Non-Steroidal Anti-Inflammatory Drug (NSAID) Associated Ulcers and Dyspepsia

NHSL Medicines Guidance
NHS Lanarkshire

Proton Pump Inhibitors (PPIs)

Preferred list (P)

LANSOPRAZOLE capsules / orodispersible tablets

  • Restriction: Orodispersible tablets should be reserved for patients with swallowing difficulties or who require a proton pump inhibitor via nasogastric (NG) or percutaneous endoscopic gastrostomy (PEG) tube.

 

Total list (T)

OMEPRAZOLE capsules

Prescribing Notes:

  • If NSAID induced gastro-intestinal bleeding or ulceration occurs, the NSAID should ideally be stopped and omeprazole or lansoprazole prescribed.

  • In patients at high risk of ulcer complications requiring management with an anti-inflammatory agent, maintenance treatment with a PPI or misoprostol will be required.

NHSL Joint Adult Formulary Key

To indicate the category of a formulary medicine, updated sections adopt the following key:

Preferred list (P): First-line formulary choices.

 

Total list (T): Alternative choices when preferred list options not effective/not tolerated, or not indicated.

 

Specialist initiation (S1): Specialist initiation, or on the advice of a Consultant or Specialist Practitioner in this therapeutic area. Continuation in primary care is acceptable.

 

Specialist use only (S2): Supply via hospital, Homecare Service or a hospital based prescription (HBP) for dispensing by community pharmacy. Not prescribed in primary care setting.

Editorial Information

Last reviewed: 31/01/2022

Next review date: 31/01/2025

Author(s): NHSL.

Version: Please refer to the introduction section for an explanation of the review dates above.

Approved By: ADTC

Reviewer name(s): ADTC.