Pill Talk: Risks Not Taken Lightly
by Caleb Pate, DO, MPH
We all have them. Staples of the medicine cabinet. A go-to with daily aches and pains. But is it the right choice? The right dose? It has become unfortunately routine to take ibuprofen, acetaminophen, or other over the counter medications for conditions which medication will not really help. The act simply masks symptoms, but doesn’t solve for the underlying condition. Let’s take a look at what these drugs are, what they do, and how they should be used.
Oral Non-Steroidal Anti-inflammatories (NSAIDs)
Trade Names: Advil®, Aleve®, Motrin®, Naprosyn®
Generic Name: Ibuprofen, Naproxen, Aspirin
Oral NSAIDs can be purchased over the counter at most grocery stores and are used for pain, swelling, and fevers. NSAIDs work by reducing the activation of COX-1 and COX-2 enzymes that transition arachidonic acid to prostaglandins. Prostaglandins are found in many forms, producing beneficial effects but do lead to increased blood vessel dilation as well as nerve activation resulting in increased swelling and pain.
Each over the counter brand of medication uses different dosing methods and many come in different pill strengths. It’s important to read the fine print for standard safe doses and don’t use it for an extended period without consulting with a physician first. Due to the positive effects of prostaglandins in our body, prolonged use of NSAIDs can result in increased nausea, bleeding, skin rashes, difficulty breathing, and possible kidney damage.
In many situations it may be inappropriate to use these medications if you have known heart disease, specific underlying medications such as warfarin, pregnancy, kidney disease, and/or diabetes. Consult your physician to determine if they’re safe and effective for your specific use.
Other Oral Analgesics (pain medication)
Trade Names: Tylenol, Paracetamol
Generic Name: Acetaminophen
Acetaminophen is a different pain medication that helps with pain and fevers, but is not helpful with inflammation. The medication is believed to predominantly be a COX-3 inhibitor, an enzyme found in the brain and spine that leads to a reduction of appreciation of pain by the brain.
Since acetaminophen is broken down by the liver, there are associated risks. High doses and prolonged use can lead to acute and chronic liver damage. Acetaminophen is also known to result in rashes, hives, swelling, difficulty breathing, and jaundice.
The most popular brand of acetaminophen, Tylenol, comes in 2 standard doses of 325 mg and 500 mg tablets, but can be found in many other formulations. It’s always important to check the packaging for appropriate dose and frequency. Due to the liver disease potential, acetaminophen can interact with some medications such as oral birth control and nutritional supplements. Specific disease may reduce the effectiveness of acetaminophen, though when used as directed is often viewed as a reasonably safe medication.
Use caution when deciding if over the counter medications are the right choice for you. They’re not meant to be a fix-all for daily aches and pains. Ask your doctor for more information or your onsite Injury Prevention Specialist to steer you in the right direction!
Caleb Patee, DO, MPH || Dr. Patee is a family medicine physician who enjoys building relationships while discussing preventative medicine and implementing disease management strategies. He has a special interest in the interchange of healthcare and technology. How technology can be used to reach more patients to help progress preventative medicine and improve overall health of patients.
Be sure to check out our other blogs for further injury prevention education and tips for the industrial athlete from Work Right NW!