Gastrointestinal bleeding is a common and sometimes life-threatening event in older people. There is often a drug-induced cause. Drugs that can lead to gastrointestinal bleeding include non-steroidal anti-inflammatory drugs (NSAIDs) like diclofenac and ibuprofen, platelet inhibitors such as acetylsalicylic acid (ASS), clopidogrel and prasugrel, as well as anticoagulants like vitamin-K antagonists, heparin or direct oral anticoagulants (DOAKs). Combination antiplatelet therapy or combined medication with platelet inhibitor and anticoagulants increase the risk of gastrointestinal bleeding compared to monotherapy. Primary and secondary prevention options include Helicobacter pylori eradication and co-medication with a proton pump inhibitor (PPI).
Keywords: Anti-inflammatory agents, non-steroidal; Anticoagulants; Gastrointestinal hemorrhage, primary prevention; Gastrointestinal hemorrhage, secondary prevention; Platelet aggregation inhibitors.