Table 2 Clinicians' guide to anti-inflammatory therapy (reproduced from reference [15], with permission)
From: OTC analgesics and drug interactions: clinical implications
| No or low NSAID gastrointestinal risk | NSAID gastrointestinal risk | |
|---|---|---|
| No cardiovascular risk (without aspirin) | Nonselective NSAID (cost consideration) | COX-2 selective inhibitor or nonselective NSAID and proton-pump inhibitor |
| COX-2 selective inhibitor and proton-pump inhibitor for those with prior GI bleeding | ||
| Cardiovascular risk (with aspirin) | Naproxena | Proton-pump inhibitor irrespective of NSAID |
| Addition of proton-pump inhibitor if gastrointestinal risk of aspirin/NSAID combination warrants gastroprotection | Naproxen if CV risk outweighs GI risk | |
| COX-2 selective inhibitor and proton-pump inhibitor for those with previous GI bleeding |