BMJ 1995;311:1518-1519 (9 December)

Editorials

Misoprostol in patients taking non-steroidal anti-inflammatory drugs

Best reserved for elderly patients at high risk

The past decade has seen considerable improvements in attempts to prevent the gastrointestinal complications of non-steroidal anti-inflammatory drugs. Increased awareness of the problems that these compounds cause and more careful prescribing have had an appreciable effect, although better access to diagnostic facilities and the availability of drugs both to treat and to prevent gastroduodenal ulceration have also contributed. However, progress in preventing the relatively rare but potentially life threatening complications such as perforation and gastrointestinal haemorrhage has until recently been disappointing.

The availability of misoprostol, a synthetic analogue of prostaglandin, has provided some cause for optimism. Endoscopic studies show that misoprostol reduces the frequency of asymptomatic gastric and duodenal ulceration induced by non-steroidal anti-inflammatory drugs, while ranitidine reduces only the frequency of duodenal ulcers but is better tolerated.1 2 The extent of benefit from proton pump inhibitors such as omeprazole is being evaluated. . . . [Full text of this article]


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This article has been cited by other articles:

  • Shield, M J, Morant, S V (1996). Misoprostol in patients taking non-steroidalanti-inflammatory drugs. BMJ 312: 846a-846 [Full text]  
  • Blenkiron, P. (1996). This reduction in risk is deemed worth while in other circumstances. BMJ 312: 846b-847 [Full text]  
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