van den Bemt Patricia M L A, Tjwa Eric T T L, van Oijen Martijn G H
*Dit artikel is in iets gewijzigde vorm gepubliceerd in Pharmaceutisch Weekblad Wetenschappelijk Platform (Van den Bemt PMLA, Kuipers EJ, Tjwa ETTL. Cardiovasculaire en gastro-intestinale veiligheid van NSAID's. 2014;8:a1420).
Ned Tijdschr Geneeskd. 2014;158:A7311.
All NSAIDs may induce cardiotoxicity. In this respect naproxen is relatively the safest choice. Selective cyclo-oxygenase-2-inhibitors (coxibs) are at least as effective in preventing clinically relevant gastrointestinal toxicity as non-selective NSAIDs plus a protonpump inhibitor (PPI). Non-selective NSAIDs plus a PPI are more effective in prevention of dyspepsia than coxibs. After a serious gastrointestinal complication while using NSAIDs, in principal the patient should no longer use NSAIDs. If needed, a coxib plus a PPI is the first choice.
所有非甾体抗炎药（NSAIDs）都可能诱发心脏毒性。在这方面，萘普生相对是最安全的选择。选择性环氧化酶-2抑制剂（coxibs）在预防临床相关胃肠道毒性方面至少与非选择性NSAIDs加质子泵抑制剂（PPI）一样有效。非选择性NSAIDs加PPI在预防消化不良方面比coxibs更有效。在使用NSAIDs期间发生严重胃肠道并发症后，原则上患者不应再使用NSAIDs。如有需要，coxib加PPI是首选。
