when a patient on a chronic NSAID should also get a PPI, misoprostol, or an H2-blocker

Questions often come up about when a patient on a chronic NSAID should also get a PPI, misoprostol, or an H2-blocker.

PPIs or misoprostol are more effective than H2-blockers for preventing NSAID-induced ulcers...AND they're proven to prevent GI bleeds.

But PPIs aren't benign. Chronic PPIs are associated with a higher risk of pneumonia, C. diff diarrhea, hypomagnesemia, and fractures.

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