Related Experiment Videos
Sustained release and enteric coated NSAIDs: are they really GI safe?
1University of Sydney, College of Health Sciences, School of Pharmacy, Sydney, New South Wales, Australia. ndavies@pharm.usyd.edu.au
Summary
Modified release non-steroidal anti-inflammatory drugs (NSAIDs) can cause serious small and large intestinal damage, including bleeding and death. These formulations do not guarantee gastrointestinal safety and require increased awareness of potential distal toxicity.
Area of Science:
- Gastroenterology
- Pharmacology
- Toxicology
Background:
- Non-steroidal anti-inflammatory drugs (NSAIDs) are frequently linked to upper gastrointestinal (GI) issues like ulcers.
- Emerging evidence suggests NSAIDs also cause mucosal injury in the small and large intestines.
- Modified release NSAID formulations (enteric-coated [EC] and sustained-release [SR]) aim to improve efficacy and reduce upper GI side effects.
Purpose of the Study:
- To systematically review toxicological effects of modified release NSAIDs in the small and large intestine.
- To analyze the identified toxicological effects of these formulations.
Main Methods:
- Systematic literature review using Medline, Embase, and Index Medicus.
- Analysis of toxicological effects induced by modified release NSAID formulations.
Main Results:
- SR and EC NSAID use is associated with small and large intestinal bleeding, anemia, strictures, ulcerations, and perforations.
- Severe adverse events, including death, have been reported.
- Modified release NSAIDs can lead to significant patient morbidity.
Conclusions:
- Modified release NSAID delivery systems do not ensure gastrointestinal safety.
- Heightened awareness of distal GI toxicities from modified release NSAIDs is crucial for reducing patient morbidity.
- Given the widespread prescription and over-the-counter availability of some EC NSAIDs, understanding these risks is vital.