> -----Original Message-----
> From: Jeff Green [mailto:[log in to unmask]]
> Sent: 22 January 2007 16:06
> To: [log in to unmask]
> Subject: Re: Interactions
>
> Adrian Midgley wrote:
> > Jeff Green wrote:
> >
> >> Since we've gone technical, I'm seeing lots of NSAIDs being prescribed
> >> with SSRIs.
> >> The BNF and my labelling systems don't like this.
> >> I thought that they'd be a better response by bringing it to your
> >> collective attention than by phoning individual GP's on 0844 numbers
> ;-)
> >>
> >> Jeff
> >>
> > How large and how bad an effect is involved, and is it better to leave
> > the depression or the pain untreated?
> >
> Extra risk of gastric bleed - paracetamol trial or PPI cover perhaps?
>
> Jeff
The real question is how big a risk is this. To avoid NSAID seems
excessive, as does routine use of PPI to cover. Our job is to manage and
tolerate / minimize risks.
Of interest had someone on Friday circa 35yrs old, with broken foot, who was
on Cipramil. She self medicated with Panadol Extra IIRC, which contains
aspirin. Admitted with malaena and epigastric pain as a result.
It happens but so do a lot of things...
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