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Ann Longterm Care. 2010;18(9):24-27.

Recognizing the Risks of Chronic Nonsteroidal Anti-Inflammatory Drug Use in Older Adults.

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Drs. Marcum and Hanlon are in the Division of Geriatric Medicine, Department of Medicine, School of Medicine, University of Pittsburgh, PA; and Dr. Hanlon is also at the Geriatric Research Education and Clinical Center (GRECC), and the Center for Health Equity Research and Promotion (CHERP), Veterans Affairs Pittsburgh Healthcare System (VAPHS).


Older adults commonly take nonsteroidal anti-inflammatory drugs (NSAIDs) chronically. Studies of older adults show that chronic NSAID use increases the risk of peptic ulcer disease, acute renal failure, and stroke/myocardial infarction. Moreover, chronic NSAID use can exacerbate a number of chronic diseases including heart failure and hypertension, and can interact with a number of drugs (eg, warfarin, corticosteroids). Preferred analgesics in older adults that may have a lower risk of these adverse drug reactions include acetaminophen, a nonacetylated salicylate (eg, salsalate), a short half-life NSAID (eg, ibuprofen), or low-dose opioid/opioid-like agents in combination with acetaminophen (in appropriate patients).

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