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Aspirin and NSAIDs -- When 2 "Rights" Make a "Wrong"
A high percentage of individuals who receive a traditional NSAID or coxib for chronic pain also require cardioprotective doses of aspirin. For example, a telephone survey of Express Scripts members in the Northeastern United States who were receiving COX-2 agents through mail order found that approximately 50% reported taking aspirin for its cardioprotective effects.[17] A similar 2004 survey that queried only coxib users found similar high rates of aspirin use.[18] Although it is relatively well documented that the use of multiple traditional NSAIDs increases the risk for GI complications,[19] the GI risk of aspirin in combination with either a traditional NSAID or a coxib is less well recognized as a risk factor by clinicians. Moreover, because coxibs were heralded as having an improved safety profile owing to fewer toxic GI effects compared with traditional NSAIDs, the potential loss of this protection in the setting of the......

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Approximate Word Count: 336
Approximate Pages: 2 (250 words per double-spaced page)

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