Biomedical Research Centre, Sheffield Hallam University, UK.
J Pharm Pharmacol. 2012 Apr;64(4):465-9. doi: 10.1111/j.2042-7158.2011.01406.x. Epub 2011 Nov 18.
Published and regulatory advice is to take NSAIDs with fluids and/or food irrespective whether NSAIDs are taken over the counter or long-term. The basis for this recommendation is not clear and we sought to establish the reasons for it through a search of published literature and personal files.
Results from experimental animals show that fasting increases the gastric side effects of NSAIDs while food increases small bowel damage, but this has not been tested in humans. The possible effects of food in modifying the gastric damage caused by NSAIDs are complex, as food quantity and composition modify the responses substantially. Food usually delays peak levels of NSAIDs (and hence onset of action) without affecting total bioavailability. This may not be important when a steady state is achieved, but rapid onset of action is highly relevant for over-the-counter use of NSAIDs. The safety of over-the-counter use of ibuprofen and naproxen appears to be excellent and comparable with paracetamol.
The rapid onset of action of NSAIDs is most important during over-the-counter use, in which case it may be more appropriate to take the drugs on a fasting stomach.
无论非甾体抗炎药（NSAIDs）是在柜台购买还是长期使用，出版界和监管机构的建议都是与液体和/或食物一起服用 NSAIDs。这一建议的依据并不明确，我们通过查阅已发表的文献和个人档案来寻找其依据。
来自实验动物的结果表明，禁食会增加 NSAIDs 的胃部副作用，而食物会增加小肠损伤，但这尚未在人类中得到验证。食物在改变 NSAIDs 引起的胃部损伤方面的可能影响较为复杂，因为食物的数量和成分会对其产生实质性影响。食物通常会延迟 NSAIDs 的峰值水平（从而延迟起效时间），而不会影响其总生物利用度。在达到稳定状态时，这可能并不重要，但对于 NSAIDs 的柜台使用，快速起效至关重要。布洛芬和萘普生的柜台使用安全性似乎非常好，与对乙酰氨基酚相当。
在柜台使用 NSAIDs 时，快速起效最为重要，在这种情况下，空腹服用药物可能更为合适。
