Celecoxib; tolerability and gastrointestinal safety

J. Monés Xiol

Research output: Contribution to journalReview articleResearchpeer-review

Abstract

Gastrointestinal affectation by NSAID has three manifestations: dyspepsia, ulcers and haemorrhages. Coxib type NSAIDs that only inhibit COX-2 have a lower complication rate on a gastrointestinal level. The results of a review of the studies published to date lead to the conclusion that Celecoxib has a significantly less number of serious gastrointestinal complications (haemorrhage and perforation) than conventional NSAIDs, and in addition, it also has a lower frequency of non-serious complications such as dyspepsia and intestinal disorders. The question now being posed is: when should gastroprotection be considered? Current guidelines suggest defining those patients considered of risk age > 65 years, background of ulcer or serious gastrointestinal complications, treatments with steroids or anticoagulants, other associated serious diseases and prolonged treatments. The eradication of Helicobacter Pylori is currently considered a treatment of choice, irrespective of the use of any type of NSAID and proton pump inhibitor. Finally adopting the best option for a certain patient results in the use of Celecoxib over NSAID + PPI in patients with risk presenting: less lesions in the lower digestive tract; better compliance with the treatment; better tolerance; and under normal conditions it is not more expensive. The recommendations of the Spanish Agency of Gastroenterology and the Spanish Gastroenterology Society suggest: The use of Celecoxib is as safe as the combination of NSAID + PPI. The overall frequency of complications of the upper and lower digestive tract is favourable to Celecoxib. Patients under treatment with low doses of aspirin should receive associated treatment with PPI.
Original languageEnglish
Pages (from-to)45-52
JournalDOLOR
Volume20
Issue number1
Publication statusPublished - 1 Dec 2005

Keywords

  • Celecoxib
  • Gastrointestinal tolerance

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