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Analgesics for Osteoarthritis—An Update

Slide: 22 of 32

Effects of Adding an H-2 Antagonist, Misoprostol, or a PPI on GI Adverse Effects Associated With NSAIDs (1 of 3)

Coprescribing H-2 antagonists, misoprostol, or PPIs all reduced the risk of endoscopically detected gastric and duodenal ulcers when compared with placebo in patients prescribed a nonselective NSAID.
Strength of evidence: High

Misoprostol was the only gastroprotective agent to reduce the risk of serious ulcer complications (perforation, obstruction, or bleeding) when compared with placebo in patients with average risk of GI bleeding who were prescribed nonselective NSAIDs. However, misoprostol was also associated with a high rate of withdrawal from studies because of other GI adverse effects (nausea, diarrhea, and abdominal pain).
Strength of evidence: High