Recent years have seen an increasing awareness of the risks associated with NSAIDS (non-steroidal anti-inflammatory drugs) which include a variety of medications from over the counter Ibuprofen (e.g. Advil®) and Naproxen (Aleve®) to the commonly prescribed Meloxicam (Mobic®) and Diclofenac (e.g. Arthrotec®).
These medications have been prescribed for years, and most of us take them without any problem. Last year, however, the FDA strengthened its warning about the risk of heart attack and stroke with NSAID use. Although Aspirin is an NSAID, it is does not increase one’s risk of heart attack or thrombotic stroke and is not covered by the latest warning.
What many are surprised to learn is that the risk of having a gastrointestinal or GI bleed may be as high as 2-4% with routine use of NSAIDS for prolonged periods of time. Kidney disease is also a potential consequence of NSAID use. Even without causing catastrophic complications, NSAIDs can interfere how well antihypertensives (medications that treat high blood pressure) work.
Certainly NSAIDS have a role in the treatment of inflammatory pain, but patients must be educated on the risks involved in taking them. This would include providing them with signs and symptoms of a GI bleed for example.
- Patients (especially those with risk factors or history of heart disease, stroke, kidney problems, etc.) should talk with their physician before starting an NSAID, even one available over the counter.
- Tylenol may be a safer analgesic (pain reliever) for patients who cannot take NSAIDs
- Aspirin is cardio-protective. It inhibits platelet function, therefore offering some protection from heart attack. It remains the best thing for patients having cardiac chest pain to take as they are headed to the ER.