TUESDAY, Nov. 1 (HealthDay News) -- High doses of the nonsteroidal anti-inflammatory drug (NSAID) ibuprofen increase the risk of gastrointestinal bleeding 3.64 times compared with placebo, and can cause occasional episodes of heavier bleeding in some patients, according to a study in the November issue of Clinical Gastroenterology and Hepatology.
Richard H. Hunt, M.D., of the McMaster University Health Sciences Center in Ontario, Canada, and colleagues conducted a retrospective analysis of patients treated in two randomized clinical trials of ibuprofen. They measured fecal blood loss (FBL) in 68 subjects using radioactive analysis of chromium-51 labeled red cells in stool. Patients took 800 mg of ibuprofen three times a day for four weeks, or a placebo.
At baseline all subjects had an average FBL of 0.36 mL a day. During the course of the study, the ibuprofen group had a mean daily FBL of 2.55 mL a day, 3.64 times greater than the mean blood loss of the control group (0.7 mL per day). In all, 26 of 31 ibuprofen patients had one to seven microbleed episodes (more than 3 mL) and in nine cases there was a maximum FBL of more than 10 mL. Two subjects experienced blood loss of 73 mL and 66 mL.
"The clinical implication of episodic blood loss while taking a nonselective NSAID in an elderly population, or those taking high doses of ibuprofen, or those taking concomitant nonselective NSAIDs with low-dose aspirin, is clear. The potential for a serious GI complication should still be considered when ibuprofen is recommended for self-medication," the authors conclude.
Abstract
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