By pH health care professionals

Reaching into the medicine cabinet for pain relief from your headache, backache or arthritis? The FDA is now strengthening an existing warning for prescription and over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs).

What is the purpose of an NSAID?

NSAIDs are used to ease pain, lower fever and reduce inflammation. Some NSAIDs are available over the counter, while others require a prescription. Over-the-counter NSAIDs are used to temporarily reduce fever and to treat minor aches and pains such as headaches, toothaches, backaches, muscular aches, tendonitis, strains, sprains and menstrual cramps, whereas prescription NSAIDs are used to address the symptoms of many debilitating conditions, including osteoarthritis, rheumatoid arthritis‎, gout and other rheumatological conditions.

NSAIDs work by blocking hormone-like substances called prostaglandins. Prostaglandins are involved in pain and inflammation, as well as protecting the stomach lining from its own digestive fluids (which is why NSAIDs can lead to stomach problems).  

What do you need to know about NSAID use and risk for heart attack and stroke?

As is the case for all drugs, NSAIDs have side effects, and regular use of NSAIDs has been linked to an increased risk of cardiovascular disease. The FDA says NSAIDs can increase your chances of a heart attack or stroke, which could lead to death, and that these serious side effects can occur as early as the first few weeks of using an NSAID. The risk may increase the longer you take them. NSAIDs already have information on heart attack and stroke risk on their labels, but the FDA is going to require prescription manufacturers to update their labels with more specific information about these risks, and will request over-the-counter manufacturers do the same.

Several studies, including one from 2011 in The BMJ and a 2013 review in The Lancet, have linked long-term, high-dose NSAID use to a greater risk for heart attack, stroke, heart failure and death from cardiovascular disease. The FDA first added a warning about the risk of heart attack in 2005 after a popular NSAID (Vioxx) was pulled from the market in 2004 after a landmark study led by Cleveland Clinic linked it to an increased risk of heart attacks and strokes.

The FDA is also warning people who regularly use NSAIDs to be careful about using other products that might contain an NSAID, such as a multi-symptom cold product.

So what about aspirin?

Note that although aspirin is an NSAID, this revised warning does not apply to aspirin, the FDA says.

How can you be a proactive consumer?

Don’t go chucking your medications in the trash in light of this increased warning. But do increase the amount of caution you exercise and be proactive in educating yourself about these important issues.

“As always, consumers must carefully read the Drug Facts label for all nonprescription drugs,” says Karen M. Mahoney, M.D., deputy director of FDA’s Division of Nonprescription Drug Products. “Consumers should carefully consider whether the drug is right for them, and use the medicine only as directed. Consumers can still take them but should be aware of this increased risk of heart attack or stroke, especially at higher doses. Therefore, consumers should take the lowest effective dose for the shortest amount of time possible.”

You should be aware that some NSAIDs, including ibuprofen and naproxen, can interfere with aspirin’s protective effect against heart attack and stroke, the FDA warns. Therefore, if you are on an aspirin regimen, make sure to take aspirin before NSAIDs (timing is important). And be alert and vigilant, stopping NSAIDs if you experience chest pain, shortness of breath, sudden or slurred speech, or sudden weakness in one part or side of your body, as these may be symptoms of heart attack or stroke. Alert a medical professional immediately to any suspected issues.

Lastly, research natural options for pain relief, including Kaprex, magnesium, SAM-e, turmeric (check out our new C3 Curcumin) and others, and discuss the safety of natural solutions with a qualified health care professional.

Enjoy Your Healthy Life!

The pH professional health care team includes recognized experts from a variety of health care and related disciplines, including physicians, attorneys, nutritionists, nurses and certified fitness instructors. This team also includes the members of the pH Medical Advisory Board, which constantly monitors all pH programs, products and services. To learn more about the pH Medical Advisory Board, click here.