Nalamachu Srinivas, Pergolizzi Joseph V, Raffa Robert B, Lakkireddy Dhanunjaya R, Taylor Robert
International Clinical Research Institute , Overland Park, KS , USA.
Expert Opin Drug Saf. 2014 Jul;13(7):903-17. doi: 10.1517/14740338.2014.924924. Epub 2014 Jun 6.
The aging of the population in the US and other countries means that a large number of people will likely take NSAIDs for the relief of pain and low-dose aspirin (LD-ASA) for cardioprotection. However, the cardioprotective value of LD-ASA can be compromised in patients who take NSAIDs concomitantly, because some NSAIDs competitively bind to critical amino-acid residues on cyclooxygenase (COX) enzymes and interfere with the mechanism of antiplatelet activity of LD-ASA.
A review of the literature was conducted to provide an overview of current issues surrounding the concomitant use of NSAIDs and LD-ASA, to explore potential mechanisms for this drug-drug interaction and to consider current and future treatment options that may mitigate the risk associated with their concomitant use.
NSAIDs offer effective pain relief for the most common forms of pain, such as low back pain, musculoskeletal pain associated with arthritis, postsurgical pain, headache, acute pain syndromes, menstrual pain and dental pain. The development of NSAID formulations that offer effective pain control with fewer or less serious adverse effects due to interference with ASA would be a valuable medical advance. Several promising treatment options and regimens may be available in the future.
美国和其他国家的人口老龄化意味着大量人群可能会服用非甾体抗炎药（NSAIDs）来缓解疼痛，并服用低剂量阿司匹林（LD - ASA）进行心脏保护。然而，同时服用NSAIDs的患者，LD - ASA的心脏保护作用可能会受到影响，因为一些NSAIDs会竞争性结合环氧化酶（COX）上的关键氨基酸残基，干扰LD - ASA的抗血小板活性机制。
对文献进行综述，以概述围绕NSAIDs与LD - ASA联合使用的当前问题，探讨这种药物相互作用的潜在机制，并考虑当前及未来可能降低其联合使用相关风险的治疗选择。
NSAIDs能有效缓解最常见的疼痛形式，如腰痛、与关节炎相关的肌肉骨骼疼痛、术后疼痛、头痛、急性疼痛综合征、痛经和牙痛。开发出能有效控制疼痛且因干扰阿司匹林而产生较少或不太严重不良反应的NSAIDs制剂将是一项有价值的医学进展。未来可能会有几种有前景的治疗选择和方案。
