title: Drug-drug interaction between NSAIDS and low-dose aspirin: a focus on cardiovascular and GI toxicity.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: International Clinical Research Institute , Overland Park, KS , USA.
authors.forename: Srinivas
authors.initials: S
authors.lastname: Nalamachu
authors.forename: Joseph V
authors.initials: JV
authors.lastname: Pergolizzi
authors.forename: Robert B
authors.initials: RB
authors.lastname: Raffa
authors.forename: Dhanunjaya R
authors.initials: DR
authors.lastname: Lakkireddy
authors.forename: Robert
authors.initials: R
authors.lastname: Taylor
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects*; D002319:Cardiovascular System / Q000187:drug effects*; D004347:Drug Interactions; D041981:Gastrointestinal Tract / Q000187:drug effects*; D006801:Humans
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin
keywords: aspirin; cardioprotection; drug–drug interaction; non-steroidal anti-inflammatory drugs