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Alendronate and Naproxen Are Synergistic for Development of Gastric Ulcers
David Y. Graham, MD;
Hoda M. Malaty, MD, PhD
Arch Intern Med. 2001;161:107-110.
Background Both alendronate sodium use and nonsteroidal anti-inflammatory drug
use are associated with gastric ulcers. The aim of this study was to investigate
whether alendronate and naproxen are synergistic as causes of gastric ulcers.
Methods We performed an endoscopist-blind, randomized, crossover, single-center
comparison of 10 mg/d of alendronate sodium, 500 mg of naproxen sodium twice
daily, or the combination taken orally for 10 days in volunteers aged 30 years
or older. Videoendoscopy was used to evaluate the presence and degree of mucosal
damage to the esophagus, stomach, or duodenal bulb before and after each treatment.
There was a 1- to 4-week washout between evaluations.
Results Twenty-six healthy volunteers participated (18 women and 8 men), aged
30 to 50 years. Gastric ulcers were present in 2 subjects receiving alendronate
(8%), in 3 receiving naproxen (12%), and in 10 receiving both (38%) (P<.05 for the combination vs either drug alone).
Conclusions Both alendronate and naproxen can cause gastric ulcers. The combination
appears synergistic. Alendronate should be used with caution in those who
simultaneously require nonsteroidal anti-inflammatory drugs.
From the Department of Medicine, Veterans Affairs Medical Center and
Baylor College of Medicine, Houston, Tex.
Corresponding author and reprints: David Y. Graham, MD, Veterans
Affairs Medical Center (111D), 2002 Holcombe Blvd, Houston, TX 77030.
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ABSTRACT
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Alendronate and Naproxen Together Increase Risk for Gastric Ulcers
JWatch Women's Health 2001;2001:5-5.
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