Stomach Protection for Patients Taking Anti-platelet and Non Steroidal Antinflamtory Drugs (NSAIDS)
What Are Anti-Platelets
Anti-platelet medications include Aspirin, Clopidogrel, Ticagrelor, Prasugrel and Dipyridamole. They are sometimes referred to as ‘blood thinners’. They are usually prescribed for patients who have a medical history of
- Ischaemic Heart Disease (angina or heart attack),
- Stroke or TIA (mini stroke),
- Arterial circulation problems.
They reduce the risk of these conditions worsening / reoccurring.
What are Non Steroidal Antinflamtory Drugs (NSAIDS)?
NSAIDs include Ibuprofen, Naproxen, Diclofenac, Celecoxib, and Meloxicam. They are usually used as pain killers. Its usually recommended to use them on a short term basis, however some patients may use them regularly and long term if they have a chronic condition such as rheumatoid arthritis.
Why Do I need to worry about my stomach?
These types of medication can increase stomach acid. This can cause symptoms including upper abdominal pain and heartburn, which are unpleasant.
More seriously, they can also cause irritation to the lining of your stomach. This can lead to stomach ulcers or bleeding from the stomach which can potentially be very serious, even life threatening.
The risks of taking these medications increases as we get older. The risk is also increased if someone has had stomach ulcers in the past, takes both type of medicaiton, or other medications that also increase stomach acid.
Patients aged 65 and over who take a regular NSAID, or 75 and over and taking a regular Anti-platelet are at higher risk.
What do I need to do?
Patients taking an anti-platelet should continue to do so, as there is usually a very important reason that you are taking it, such as heart disease or previous stroke. DO NOT STOP taking it. If you are unsure why you are prescribed it, please check with the surgery.
It may be safe for patients who are taking regular NSAIDs to stop, or reduce how much they are taking. However you may wish to continue taking them if you need them to manage pain. Please discuss this with a GP if you would like to review your options.
Prescribing guidelines recommend that people at higher risk of developing stomach acid problems should be prescribed a daily stomach protecting medication, known as a ‘PPI’.
What is a PPI?
PPI stands for Protein Pump Inhibitor. Examples of PPIs include Lansoprazole and Omeprazole. They reduce the amount of acid that is produced in the stomach. This reduces the risk of developing a stomach acid related problem for people who take regular Antiplatelet medication or NSAID.
Like all medications, PPIs can have risks and possible side effects. They should only be used long term if there is a clear reason to do so.
They are very widely prescribed, and generally considered to be safe. For patients who are at increased risk of stomach acid problems, the benefits of taking a PPI usually significantly outweigh the potential risks to taking them.
