SOURCES: Byron Cryer, MD, spokesman, American Gastroenterological Association; associate professor of medicine, University of Texas Southwestern Medical Center, Dallas. Nieca Goldberg, MD, spokeswoman for the American Heart Association; chief of women's cardiac care, Lennox Hill Hospital, New York; author, Women Are Not Small Men: Lifesaving Strategies For Preventing And Healing Heart Disease In Women . John Klippel, MD, president and CEO, Arthritis Foundation, Atlanta. Scott Zashin, clinical assistant professor, University of Texas Southwestern Medical Center; author of Arthritis Without Pain . American College of Rheumatology web site. Arthritis Foundation web site. American Heart Association web site. American College of Gastroenterology web site. American Gastroenterological Association web site. American Academy of Family Physicians web site. American Academy of Allergy, Asthma, and Immunology web site.
The new concerns prompted the FDA in 2005 to require new warnings on all NSAIDs (except aspirin), stating the risk of stomach, heart, or skin problems. Ulcers and gastrointestinal bleeding linked to the use of NSAIDs are responsible for an estimated 15,000 to 20,000 deaths in the . each year, and more than 100,000 hospitalizations, according to the American College of Gastroenterology. In February 2007 the American Heart Association advised physicians that, except for aspirin, NSAIDs and especially COX-2 inhibitors should be used only as a last line of treatment for people with heart disease or heart disease risk factors.
In the past several years, some newer medications have come on the market; these are commonly referred to as COX-2 inhibitors . Remember, all NSAIDs work against cyclooxygenase (COX). Traditional NSAIDs (. Ibuprofen, Motrin, Aleve) work against both COX-1 and COX-2. COX-1 and COX-2 are both types of cyclooxygenase enzymes that function in your body. The new medications (. Celebrex) work primarily against COX-2, and allow COX-1 to function normally. Because COX-1 is more important in producing the protective lining in your gut (gastric mucosa), these newer NSAIDs are believed to have less of a risk of causing stomach ulcers.