Non-steroidal anti-inflammatory drugs: use and co-treatment with potentially interacting medications in the elderly

Abstract

Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used in the elderly. NSAIDs may cause a series of adverse drug reactions, of which gastrointestinal, renovascular/cardiovascular and bleeding complications are of particular concern. Concomitant use of several other drugs may further increase the risk of these adverse effects.

Objective: To examine the extent of chronic use of NSAIDs and co-prescription of drugs which may seriously interact with NSAIDs in elderly subjects, by using data from the Norwegian Prescription Database.

Results: A total of 7.3% of all individuals (71,681/984,457) over 60 years of age filled at least one prescription for reimbursed NSAIDs during the 1-year study period (2006). Co-prescription of medications which may interact with NSAIDs was prevalent for drugs used for hypertension and/or heart failure (59.5%), antithrombotic drugs (35.1%), systemic glucocorticoids (12.9%) and SSRI antidepressants (8.3%). As many as 4.8 and 3.8% of NSAID users were co-prescribed warfarin or oral methotrexate respectively.

Conclusion: The frequent co-prescription of medications which may cause detrimental interactions in elderly chronic NSAID users adds to safety concerns regarding this widely prescribed class of drugs.