Warfarin and COX-2 Inhibitors Do Not Mix

Published Online: Tuesday, March 1, 2005

Patients taking warfarin and antiinflammatory drugs for arthritis have a higher risk of deadly stomach bleeding. The class of drugs known as COX-2 inhibitors also poses a danger, according to lead investigator Muhammad Mamdani, PharmD. Research has shown that ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) increase the possibility of upper gastrointestinal bleeding because they can irritate the stomach lining and also boost the chance of bleeding.

For the study, the researchers examined prescription and health care databases in Ontario, Canada. The study focused on patients over the age of 66 who were on warfarin during a yearlong study in 2000-2001. The results of the study showed that those admitted to hospitals for gastric bleeding were more likely to be taking NSAIDs or COX-2 inhibitors in addition to the blood thinner. Dr. Mamdani said approximately 1 in 10 patients with a serious stomach bleed die before having life-saving surgery. The analysis also suggested that "physicians seem to be a little more lax in prescribing the COX-2 inhibitors,"according to Dr. Mamdani. He noted that twice as many older individuals on warfarin are given a COX-2 inhibitor, compared with NSAIDs. (The findings were published in the Archives of Internal Medicine, January 24, 2005.)

Latest Articles
Donnie Calhoun, RPh, PD, National Community Pharmacists Association (NCPA) Foundation vice president, discusses how pharmacists can prepare themselves and their business before, during, and after a disaster.
Ken Whittemore Jr, Surescript's senior vice president of professional and regulatory affairs, talks about some new transactions available that can help pharmacists.
In case you got caught up in the Thanksgiving holiday rush, here are the top trending stories you may have missed in November:
Bryan Ziegler, PharmD, executive director of Kennedy Pharmacy Innovation Center, provides some resources for community pharmacists to use when implementing new collaborative services with primary care providers.
Latest Issues