Wednesday, February 14, 2018

OTC painkillers - are we taking too many?

Ibuprofen tablets. Ragesoss, CC3.0 license

A study published in the journal Pharmacoepidemiology & Drug Safety in January 2018 found that people are taking too much ibuprofen.

Ibuprofen is part of a group of drugs known as NSAIDs (non-steroidal anti-inflammatory drugs). Another popular over-the-counter NSAID is naproxen. They are generally used to treat pain, often chronically. Another well known pain killer that is not an NSAID is acetaminophen, more popularly known by its brand name Tylenol (which is manufactured by the company that sponsored this study).

NSAIDs do have side effects, especially if the daily dose limit is exceeded. The drugs act to reduce inflammation, which has effects on blood pressure, the heart, liver, and kidneys. And it's important to follow dosing guidelines, as they've been established based on toxicity studies.

However, the study authors were quoted in the New York Post as recommending NSAIDs become prescription only, pushing acetaminophen as a safer option (though that drug has liver toxicity and a known history of being pulled from shelves). It's a bit of an extreme conclusion based on a single week of self-reporting and limited findings. For example, less than 10% of subjects recorded exceeding the dose with NSAIDs, and they also exceeded the dosing on other drugs they took in that same time period at near the same levels.

So maybe the conclusion should be that we need to communicate dosing better, or find better pain killers in general, rather than limit the availability of what currently works for people. And because of the conflicts of interest regarding the sponsorship of the work, this study just comes across as industry shill.

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