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Best Practices for Using NSAIDs

Most people have taken one or more of drugs from the NSAID class at one time or another.
Maybe you're not familiar with the term NSAID, but I bet you know the names ibuprofen or naproxen, or the trade names: Motrin, Advil, Aleve.  The National Ambulatory Study,  conducted in recent years, revealed that 95% of those questioned over a period of 7 years had taken this type of drug.




My whole reason for writing this blog is to promote the "less is more" mentality when using medication for pain, and this class of drugs illustrates my point very nicely. So, without further ado, let me elaborate a little bit.

While we are greatly familiar with what a great tool these drugs are in the world of pain management, many do not know the risks/side effects that go along with them.  The first one that comes to mind is damage to the GI mucosa...leading to ulcer formation, or even worse, GI bleed.  The more regularly you take these drugs, the more likely you will be to have the problem.  There was a combination product available at one time that combined an NSAID drug with another drug that was supposed to protect the stomach. It was available by prescription, but as I recall, it never became very popular.  More recently, the COX-2 drugs (which are a subclass of the NSAID family) entered the market place.  They were introduced to the marketplace because they were safer for the stomach...but then.....

You might know the names Celebrex , Bextra and Vioxx.  At this time only Celebrex remains on the available list.  Bextra and Vioxx were removed from production some time ago. The issue here was an increased risk of heart attack and stroke.  This is another possible danger that is possible with all NSAIDs, but these two drugs showed a higher risk than the others.  There was also a problem with skin reactions. So, Bextra and Vioxx are no more.

Another concern when using NSAIDs has to do with kidney and liver function.  As people age, the distribution of drug in the body and how drug is eliminated changes.  Pair that with the possibility of dehydration or the use of multiple drugs and existence of multiple health concerns in an aging adult and the risk of an adverse event is multiplied.

So if you want to use these drugs as a pain management tool, my advice is this:
  •  Use only when it's really needed. Use as sparingly as possible.
  •  Don't take these drugs on a regular schedule for an extended period of time.
  •  Take with food or milk. 
  •  Take the lowest dose that will do the job.
Sources: Medscape; Cleveland Clinic; Pixabay


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