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posted by janrinok on Tuesday February 11 2020, @08:15PM   Printer-friendly
from the its-a-pain dept.

Choosing common pain relievers: It's complicated: Researchers examine benefits and risks of nonsteroidal anti-inflammatory drugs:

To provide guidance to health care providers and their patients in their clinical decision-making, researchers from Florida Atlantic University's Schmidt College of Medicine have published a review in the Journal of Cardiovascular Pharmacology and Therapeutics addressing cardiovascular risks and beyond, which include gastrointestinal and kidney side effects of pain relievers. They examined the benefits and risks of over-the-counter and prescription drugs for pain relief such as aspirin, ibuprofen (Motrin or Advil), naproxen (Aleve), and prescription drugs such as diclofenac (Voltaren), a non-aspirin NSAID [Non-Steroidal Anti-Inflammatory Drugs], and selective cyclooxygenase-2 inhibitors such as celecoxib (Celebrex) as well as acetaminophen (Tylenol).

NSAIDs include aspirin, traditional non-aspirin NSAIDs such as ibuprofen, (Motrin or Advil), naproxen, (Aleve) and diclofenac, (Voltaren) as well as selective cyclooxygenase 2 inhibitors (COXIBs), such as celecoxib (Celebrex), and acetaminophen (Tylenol).

All of these drugs have benefits and risks. Aspirin decreases inflammation as well as coronary events and stroke, but increases gastrointestinal symptoms and bleeding, however, without adverse hepatic or renal consequences. Non-aspirin NSAIDs decrease inflammation, but have been associated with adverse major coronary events and stroke with long-term use as well as major upper gastrointestinal and kidney side effects, as well as electrolyte imbalances such as high sodium or potassium and even heart failure.

Cyclooxygenase 2 (COX2) inhibitors were developed primarily because of their more favorable gastrointestinal side effect profile relative to aspirin and traditional non-aspirin NSAIDs, but confer adverse cardiovascular as well as hepatic and renal effects. Acetaminophen has no clinically relevant anti-inflammatory properties and accounts for more than 50 percent of drug overdose related liver failure and about 20 percent of liver transplant cases, as well as kidney disease.

[...] "The factors in the decision of whether and, if so, which drug to prescribe for relief of pain and inflammation, should not be limited to risks of cardiovascular or gastrointestinal side effects. These considerations should also include potential benefits including improvements in overall quality of life resulting from decrease in pain or impairment from musculoskeletal pain syndromes," said Charles H. Hennekens, M.D., Dr.P.H., corresponding author, first Sir Richard Doll Professor and senior academic advisor in FAU's Schmidt College of Medicine.

Journal Reference:

Manas A. Rane, Alexander Gitin, Benjamin Fiedler, Lawrence Fiedler, Charles H. Hennekens. Risks of Cardiovascular Disease and Beyond in Prescription of Nonsteroidal Anti-Inflammatory Drugs$. Journal of Cardiovascular Pharmacology and Therapeutics, 2019; 25 (1): 3 DOI: 10.1177/1074248419871902


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  • (Score: 2) by stretch611 on Tuesday February 11 2020, @09:01PM (1 child)

    by stretch611 (6199) on Tuesday February 11 2020, @09:01PM (#956964)

    I had Voltaren prescribed to me roughly 20 years ago.

    The whole time I was on it, I was also on the toilet because of it. (I actually changed Drs due to it, because my Dr thought i should just get Milk of magnesia instead of switching me to something my stomach would tolerate.)

    Voltaren is the only drug that made me react that way in such a constant fashion. I have been on all the others without problems, both prescription and non-prescription of various strengths, (including COX-2 inhibitors which I did not think were still available due to the heart issues,) and never had the issues with any of the others.

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  • (Score: 2) by c0lo on Tuesday February 11 2020, @11:18PM

    by c0lo (156) Subscriber Badge on Tuesday February 11 2020, @11:18PM (#957008) Journal

    I had Voltaren prescribed to me roughly 20 years ago.

    Don't feed it to buzzards [wikipedia.org], or else S/N may suffer...

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