Don’t Overdo the Ibuprofenby Robert Gal o, MD
Non-steroidal anti-inflammatory drugs(NSAIDs), a class that includes naproxen (Aleve),ibuprofen (Motrin, Advil), celecoxib (Celebrex),and diclofenac (Voltaren) among others, arethe most commonly used medications amongactive adults. While many NSAIDs are availableover-the-counter, these medications are notcompletely benign, especially when takenbeyond recommended dosages.
NSAIDs work by limiting the body’s ability to produce prostaglandins, chemicals importantin the body’s ability to mount an inflammatoryresponse. While this characteristic makes NSAIDspopular in treatment of pain due to both acute injuries and chronic conditions, such as osteoarthritis, prostaglandins have important
roles in maintaining proper gastrointestinal, renal,
cardiovascular toxicity remains a major safety
and cardiovascular function. NSAID use has been
concern and caused the withdrawal of several
linked to increased risk of ulcers, kidney failure,
NSAIDs from the market. However, naproxen
and heart attacks and is responsible for nearly
and low-dose ibuprofen have been demonstrated
30 percent of all hospital admissions due
to have the least side-effects among NSAIDs.2
Despite these shortcomings, NSAIDs remain
Stomach upset is the most common side effect
effective pain relief for the treatment of arthritis
from NSAIDs and ranges in severity from mild
and many other common athletic ailments.
to severe. One study reported an eight percent
To limit potential complications, avoid exceeding
incidence of peptic ulcers,1 while another revealed
that those taking NSAIDs have a 1.3 percent
discussion with a physician if using an NSAID
consistently for longer than six weeks.
Kidney issues associated with an increased
use of NSAIDs often result from a decrease
1. Allison MC, Howatson AG, Torrance CJ. Gastrointestinal damage
of blood flow to the kidney caused by loss
associated with the use of nonsteroidal anti-inflammatory drugs.
of prostaglandins. This effect appears to be
N Engl J Med. 1992;327:751-754.
dose-dependent and more detrimental in those
2. McGettigan P, Henry D. Cardiovascular risk with non-steroidal
with underlying heart, liver, and kidney disease
anti-inflammatory drugs: systematic review of population-based
and in chronic NSAID users. In order to prevent
controlled observational studies. PLoS Med. 2011;8:e1001098.
irreversible kidney damage, routine blood work
3. Pirmohamed M, James S, Meakin S, et al. Adverse drug reactions
as a cause of admission to hospital: prospective analysis of 18,820
to monitor kidney function should be considered
patients. Br Med J. 2004;329:15-19.
4. Singh G, Rosen Ramey D. NSAID-induced gastrointestinal
NSAID use has recently also been linked to an
complications: the ARAMIS perspective. J Rheumatol Suppl.
increased risk of heart attacks. While the relative
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Don’t Overdo the Ibuprofenby Robert Gal o, MD
Non-steroidal anti-inflammatory drugs(NSAIDs), a class that includes naproxen (Aleve),ibuprofen (Motrin, Advil), celecoxib (Celebrex),and diclofenac (Voltaren) among others, arethe most commonly used medications amongactive adults. While many NSAIDs are availableover-the-counter, these medications are notcompletely benign, especially when takenbeyond recommended dosages.