Got a headache? Some knee pain? Feeling a little feverish? Take five before you reach for that over-the-counter pain reliever and make sure it's the right move.
About 35% of Americans use over-the-counter (OTC) drugs regularly, and many of these meds are analgesics. But recent revelations about the very real cardiac, liver, kidney, bleeding, and stroke risks that these popular medications present have led health care providers to reframe their recommendations about how we should use them. Since people can buy these pain medicines without a prescription, they mistakenly believe they are completely safe. Especially if you have other health problems, you need to take time to learn about these risks, either by reading about them on your own or by asking your doctor or pharmacist. So, if you don't think of OTC pain relievers as serious medicine, chalk that up as mistake.
Taking them for every ache and pain?
Two basic types of analgesics are available over the counter: acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs), which include ibuprofen (Advil, Motrin), naproxen (Aleve), and aspirin. It is believed that acetaminophen works by blocking pain receptors in the brain. NSAIDs, on the other hand, block the production of prostaglandins, which trigger pain and inflammation when cells are damaged. These are powerful drugs. If your pain is mild or moderate, there are lots of nondrug alternatives that you might want to consider first, like rest or hot and cold therapies.
There's lots of talk about which analgesic to use for what kind of discomfort. And there's some truth to what you hear. For instance, because of their anti-inflammatory properties, NSAIDs might better alleviate pain from sprains and strains than acetaminophen would. In general, however, all of these medications can do a pretty good job at relieving pain and fever. The big difference is the way they affect the body and the very different risks they present. The key to using these medications correctly is making sure the one you choose is the right medication for you.
Experts have known for some years that using NSAIDs can increase a person's risk of heart attack and stroke. Only recently, however, has the Food and Drug Administration warned that the risk can spike as early as the first week that a person starts using one of these drugs.
Emerging research suggests that NSAIDs can significantly inhibit ovulation. After just 10 days, 75% of female participants in a 2015 study who took naproxen, for example, did not release an egg, compared with 100% of those who took a placebo. Ninety percent of those who took the prescription NSAID diclofenac (often used to treat menstrual cramps) didn't ovulate. NSAIDs inhibit prostaglandin release, which is a critical part of egg release. So the thinking is that NSAIDs can interfere with the release of the egg from the ovary.
To some extent, nonprescription pain meds can help people stay active, which is a health bonus. They are also a big help for patients working through the pain that often comes with physical therapy. But if you're regularly dosing up so you can push the exercise envelope, beware. Pain is a safety mechanism that tells you what is happening in your body.