Hisham Alshadfan1, 2,
Qais Jarrar3,
Mohd Sofian Omar Fauzee4,
Zainul Amiruddin Zakaria5,
Yong Yoke Keong6,
Muhammad Nazrul Hakim7-9 
For correspondence:- Muhammad Hakim Email: nazrulh@upm.edu.my
Received: 19 March 2025 Accepted: 14 June 2025 Published: 03 July 2025
Citation: Alshadfan H, Jarrar Q, Fauzee MO, Zakaria ZA, Keong YY, Hakim MN. Non-steroidal anti-inflammatory drug-induced gastric ulcers: A review on some current issues. Trop J Pharm Res 2025; 24(6):839-846 doi: https://dx.doi.org/10.4314/tjpr.v24i6.11
© 2025 The authors.
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Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for their analgesic, antipyretic, and
anti-inflammatory effects, but with associated risks. A comprehensive literature search was conducted
to identify mechanisms of NSAID-induced gastric ulcers, risk factors and conditions that exacerbate
NSAID-induced gastric ulcers, local and systemic risks and management. Key risk factors, such as age,
Helicobacter pylori infection, high-dose usage, and co-morbidities, exacerbate the risk of NSAIDinduced
ulcers and highlight the need for careful prescription practices. Effective preventive strategies
using drugs such as proton pump inhibitors (PPIs), misoprostol, and selective COX-2 inhibitors, reduce
ulcer risk with potential side effects. This review identifies several limitations in the current study,
including methodological variability, underrepresentation of high-risk populations, and limited data on
long-term effects. Future studies should focus on long-term investigations, genetic risk stratification, and
alternative pain management approaches to mitigate the adverse effects of NSAIDs while preserving
therapeutic benefits. A multi-disciplinary approach, incorporating pharmacologic and non-pharmacologic
strategies, is essential to improving patient outcomes and minimizing NSAID-induced gastric ulcers.
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