PPIs in patients receiving NSAIDs

Should proton pump inhibitors (PPIs) be prescribed in patients treated with nonsteroidal anti-inflammatory drugs (NSAIDs)?

Paul Moayyedi, MB ChB, PhD: I would say they are not mandatory except in certain circumstances. A young person can just take a nonsteroidal alone for pain in their knee. Even if they need to take it more long term, a young person is not going to be at risk of gastrointestinal bleeding.

It is usually those over 65 years with other risk factors, such as taking aspirin as well, other anticoagulant, previous history of ulcer disease; these are all cases when I would give a PPI as well as a nonsteroidal. But it would not be in every person who takes nonsteroidals.

See also

Pain management in chronic pancreatitis What are the principles of pain management in patients with chronic pancreatitis? Can we use strong opioids?
PPIs in patients receiving oral glucocorticoids Should proton pump inhibitors (PPIs) be prescribed in patients treated with oral glucocorticoids?
Results of surgical treatment in GERD What are the results of surgical treatment of gastroesophageal reflux disease? Is symptom resolution permanent? What are the most frequent and most severe complications?
PPIs for intestinal metaplasia of the gastroesophageal junction Would you prescribe proton pump inhibitors (PPIs) for patients with intestinal metaplasia of the gastroesophageal junction when the biopsy was taken from a Z line with <1 cm of variability?
Current management of Clostridium difficile infection A lecture by Dr Christine Lee, from McMaster University, Canada, delivered at McMaster International Review Course in Internal Medicine in Kraków in May 2017.
Approach to a patient with decompensated liver cirrhosis A lecture by Dr Pere Ginès, from University of Barcelona, Spain, delivered at McMaster International Review Course in Internal Medicine in Kraków in May 2017.
Current management of dyspepsia A lecture by Dr Paul Moayyedi, from McMaster University, Canada, delivered at McMaster International Review Course in Internal Medicine in Kraków in May 2017.

PPIs in patients receiving NSAIDs

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