Keep away from ibuprofen?

[Lance Dopestrong]

By their very own admission on Radio 4 this morning, the study was actually a review of the results of previous studies rather than new research, and they are unable to say whether NSAIDS are actually causing this or whether people prescribed them are in groups with a greater predisposition for heart problems anyway. Until the mechanism - if there is one - is discovered and understood they are unable to say whether NSAIDS are the cause or a non contributory commonality.

[Vorpal]

My aunt who is retired now, but had a long career as a medical doctor said that occasional use of ibuprofen is fine, and even short term moderately high dosage is okay, but long term, or very high dosage will damage the kidneys. NSAIDs in general can affect blood flow to the kidneys, and I gather ibuprofen is especially problematic in this regard.

She told me not to take it for arthritis, and said that if paracetemol isn't enough, I should get a prescription for a lower risk pain killer.

Doctors & GPs advise (or should do) against using the ibuprofen with any other NSAID drug, including aspirin. This might be especially important for patients who take aspirin daily as a preventive measure against stroke or heart attack. Older people, and those who are also on diuretic medications are more at risk than others to kidney damage.

Also, she told me (I haven't checked research on this) that over about 600 or 800 mg, there is no additional benefit to be gained by taking more. That is, it has done as much as ibuprofen can do at the point, and taking 1 gram won't do anymore pain reduction than taking 800 mg (600 mg for a smaller person).


With regard to the Guardian article, they should include absolute risk, or change in numbers required to treat. Because a 100% increase is meaningless if 1 person in 100 000 becomes 2 in 100 000. Also, it is important to note that this is an observational study combining several NSAIDs, which means that they are using reported information combined with clinical information. It is different than studying groups of people (e.g. a control group and a group prescribed a specific medication) over time. The cause of changes cannot be certain, and it is impossible to sort out all of the other things that can cause the same effect.

[Bonefishblues]

Is the ibupofen to deal with the results of that day's cycling or for a longer term and possibly non-sport related pain?

The former, I'm pleased to say

[bigjim]

Is the ibupofen to deal with the results of that day's cycling or for a longer term and possibly non-sport related pain?

The former, I'm pleased to say

But is the pain a sign by the body that you are cycling too much and you should back off? Less of the excercise that the body is complaining about and therefore less drugs that raise the risk of damage in other areas. I'm certainly guilty of pushing too much and must learn to back off.

[Tangled Metal]

Was this report based on meta analysis by any chance? Hmmm! Me thinks a rush to publish research before there is merit to it.

There seems to be a problem in research sector. Jobs are given out based on reputations but they are often based on publications with your name on them. I know Ph.D.s with publications before they graduate and some without. The consensus among them is publications help with getting work. If you're carrying out such a study you'll want to use it to your advantage, which is publication.

It is quite possible a few things might be going on here. First they've published too early. Second they've published in the wrong place. Third their study has been picked up by a general science based reporter who's brought it out of the circles who would have normally seen this study, which then leads to ppl with a lack of understanding about what can actually be taken from this study.

Any number of these issues, and more, could result in misinterpretation and a knee-jerk reaction from anyone taking it, as reported, at face value.

The other point is, we don't know anything about the validity of the reports being used in this meta analysis. What was their criteria for choosing the study's used in this research?

I'm sorry but there really no way to confirm the validity or significance of this study. IMHO whichever newspaper first picked up on this should not have written an article on it. There are too many doubts and uncertainties that professional researchers would not draw any value from it let alone the layperson. It is time the press had a moratorium on reporting medical research without it being widely accepted and easily understood. This might sound academically elitist but sometimes research is best kept within the research community that's capable of understanding it fully.

[Psamathe]

Ibuprofen's a very useful drug, I find.....

I think it is a personal thing as I found Ibuprofen totally ineffective (as well as Naproxen and Diclofenac).

I once asked a physio I use sometimes about this and she said it varies, for some they work, for others they don't. My Mum uses NSAIDs a lot (desperately bad arthritis, under prescription, etc.) and they help her massively.

Ian

[Paulatic]

I was given a couple of ibuprofen pain relief tablets about 20 yrs ago. I felt so odd after taking them and it felt like my heart was racing. Never ever took another even when in pain I've been offered some.

[Psamathe]

Report I heard on the radio and reports I read said the risk seemed to increase over the 1st week of taking the drug and then "plateaued"; other report was over the 1st month. (I guess they were not commenting on the stomach issues, and other complications of longer term use).

Interestingly different NSAIDs have different increased risk

They said the potential increase in risk was 75% for ibuprofen and naproxen and more than 100% for rofecoxib but that uncertainty about the extent of the increased risk was greatest for ibuprofen and naproxen.

. That said, different studies do find very different increased risks e.g.

Taking the over-the-counter drug was associated with a 31% increased risk, researchers in Denmark found.

What I've not seen is how quickly the risk drops when you stop taking them. Is it a case of flush them out of your system and the risk is back to what it was before you started or does the risk remain high for some time (or even forever ...)? Relevant because a previous study found they can cause heart damage which might mean a very slow drop in risk long after the drugs have left your system.

I wonder if the relevance might be that whilst I don't any more (because these NSAIDs incl. ibuprofen seem to have no effect for me), some might reach for ibuprofen very easily for minor complaints where they have minimal effect as recovery would be pretty quick even without the drug (and they are unbelievably cheap in the supermarkets!).

Ian

[ChrisOntLancs]

ibuprofen is the only painkiller OTC or otherwise (we're talking local anesthetic here too, no really) that works with my tooth ache, always got a pack in my saddle bag. i tend to avoid it anyway though because it turns my insides to stone.

i've never found them to be effective with other pains, sort of starting to wish that i struggled with elbow ache instead.

[reohn2]

Story alert:-
16 months ago before a rough MTB ride I took 1g of Ibuprofen and 1g of Paracetamol ...

Is that not around 3 times the recommended dose? The ibuprofen pkt I have states 1 or 2 200mg tabs 3 times daily......

You're right,my mistake.
I thought they were 500mg capsules,just looked at the prescription,they're 200mg which reads take upto two three times a day.
So the dose was 400mg not 1g as previously posted(I've edited it).
The Paracetamol dose was 1g(two 500mg tablets)

My ibuprofen story isd that I had a foot injury for 6 to 9 months. Plantar fasciitus I believe according to symptoms. Stopped me jogging at all though I could walk or cycle. I tried ibuprofen at recommended dose 400mg 3 or 4 times a day. For a few days at a time. Stoped the pain but didn't cure it.

Then I attended hospital for a bad sprain/fracture. X-ray eliminated fracture. Nurse practitioner advised higher dose of ibuprofen I think - 600 or 800mg (for wrist sprain) for a week based on my size and weight). Helped with sprain and and also completely cured foot issue. Of course with a body weight of 16.5 stone I was probably under dosing at 400mg as doses depend on body weight.

So I think ibuprofen is great. I'd be wary of taking it in any dose for an extended period though.

As for increased risk. As already said from what base. A 50% increase in risk for an person with no risk factors is next to nothing and presumably only raises the risk while taking the drug. Risk will go back to normal soon after.

My perception is that paracetamol is dangerous because the toxic dose is very close to the therapeutic dose. Can't say offhand where I got this from but I'd be more wary of high/frequent doses of paracetamol than any other over the counter painkiller.

I've been prescribed 800mg three times a day in the past for a bad back,I weighed 80kg(not grams) at the time and was extremely fit.
Edited for weight differential anomalies

[Cyril Haearn]

Story alert:-
16 months ago before a rough MTB ride I took 400g of Ibuprofen(not 1gram as previously posted) and 1g of Paracetamol for pain relieve in an arthritic hip joint,I was on no other medication prescribed or otherwise at the time
I hour later on a stiff climb I had a heart attack.
During my 4 day stay in hospital I had an Angiogram,the consultant who carried out the procedure said I had the heart and arteries of a man half my age which he put down to cycling,not smoking,no alcohol,and a vegetarian diet, and said he was puzzled as to what had caused it.
My heart rate during my stay in hospital didn't rise above it's normal(I check it regularly) 55bpm and only went above 60bpm when the twenty-something Ali McGraw look a like nurse came on the ward(WOW! ).
A couple of months later I had an MRI scan and was informed I had 'very slight scarring' to the heart muscle.
The consultant discharged me 6months later saying the HA was slight,probably due to stress and not to worry.
Easier said than done.
Unless you've experienced it you've no idea what it does to your confidence.

I make no claims,I know nothing about over the counter medication other than what I read on the packet and what's on the 'net,nor did I make any possible connection between the HA and Ibuprofen/Paracetamol for some time after the event,however......
EDITED

You took 400g or 400mg?

[Cyril Haearn]

And when you are in real pain your priorities change. The last time I had toothache I would have taken anything that got rid of it. Anything.

I just had the tooth removed. Despite what dentists say the freestanding teeth did not wobble or fall out

I think many of us are very lucky, I am at least, do not keep any medicines at home, have not been to the doc for years

[reohn2]

You took 400g or 400mg?

400mg....... .........It's me age you know

[661-Pete]

You took 400g or 400mg?

400mg....... .........It's me age you know

400g would kill an elephant.
I've had to take 400mg just a couple of hours ago. The sciatica which I thought had gone away, flared up this morning while cycling, possibly due to my twisting awkwardly whilst filtering (there! another reason not to filter! ). Only half a mile from home but it was agony getting back. I'll have to spend the rest of the day flat on my back: even getting up to type this post is stil painful.
Perhaps I'll try paracetamol next. I don't have any prescription painkillers to hand, yet...

[Bonefishblues]

You took 400g or 400mg?

400mg....... .........It's me age you know

400g would kill an elephant.
I've had to take 400mg just a couple of hours ago. The sciatica which I thought had gone away, flared up this morning while cycling, possibly due to my twisting awkwardly whilst filtering (there! another reason not to filter! ). Only half a mile from home but it was agony getting back. I'll have to spend the rest of the day flat on my back: even getting up to type this post is stil painful.
Perhaps I'll try paracetamol next. I don't have any prescription painkillers to hand, yet...

Yes, but without pain