprazole (Nexium®)3, pantoprazole (Protonix® ) 4 or other co-therapies which reduce NSAIDS GI risk such as misoprostol (Cytotec®) 5 or COX-2 Inhibitors, like celecoxib (Celebrex® 6), which is still considered a safe option for some patients. Because some NSAIDS also are available without a prescription, patients often do not report NSAID use to their physicians, thereby placing themselves at risk. 15Conversely, patients who are prescribed NSAID therapy by their physician may neglect to take it as prescribed, which may also be detrimental to their GI health.16 Therefore, regardless of whether a patient is taking NSAIDs over-the-counter or by prescription, it is important for physicians and patients to connect to discuss their use. 1. Pepcid is a registered trademark of Johnson & Johnson and Merck Consumer Pharmaceuticals Co. 2. Prevacid is a registered trademark of Takeda Pharmaceuticals North America, Inc., and is used under license by Takeda Pharmaceuticals America, Inc. 3. Nexium is a registered trademark of AstraZeneca 4. Protonix is a registered trademark of Wyeth 5. Cytotec is a registered trademark of Pfizer 6. Celebrex is a registered trademark of Pfizer