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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

NSAID Cardiovascular Safety Review

The MHRA have conducted a full review of the cardiovascular safety of NSAIDs and concluded that the availbale data does not support a change to current practice.

The current advice can be found in the full review. In summary:

  • Use Paracetamol based analgesia as first line where ever possible
  • prescribing of NSAIDs should be based on overall safety profiles (including cardiovascular and gastrointestinal safety) as set out in product information, and risk factors for individual patients
  • all patients should take lowest effective dose of NSAIDs or COX-2 inhibitors for the shortest time necessary to control symptoms

Particular to COX-2 Inhibitors:

  • patients with established ischaemic heart disease (IHD), cerebrovascular disease should not take coxibs: celecoxib (Celebrex), etoricoxib (Arcoxia), and parecoxib (Dynastat)
  • for patients with risk factors for cardiovascular events, individual risk assessment is appropriate before a selective COX-2 inhibitor is prescribed

Action: Ensure that you are using Paracetamol based analgesia as first line and that appropriate risk assessments are carried out on patients prescribed NSAIDs.

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2 Comments to “NSAID Cardiovascular Safety Review”

  1. […] MHRA advice regarding the safety of NSAIDs has already been summarised on this […]

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  2. […] Prescribers should continue to follow the MHRA Advice when considering prescribing any […]

    Pingback by First Vioxx Case Complete | Prescribing Advice for GPs — August 22, 2005 #

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