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Might Proton Pump Inhibitors Prevent the Antiplatelet Effects of Low- or Very Low-Dose Aspirin?
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I read with interest the article on ulcer prevention in long-term users
of nonsteroidal anti-inflammatory drugs (NSAIDs) by Graham et al.1 As the authors note, studies are needed to test
whether a proton pump inhibitor can prevent life-threatening ulcer complications
in long-term users of NSAIDs. They state that the ideal study should compare
a proton pump inhibitor with or without low-dose misoprostol vs placebo, although
such studies are unlikely to be realized if the cyclooxygenase 2 inhibitors
prove to eliminate life-threatening NSAID ulcer complications. In this respect,
further studies might be of interest. Aspirin and several other NSAIDs are
weak acids that cross the mucosa in their lipid state. The suppression of
acid production reduces the lipophilic nature of these drugs and, theoretically,
might reduce their absorption and bioavailability. I wonder if there is need
for concern that concurrent administration of a proton pump inhibitor with
low- or very low-dose . . . [Full Text of this Article]
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