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NSAIDs can cause problems

NSAIDs (nonsteroidal anti-inflammatory drugs) are among the most popular pills in the pharmacy. Every day, tens of millions of Americans swallow products containing ibuprofen or naproxen, NSAIDs that are available without a prescription.

Most people do not realize that these medications are among the most dangerous drugs in the drugstore.

Many Americans assume that if you can buy medicine over the counter without a physician's supervision, then it must be totally safe. They take ibuprofen or naproxen for headaches, arthritis, back pain, menstrual cramps, toothaches or just about anything else that hurts.

Because NSAIDs are perceived to be so safe, only about one person in five reads the directions on the label (Journal of Rheumatology, November 2005). About one-quarter of the people taking them go over the recommended dose. What's more, half of these people don't know or care that NSAIDs can have serious side effects.

That could be a fatal error. An analysis of 31 clinical trials that included more than 116,000 patients concluded that many NSAIDs increase the risk of heart attacks and strokes (BMJ online, Jan. 11, 2011). Although naproxen appears to pose less of a problem for the heart than other NSAIDs, it should not be considered a harmless drug.

All such medications can be damaging to the digestive tract. Bleeding ulcers are a potentially life-threatening consequence of regular NSAID use. Over-the-counter pill bottles caution people to "Stop use and ask a doctor if: you feel faint, vomit blood, or have bloody or black stools. These are signs of stomach bleeding ..."

Despite admonitions to take OTC pain relievers for no longer than 10 days, many Americans take NSAIDs daily for weeks, months or even years. They don't realize that there are many other potential side effects, including high blood pressure, kidney or liver damage, dizziness, drowsiness, rash, itching, fluid retention, ringing in the ears, indigestion, constipation, nausea, worsening of asthma symptoms, visual disturbances and blood disorders.

Not surprisingly, many people space out when they are faced with such a daunting list of complications. Most probably assume none of these dreadful things will happen to them. But visitors to our website have had some distressing experiences:

"I am a middle-aged serious athlete who let his competitive desire overwhelm his common sense. I took ibuprofen (about 1,800 mg) daily for two years to relieve back pain and plantar fasciitis. Then I developed signs of kidney damage. I will never overuse NSAIDs again. I know there are others like me and urge them to be cautious."

Another visitor to our website reported kidney damage from naproxen use so severe that he required a kidney transplant. Others have reported serious elevations of blood pressure, anaphylactic shock, strokes and liver damage.

Anyone who would like more information about the dangers of NSAIDs and other ways to cope with pain may be interested in our Guide to Alternatives for Arthritis (online at

Just because a drug is available over the counter does not make it safe for regular use.

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