Small risk of gastric bleeding with SSRI antidepressants
Any risk of gastrointestinal bleeding in patients taking selective serotonin reuptake inhibitors is small, according to this month's Drug and Therapeutics Bulletin (2004:42;17).
However, these drugs should be avoided, or used with caution, in patients
aged over 80 years, those with prior upper gastrointestinal bleeding,
and in those taking aspirin or another non-steroidal anti-inflammatory
drug. The DTB estimates that the absolute risk is equivalent
to about three extra episodes of upper gastrointestinal bleeding requiring
admission
to hospital per 1,000 patient years of treatment. This represents a similar
risk to that experienced by users of aspirin or other NSAIDs.
Use of epoetin Current
evidence best supports the use of epoetin alfa, epoetin beta and
darbepoetin alfa in patients with solid or non-myeloid tumour receiving
chemotherapy and with a haemoglobin at or below 10g/dl, says the DTB (ibid,
p21). It adds that rigorous studies are needed to define further
the role of these agents.
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The
Pharmaceutical Journal