Cookie policy: This site uses cookies (small files stored on your computer) to simplify and improve your experience of this website. Cookies are small text files stored on the device you are using to access this website. For more information please take a look at our terms and conditions. Some parts of the site may not work properly if you choose not to accept cookies.


Subscribe or Register

Existing user? Login


Combining NSAIDs with misoprostol may reduce risk of cardiovascular side effects

Patients taking non-steroidal anti-inflammatory drugs (NSAIDs) and misoprostol, a drug commonly used to prevent and treat stomach ulcers, have a lower risk of experiencing a serious cardiovascular event compared with patients taking NSAIDs alone, according to research due to be presented at the American College of Cardiology’s 66th Annual Scientific Session.

The study, to be presented as a poster on 17 March 2017, analysed the health records of more than 1.6 million people in the United States Veterans Affairs health system who took prescriptions of NSAIDs and/or misoprostol between 2005 and 2013.

By looking at their baseline health status, the researchers matched 1,827 individuals taking NSAIDs alone with 1,827 individuals taking NSAIDs and misoprostol. The health outcomes of the two groups were then compared over five years. The results showed that the group taking NSAIDs in combination with misoprostol had a 44% lower risk of having ventricular fibrillation, cardiac arrest or a heart attack than those taking NSAIDs alone (hazard ratio [HR] 0.56; 95% confidence interval [CI] 0.34-0.94). The group taking both pills also had a 25% lower risk of having a stroke (HR 0.75; 95% CI 0.60-0.95) and a 34% lower risk of acute kidney failure (HR 0.66; 95% CI 0.49-0.0.89), compared with the group taking just NSAIDs. All-cause mortality was not statistically different between the two groups (HR 1.05; 95% CI 0.87-1.25).

The findings suggest that combining NSAIDs with misoprostol either by prescribing them together or developing a combination pill could help reduce the risk of cardiovascular and renal side effects associated with NSAID use.

Mark Munger, professor of pharmacotherapy at the University of Utah College of Pharmacy and the study’s lead author, says: “The study results may apply to all patients who take NSAIDS, but more specifically to those who take them early in treatment, in higher doses, or for longer durations of treatment.”

Munger says that he hopes the study will help reduce the incidence of NSAID-induced cardiovascular and renal adverse effects “in an era in which pain management is in flux”.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2017.20202437

Have your say

For commenting, please login or register as a user and agree to our Community Guidelines. You will be re-directed back to this page where you will have the ability to comment.

Recommended from Pharmaceutical Press

RPS publications

Pharmaceutical Press is the publishing division of the Royal Pharmaceutical Society, and is a leading provider of authoritative pharmaceutical information used throughout the world.


Search an extensive range of the world’s most trusted resources

Powered by MedicinesComplete
  • Print
  • Share
  • Comment
  • Save
  • Print Friendly Version of this pagePrint Get a PDF version of this webpagePDF

Newsletter Sign-up

Want to keep up with the latest news, comment and CPD articles in pharmacy and science? Subscribe to our free alerts.