![]() Still, with judicious use, most people can take these painkillers without incident. In the U.S., acetaminophen poisoning has displaced hepatitis as the most common reason people experience acute liver failure-a condition that leads to about 6 percent of liver transplants in the country.* Krebs says it’s “crazy” that the drug is present in more than 600 products (such as cold and flu formulas) because that makes it all too easy to go overboard. “It is very safe up to a certain threshold, and above that line it is very hazardous,” says Erin Krebs, a pain researcher and professor of medicine at the University of Minnesota. Though useful for pain and fever, this drug, unlike NSAIDs, does not reduce inflammation, and it has an unusual safety profile. People who cannot take NSAIDs because of heart or kidney disease or pregnancy are often advised to use acetaminophen, also called paracetamol. Last year the FDA warned against taking NSAIDs at 20 weeks or later in pregnancy, when they might harm fetal kidneys and thereby cause low levels of amniotic fluid. The impact on kidneys underlies dangers during pregnancy. Aspirin does not cause these issues, but because it raises the odds of bleeding, it is no longer widely used for pain relief, nor is it as widely recommended for preventing heart attacks. “They can impair wound healing after a heart attack, and they promote fluid and salt retention, which can overburden the heart and cause it to fail.” NSAIDs can also damage the kidneys, which in turn burdens the heart. “They increase heart attack and stroke risk by promoting clotting,” Ruff explains. “What I tell patients is to use NSAIDs for short periods and to take the lowest dose that provides the necessary pain relief.”īecause they inhibit COX enzymes, which play a downstream role in everything from blood clotting to tissue repair, NSAIDs affect the cardiovascular system in multiple ways. That does not mean Advil and Aleve (naproxen) are off-limits for heart patients when they twist an ankle or strain their back, says Christian Ruff, director of cardiology at Brigham and Women’s Hospital in Boston. ![]() Food and Drug Administration strengthened warnings about the dangers, which are greatest for people with heart disease or risk factors for it. ![]() (A third, celecoxib, or Celebrex, remains on the market.) These events prompted more scrutiny of other nonaspirin NSAIDs, and all were found to carry cardiovascular risks. Designed to be easier on the gut, they proved rough on the circulatory system, and two of these drugs were withdrawn. These dangers came into sharper focus in the early 2000s after the release of a new kind of NSAID called COX-2 inhibitors, which block an enzyme called cyclooxygenase-2 (most NSAIDs target both COX-1 and COX-2 enzymes). In addition to causing bleeding, almost all NSAIDs-aspirin is the exception-can raise the risk of heart attacks, strokes and heart failure. It’s inevitable,” says Sean Mackey, chief of pain medicine at Stanford University. “With this mad rush to get people off opioids, we will undoubtedly start to see an increase in adverse events from NSAIDs and acetaminophen. ![]() As our reliance on these pills grows, it makes sense to take a closer look at their potential harms and why they occur. ![]() Beyond dangers that have been known for decades-NSAIDs can irritate the gastrointestinal tract and cause serious bleeding acetaminophen in daily doses of more than 4,000 mg can poison the liver-additional problems have emerged in more recent years. Still, there is no such thing as a risk-free drug, and that goes for our most trusted painkillers. And they are safer than and at least as effective as opioids for arthritis pain and lower backaches. NSAIDs are good even for excruciating kidney stones and minor fractures. Five hundred milligrams (mg) of acetaminophen given with 200 mg of ibuprofen is more effective than opioids for postoperative pain and dental pain, research has shown, and the combo causes fewer side effects, with essentially no risk of addiction. Instead of prescribing Ox圜ontin or Percocet for acute pain, doctors are increasingly offering patients prescription-level doses of popular painkillers sold over the counter: acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin or Advil). After tens of thousands of overdose deaths and billions of dollars in lawsuits, the medical establishment has gotten the memo on opioids. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |