The Pharmaceutical Journal
Vol 279 No 7481 p641
8 December 2007

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NPC calls for review of NSAID prescribing

Prescribers need to be vigilant when considering the use of some traditional anti-inflammatory painkillers, such as diclofenac, for patients at risk of cardiovascular events, the National Prescribing Centre warns in the latest MeReC Extra bulletin.

The bulletin points out that diclofenac, when used at a daily dose of 150mg, appears to be associated with a similar excess risk to that of cyco-oxygenase-2 inhibitors. Low-dose ibuprofen (1,200mg daily) and naproxen (1,000mg daily) appear to have a lower risk.

Neal Maskrey, director of evidence-based therapeutics at the NPC, said: “Risks to individual patients from the cardiovascular or gastrointestinal complications from non-steroidal anti-inflammatory drugs are low. The need to review current prescribing only becomes important because these medicines are so widely prescribed.”

He added that research indicates that use of fewer NSAIDs overall, where possible, or a greater proportion of NSAID prescribing being ibuprofen or naproxen would be prudent.

The bulletin points out that, in England, diclofenac accounts for 46 per cent of all NSAID prescribing.