Have a patient with GERD or a history of peptic/gastric ulcers and is in need of moderate to long term analgesia or inflammation reduction and you are wary of prescribing them NSAIDs or corticosteroids?

A great way to mitigate the GI risk/GI side effects of NSAIDs is to put the patient on acid suppression therapy along with the NSAID or corticosteroid.

A reasonable protocol is to have the patient start either of the following while on the long term NSAID or corticosteroid:  famotidine 20mg twice daily or omeprazole 20mg daily.

This will decrease the GI complaints that come along with NSAID use and can even prevent an ulcer. I have had dozens of patients tolerate the NSAID/steroid therapy while being on prophylactic acid suppression.