Reducing The Side Effects of NSAIDs
By editor | March 9, 2008
The NSAIDs prescribed for inflammatory diseases are likely to be the stronger ones, and they can cause serious side effects in some people, particularly the elderly. As we mentioned earlier, the most common problems are stomach irritation and ulcers, or sores on your stomach lining that may bleed. Regular use of NSAIDs can also cause other gastrointestinal troubles such as indigestion, stomach pain, and diarrhea. Fortunately, more serious consequences, such as colitis, are much less common. Very, very rarely, kidney or liver failure is possible.
The differences between various NSAIDs are hotly debated. Ibuprofen in low doses is probably the safest. Reports on the differences between the other types, and there are many, vary from research study to study. All NSAIDs, however, can potentially cause some side effects. Because the NSAID picture can be confusing, as you work with your doctor, hang in there. Although you may need to try more than one kind, you’ll eventually find the one that works best for you.
Avoiding overuse. Realize that if you should take an over-the-counter medication such as aspirin or ibuprofen in addition to your prescribed NSAID, you would be essentially increasing your NSAID dosage and therefore increasing your risk of side effects. It’s unwise to be taking two NSAIDs at once. So, if you need pain relief in addition to your prescribed medication, acetaminophen is the safer choice. (And, of course, be sure to clear any over-the-counter medication with your doctor.)
Staying in touch with your doctor. Report any signs of gastrointestinal problems to your doctor right away. These include vomiting blood or having a black, tarry stooL Signs of an ulcer include severe heartburn or stomach cramps, nausea or vomiting, and stomach pains that disappear if you take antacids.
Considering alternative drugs. Fortunately, if you have unavoidable risk factors for ulcers but you nonetheless need NSAIDs, there are additional medications that can reduce your chances of ulcer problems. One such drug is misoprostol (Cytotec). In a six-month study of people with rheumatoid arthritis, the misoprostol helped reduce gastrointestinal side effects caused by taking NSAIDs. Those most vulnerable are men over 65 who have had peptic ulcers, use antacids, or have heart disease. Misoprostol reduced gastrointestinal problems in all these categories. Ironically, misoprostol itself can sometimes cause diarrhea, nausea, and stomach pain. One study found, however, that taking the 200-microgram dosage two to three times a day rather than four times reduced those side effects and was still effective. Another ulcer blocking drug is famotidine (Pepcid), which is prescribed in doses of 40 milligrams to prevent ulcers (twice the usual dose of 20 milligrams).
Tagged under:Arthritis black tarry stool gastrointestinal gastrointestinal problems heartburn liver failure nsaids risk factors signs of an ulcer stomach cramps
Topics: Arthritis |
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