SoylentNews is people
SoylentNews
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
(Score: 4, Interesting) by NotSanguine on Tuesday February 11 2020, @09:29PM (4 children)
Personally, I take ibuprofen when I'm in need of an analgesic/NSAID. It works really well -- for me. That said, I have the metaphorical cast iron stomach.
Then again, I don't (at least not in a long time -- my herniated lumbar discs have been asymptomatic for many years) take ibuprofen unless there's pain/inflammation, but when I was having issues with sciatica, I took 2400mg daily for several years without any GI issues.
What's more, Naproxen and Acetominophen have zero effect on me and, as such, are worse than useless -- for me.
Some folks do have serious gastrointestinal issues with ibuprofen and/or other NSAIDS.
I don't have experience with Voltaren or any COXIBs, so I can't comment on those.
As I understand it, some people find that NSAIDs other than ibuprofen, COXIBs and/or acetominophen to be very effective.
I don't think it's complicated to choose an analgesic at all. Just try them all, see what works best and has the fewest/no side effects, and stick with that.
No, no, you're not thinking; you're just being logical. --Niels Bohr
(Score: 2) by Hartree on Wednesday February 12 2020, @01:02AM (3 children)
Yep. Different ones work differently in different people.
Aspirin works best for me in terms of both agreeing with my stomach, killing pain and damping down inflammation.
Ibuprofen tears up my stomach. Acetaminophen doesn't work nearly as well as aspirin.
(Score: 2) by takyon on Wednesday February 12 2020, @01:40AM (2 children)
Ibuprofen is putting in the work. Aspirin is also good but 1,300 mg makes me feel weird.
Acetaminophen? Get it outta here.
[SIG] 10/28/2017: Soylent Upgrade v14 [soylentnews.org]
(Score: 0) by Anonymous Coward on Wednesday February 12 2020, @03:39AM (1 child)
I've ended up feeling weird from aspirin (dizzy, ringing in the ears, a sense of being spacey) but only during a rare severe eye splitting migraine and only after taking about 3000 mg -- but in the middle of a migraine, it's easy to do stupid stuff. I checked wikipedia though, and I'd have to take about 12,300 mg to hit a mildly toxic level, and 25,000 or so for life threatening toxicity, so I'll probably do the same thing again next time I get migraine. https://en.wikipedia.org/wiki/Salicylate_poisoning [wikipedia.org]
(Score: 0) by Anonymous Coward on Wednesday February 12 2020, @11:11PM
First, DON'T TRUST WIKIPEDIA as your source for something like this. (oopsie! someone misplaced a decmial point! oh well!)
Second, tinnitus (ringing in ears) is a symptom and your 'spaceyness' may be coming from hyperventilating which is also an early sign of aspirin poisoning, and confusion is a later sign. Don't pay attention to the numbers, pay attention to your symptoms. You likely did indeed poison yourself.
Third, what you interpreted as a migraine.... Could it have been a headache from increased intracranial pressure (a throbbing that won't go away)? If you had increased ICP it could be that your aspirin levels up in your head were higher than the rest of your body from localized vasoconstriction. I'm not saying it was, just thinking that's anatomically plausible. And again, you could have gotten salicylate poisoning from a lower dosage, especially if you had anything going on with your kidneys at the time. The maximum safe dosage level for a *healthy* adult is 4,000 mg/day, and normal max dosing is 1,200 mg per every six hours.
But I'm not your Doctor. The point here is before you exceed any dosage recommendations on an OTC package you should get the advice of a medical professional.
It's your life.