Gastrointestinal bleeding associated with chronic excessive use overdosing with topical ketoprofen patch in elderly patient

Abstract

Extensive care should be taken to avoid ulcerative intestinal hemorrhage to elderly patients receiving multiple doses of non-steroidal anti-inflammatory drug patch for multiple days.

Safety of Oral and Topical Nonsteroidal Anti-Inflammatory Drugs

“…A patient case report from Japan found an association with excessive GI bleeding from ulcerative lesions in an elderly patient chronically using multiple ketoprofen patches at once (Hirose et al, 2018). The report led to the conclusion of caution of topical NSAID patches overutilization in elderly patients due to associated incidence of GI bleeding (Hirose et al, 2018). While ketoprofen patches are not used in the United States, it is an important consideration to note, monitor, and counsel.…”

Riscos Associados ao Uso Não Racional de Anti-Inflamatórios Não Esteroides

“…Os anti-inflamatórios não esteroides (AINEs) constituem uma classe de medicamentos muito utilizada para o alívio de dores musculoesqueléticas, cefaleia, controle da febre, dismenorreia, em pós-operatório ou pós-parto e como profilaxia cardiovascular, no caso do ácido acetilsalicílico (DOGAN et al, 2019). Essa ampla variedade de indicações e sua venda livre, podem resultar em um uso irracional e exacerbado desses fármcos, podendo causar intoxicações graves (HIROSE et al, 2018). Segundo relatórios dos Centros de Controle de Intoxicações dos Estados Unidos, em 2007, foram relatados 79.000 casos de ingestão abusiva de ibuprofeno no país.…”

Refractory gastric ulcer due to undisclosed use of topical diclofenac epolamine patches

“…T OPICAL FORMS OF nonsteroidal anti-inflammatory drug (NSAIDs) have been developed to lessen systemic adverse effects associated with oral NSAIDs, such as gastrointestinal injury and renal toxicity and currently are commonly to relieve pain from localized musculoskeletal ailments such as epicondylitis, ankle sprains, and knee osteoarthritis. 1 In general, they are believed to be well tolerated and appropriate for use as an over-the-counter (OTC) drug without a medical prescription or supervision of healthcare professionals. 2 We report a case of recurrent peptic ulcer bleeding caused by chronic excessive use of topical diclofenac epolamine patches in an elderly female patient.…”