Pills, glorious pills - but are they safe? (Image via Wikipedia)
1/17/2012 @ 5:54AM
Could your attempts to cope with common headaches, sore knees or backache be putting you at risk for heart attack, stroke and liver disease? Recent research suggests that both ibuprofen and acetominophen — the two most popular over-the-counter painkillers — carry some potentially and even deadly risks.
Advil and Motrin Linked to Stroke and Heart Attack
Taking ibuprofen and other common NSAIDs (non-steroidal anti-inflammatories) over a long period of time triples the risk of strokes and increases the likelihood of a heart attack, according to this week’s headliner study, published in the British Medical Journal. The new research, conducted at the University of Bern in Switzerland, involved a huge number of subjects; the data were drawn from more than 31 clinical trials involving 116,429 patients. Those who suffered strokes were found to be taking a normal recommended dose (400-600 mg) of ibuprofen three or four times a day.
Meanwhile, the study also found a greatly increased risk of heart attack from all the prescription NSAIDs in the class known as Cox-2 inhibitors. Several years ago, the prescription NSAIDs Vioxx and Bextra were pulled from the market after they were found to put people at risk for heart attack. Another such drug, Celebrex, is still on the market and has also come under attack; a prior study found that people taking Celebrex had twice as many heart attacks as those taking a placebo. The FDA has suggested that people consider alternatives to Celebrex but hasn’t withdrawn its approval. The BMJ study raises the spectre that all the drugs in this class could carry this deadly risk.
Tylenol just as risky – but for your liver
Then there’s last month’s shocker: If you’re regularly taking just a little too much Tylenol (generic name: acetominophen) over the course of the day, you could be permanently damaging your liver and not even know about it. In fact, people who regularly take slightly too much acetominophen over a period of time to relieve pain could be at a higher risk of dying than those who take single overdose of the drug. That’s the message from a study published in the British Journal of Clinical Pharmacology in which researchers tested the blood of people admitted to the hospital and found that the danger of a “staggered overdose,” was much greater than previously thought, often because doctors can’t identify the problem in time to help.
If Tylenol is your go-to painkiller of choice, you’re in good company; acetaminophen is one of the most commonly used drugs in the country, with more than 28 billion doses purchased in the U.S. a year. But since it’s so common, it’s easy to forget it’s an extremely powerful drug; Tylenol overdose is the leading cause of acute liver failure in the U.S., leading to 26,000 hospitalizations and nearly 500 deaths annually, according to the Food and Drug Administration.
Another problem with acetominophen is that’s it’s a standard ingredient in many combination drugs, such as almost all the popular multi-symptom cold remedies, and it’s also in some prescription painkillers like Vicodin. So it’s possible to overdose by mistakenly taking acetominophen in several forms at the same time.
So which painkillers are safe?
Ah, good question. There’s good old aspirin, which hasn’t been associated with serious risks, but also hasn’t been well-studied since it went on the market long before the FDA’s stringent approval proccess was put in place. Aspirin is an NSAID, and as such carries the risk of the standard side effects such as gastrointestinal bleeding and ulcers. However, aspirin has not been linked with heart attack, stroke or liver damage, so that’s something.
Best of all, though, would be to find a treatment that gets at the root cause of your pain, whether it’s headache, back pain, or arthritis. Preventing or eliminating pain through physical therapy, better ergonomic practices, or one of the new biomechanical or neuromuscular therapies. There’s also surgery, of course, but before going that far you might consider one of the new treatments available as an alternative.
At this point, it’s worth considering all your options. Given the risks of these common pain meds, there are many approaches that may be safer in the long run than trying to medicate your pain away.
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