Low-dose aspirin reduces gastro-protective properties of COX-2 selective inhibitors.
We present the case of a patient taking aspirin and etoricoxib who was admitted with upper digestive haemorrhage due to duodenal ulcer. With this case we emphasize that the potential of the stomach-protecting properties of COX-2 selective inhibitors may be reduced in patients who are simultaneously taking aspirin. We also review several pathogenic mechanisms that have been advanced by animal studies to explain the finding that a COX-2 selective inhibitor plus low-dose aspirin leads to an ulcer rate near that of a dual COX-1/COX-2 inhibitor alone.
Soares
João
J
Hospital de Braga, Braga, Portugal.
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001241:Aspirin / Q000009:adverse effects*; D052246:Cyclooxygenase 2 Inhibitors / Q000009:adverse effects*; D004347:Drug Interactions; D004381:Duodenal Ulcer / Q000139:chemically induced* / Q000188:drug therapy*; D000077613:Etoricoxib; D005260:Female; D006801:Humans; D008875:Middle Aged; D000077402:Pantoprazole; D010438:Peptic Ulcer Hemorrhage / Q000150:complications / Q000517:prevention & control*; D011725:Pyridines / Q000009:adverse effects*; D013450:Sulfones / Q000009:adverse effects*
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents; D052246:Cyclooxygenase 2 Inhibitors; D011725:Pyridines; D013450:Sulfones; D000077402:Pantoprazole; D001241:Aspirin; D000077613:Etoricoxib