Table 1 Clinicians' guide to anti-inflammatory therapy
From: The use of proton pump inhibitors in treating and preventing NSAID-induced mucosal damage
Cardiovascular risk | No or low gastrointestinal risk | Increased gastrointestinal risk |
|---|---|---|
No cardiovascular risk (no aspirin use) | Nonselective NSAID (cost consideration) | COX-2 selective inhibitor or nonselective NSAID + PPI COX-2 selective inhibitor + PPI for those with prior gastrointestinal bleeding |
Cardiovascular risk (aspirin use) | Naproxena | PPI irrespective of NSAID |
| Â | Addition of PPI because gastrointestinal risk of aspirin + NSAID combination typically warrants gastroprotection | Naproxen if cardiovascular risk outweighs gastrointestinal risk |
| Â | Â | COX-2 selective inhibitor + PPI for those with previous gastrointestinal bleeding |