Can NSAID-related ulcers and complications be prevented?
NSAIDs are valuable medications for patients with inflammatory arthritis and other inflammation of body tissues. For patients who need long-term NSAID treatment, several steps can be taken to decrease NSAID-related ulcers and complications. The risk of ulcers and complications tend to be dose related. Therefore, the smallest effective dose of NSAIDs is taken to minimize the risk. NSAIDs might be selected that have less effect on the stomach production of prostaglandins. Some of these NSAIDs are called selective Cox-2 inhibitors. Cox-2 inhibitors block the Cox-2 enzyme that produces prostaglandins of inflammation without blocking the natural prostaglandin production of Cox-1 in the stomach [currently in the U.S., the only available Cox-2 inhibitor is celecoxib (Celebrex)]. Taking NSAIDs with meals may minimize stomach upset with NSAIDs but not ulcerations. A synthetic prostaglandin, misoprostol (Cytotec), can be administered orally along with NSAIDs. Misoprostol has been shown to decrea
