To the Editor.—
It has been repeatedly demonstrated that antirheumatic doses of aspirin, especially when given unbuffered and without food, result in the daily loss of 3 to 5 ml of blood into the gastrointestinal tract. The phenylalkanoic acids appear to be less culpable with regard to minor daily blood loss, as redemonstrated by Loebl et al (237:976,1977). It is less clear whether major gastrointestinal bleeding, which occurs in one in 6,700 heavy aspirin users annually, is any less common with the phenylalkanoic acids.1The Medical Letter on Drugs and Therapy recently reviewed reported bleeding and fatal hemorrhage in patients receiving phenylalkanoic acids.2Loebl concludes that "nonsteroidal, anti-inflammatory drugs have relatively similar degrees of efficacy," citing a recent review.3The Mills3 article does not mention fenoprofen calcium or other phenylalkanoic acids specifically but does state that "none [of the nonsteroidal drugs] has any advantage over salicylate
Hanauer LB. Gastrointestinal Blood Loss. JAMA. 1977;238(9):937. doi:10.1001/jama.1977.03280100021006
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