Box 1.

Risk factors for non-steroidal antiinflammatory drug gastrointestinal complications

Age ≥65 years.
History of peptic ulcer (complicateda>uncomplicated).
Concomitant therapy with antiplatelet agent, anticoagulants, corticosteroids and SSRIs.
Severe illness.
Helicobacter pylori infection.
Class of NSAID:

  • ns-NSAID > COX-2 inhibitor

  • naproxen>indomethacin>diclofenac>ibuprofen>rofecoxibb >celecoxib.

High dose of NSAIDs.
Chronic use of NSAIDs.

  • ↵a = complicated (bleeding or perforated) peptic ulcer disease are at highest risk of rebleeding;

  • ↵b = withdrawn from market; COX = cyclo-oxygenase; ns = non-selective; NSAID = non-steroidal anti-inflammatory drug; SSRIs = selective serotonin reuptake inhibitors.