PMID: 9437376Jan 23, 1998Paper

Risk of hospitalization for upper gastrointestinal tract bleeding associated with ketorolac, other nonsteroidal anti-inflammatory drugs, calcium antagonists, and other antihypertensive drugs

Archives of Internal Medicine
L A García RodríguezL Agostinis

Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) cause substantial morbidity and mortality from upper gastrointestinal tract disease. Ketorolac tromethamine has been singled out as an NSAID with a distinct gastrotoxicity profile. Calcium channel blockers, a class of antihypertensive drugs, have also been found to increase the risk of gastrointestinal tract bleeding. We identified 1505 patients hospitalized because of upper gastrointestinal tract bleeding and/or perforation, and we randomly sampled 20,000 controls in the source population. The adjusted relative risk (RR) for upper gastrointestinal tract bleeding and/or perforation in NSAID users compared with nonusers was 4.4 (95% confidence interval [CI], 3.7-5.3). The risk increased with higher daily doses. Ketorolac presented the highest risk (RR, 24.7; 95% CI, 9.6-63.5) and piroxicam ranked second (RR, 9.5; 95% CI, 6.5-13.8). Ketorolac was 5 times more gastrotoxic than all other NSAIDs (RR, 5.5; 95% CI, 2.1-14.4). The excess risk with ketorolac was observed with both oral and intramuscular administration and was already present during the first week of therapy. Among the various antihypertensive drug classes, beta-blockers were associated with the lowest relative risk (RR, 1.0;...Continue Reading

Citations

Apr 16, 2002·Arthritis and Rheumatism·Miriam C J M SturkenboomSalvatore Mannino
Sep 19, 2008·Current Gastroenterology Reports·Anne Ballinger
May 24, 2000·Comprehensive Therapy·F L Lanza
Feb 15, 2001·The American Journal of Medicine·S Hernández-Díaz, L A García-Rodríguez
May 29, 2002·Urology·Stephen J FreedlandH Albin Gritsch
Feb 3, 1999·Lancet·C J Hawkey
Feb 27, 2003·Journal of Pain and Symptom Management·Loren Laine
Feb 7, 2001·Gastroenterology Clinics of North America·M S Cappell, J R Schein
Jan 26, 2002·Journal of Clinical Epidemiology·Sonia Hernández-Díaz, Luis Alberto García Rodríguez
Mar 17, 2004·Journal of Clinical Epidemiology·M GalleraniUNKNOWN Investigators of the GIFA Study (Gruppo Italiano di Farmacovigilanza nell'Anziano)
Oct 12, 2001·Journal of Physiology, Paris·K D Rainsford
Jul 2, 2002·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·S MercadanteA Casuccio
Aug 14, 2003·Best Practice & Research. Clinical Rheumatology·Ted R Mikuls
Sep 7, 2000·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·M KochL Capurso
Feb 6, 2002·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·A Lanas
Jun 18, 1999·British Journal of Pharmacology·F Giuliano, T D Warner
Dec 1, 1999·British Journal of Pharmacology·J A Mitchell, T D Warner
Dec 12, 2001·British Journal of Clinical Pharmacology·L A García RodríguezF J de Abajo
Sep 13, 2003·Kidney International·Haimanot WasseCatherine O Stehman-Breen
Aug 11, 2001·The New England Journal of Medicine·G A FitzGerald, C Patrono
Dec 2, 2005·The New England Journal of Medicine·Carlo PatronoColin Baigent
Mar 8, 2008·Journal of Endourology·C Charles WenStephen Y Nakada
Jul 5, 2003·BMJ : British Medical Journal·Giuseppe TraversaMauro Venegoni
Nov 1, 2003·BMJ : British Medical Journal·Alfonso CarvajalFrancisco de Abajo
Jul 4, 2001·The Journal of Clinical Investigation·C PatronoL A García Rodríguez
Dec 19, 2013·PloS One·Arianna GhirardiUNKNOWN BEST Investigators
Jan 22, 2003·Drugs & Aging·Imrich Blasko, Beatrix Grubeck-Loebenstein
Jun 9, 2004·Drugs & Aging·Christianne L Roumie, Marie R Griffin
Nov 10, 2012·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Jordi CastellsagueUNKNOWN Safety of Non-Steroidal Anti-Inflammatory Drugs (SOS) Project
Apr 26, 2007·Clinical Medicine & Research·C K S OngR A Seymour
Oct 13, 2011·World Journal of Gastroenterology : WJG·Phunchai CharatcharoenwitthayaSomchai Leelakusolvong
Jan 19, 2012·Oman Medical Journal·Abdulwahed Al-Saeed

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antihypertensive Agents: Mechanisms of Action

Antihypertensive drugs are used to treat hypertension (high blood pressure) which aims to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Discover the latest research on antihypertensive drugs and their mechanism of action here.