Gastrointestinal conditions

Notes

  1. Prescribe NSAIDs with caution to people with a history of GI ulceration or bleed or people at high risk of GI adverse effects. Risk factors for NSAID–induced gastrointestinal (GI) adverse events include:
    • Aged over 65 years
    • A high dose of an NSAID
    • A history of gastroduodenal ulcer, GI bleeding, or gastroduodenal perforation
    • Concomitant use of medications that are known to increase the likelihood of upper GI adverse events (for example, anticoagulants, corticosteroids, selective serotonin reuptake inhibitors)
    • A serious comorbidity, such as cardiovascular disease, hepatic or renal impairment (including dehydration), diabetes, or hypertension
    • Heavy smoking
    • Excessive alcohol consumption
    • Previous adverse reaction to NSAIDs
    • Prolonged requirement for NSAIDs

A PPI should be co-prescribed with an NSAID – liaise with the patient’s GMP if a PPI is not currently prescribed.
If in doubt about the patient’s level of GI risk or appropriate analgesics, consult with their GMP.

  1. Prescribe NSAIDs with caution to people with inflammatory bowel disease (NSAIDs may increase the risk of developing or cause exacerbations of ulcerative colitis or Crohn's disease).