nonsteroidal anti-inflammatory drugs (nsaids) • aga

8/12/2019 Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) AGA

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http://www.gastro.org/patient-center /diet-medications/nonster iodal-anti -inflammatory-drugs-nsaids

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Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

What Are NSAIDs?

How Do NSAIDs Cause Stomach Problems?

NSAIDs and Cardiovascular Risks

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Every day more than 30 million people take over-the-counter and prescription drugs

known as nonsteroidal anti-inflammatory drugs (NSAIDs) for relief from pain,

headaches and arthritis.

These drugs have been around for a long time and have benefited many people.

Although they are generally safe, NSAIDs, like all drugs, do have some potential side

effects.

Many people dont know that NSAIDs can cause problems ranging from mild stomach

upset and pain to serious stomach bleeding and ulcers (holes in the lining of the stomach)

and even death. There is no medical test that can tell for sure if you will develop a

problem, and in most cases, these problems can happen without warning. In fact, serious

side effects of NSAIDs, such as stomach bleeding, result in more than 100,000

hospitalizations and thousands of deaths each year in the U.S. Learn more facts about

NSAIDs.

Back to Top

What Are NSAIDs?

NSAIDs are pain relievers that reduce pain and inflammation. Aspirin is the most

commonly used NSAID. About 20 NSAIDs are available with a doctors prescription.*

They include drugs such as celecoxib (Celebrex), diclofenac (Voltaren) and

nabumetone (Relafen). Three prescription NSAIDsibuprofen, naproxen and

ketoprofenalso are available over-the-counter. The over-the-counter versions of

these drugs are better known by names like Advil, Motrin, Aleveand Orudis.

The only difference is that prescription versions are a higher strength than those

purchased over the counter. Other examples of NSAIDs include products with aspirin

that are available over the counter, like Bayerand Excedrin. NSAIDs also are found

in common cold and flu medications such as Advil Cold and Sinus, Motrin IB Sinus,

and Aleve Cold and Sinus. (Look for aspirin, naproxen or ibuprofen on the box or

bottle to find out if your medicine contains an NSAID.) View a dictionary of terms.

Back to Top

How Do NSAIDs Cause Stomach Problems?

Problems caused by NSAIDs can range from mild stomach upset to stomach bleeding

and ulcers. These problems occur because NSAIDs stop a substance in the body that

protects the lining of your stomach from damage. Some people are at higher risk than

others for stomach problems.

Are You at Risk for NSAID-Related Stomach Problems?
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Everyone who takes NSAIDs is at some risk for developing a stomach problem. Below

are some factors that doctors think are "high-risk" and may make you most likely to

have serious side effects.

To find out if you fall within this high-risk group, fill out this simple risk checklist. Mark

all that apply to you.

Personal Risk Factors

Over the age of 60

Have had previous ulcers

Take steroid medications (such as prednisone)

Take blood thinners (such as warfarin or Coumadin)

Consume alcohol on a regular basis

Take NSAIDs in amounts higher than recommended on the bottle or by the

doctor

Take several different medications that contain aspirin and other NSAIDs

Take NSAIDs for long periods of time

If youve checked any of the boxes in the checklist, take this brochure to your next

doctor visit. Talk with your doctor about how to lower your risk. Many people who

take over-the-counter NSAIDs take more than the recommended dose.

This can happen by:

Taking the next dose sooner than directed on the label.

Taking more tablets or capsules at a single time than recommended.

Taking more than the recommended number of doses per day.Taking several different medications that contain aspirin and other NSAIDs at the

same time.

Even taking small amounts of over-the-counter NSAIDs can increase your risk of

developing stomach problems. This includes taking daily, low-dose aspirin to prevent a

heart attack or stroke.

Back to Top

NSAIDs and Cardiovascular Risks

Recent studies indicate that NSAIDs (except for low-dose aspirin) may increase the

chance of heart attack or stroke. If you have heart disease, heart disease risk factors,

such as high blood pressure, or are taking NSAIDs for long periods, talk to your doctor

about cardiovascular risks and NSAIDs.

The Warning Signs
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In addition to knowing your risks, its important to know the signs of a serious stomach

problem. See your doctor immediately if you experience any of the following:

Stomach pain

Dark black, tarry or bloody stools

Vomiting of blood or matter that look like coffee grounds

However, remember that about 80 percent of people who have a serious stomach

problem as a result of taking an NSAID have no warning symptoms. Problems can

even occur within one week of starting to take these pain relievers.

It is also important to know the signs of a heart problem. See your doctor immediately if

you experience either of the following:

Chest pains

Shortness of breath

Lower Your Risk

There are steps you can take to lower your risk for developing a serious stomach

problem. Here are some important tips to guide you when taking any over-the-counter

or prescription NSAID:

Know your personal risk factors (review the risk checklist).

Since problems can develop even if you do not have any of the common risk

factors, talk to a doctor before you begin taking any medication. Also ask

questions and tell your doctor if you have any side effects.

Read the label on your medications and follow the instructions. Know all the

ingredients in your medications, how much to take (dose) and length of time

(duration) you can safely take the product. Talk with your doctor before taking

any pain reliever for more than 10 days.

Take a medication only as directed and know its side effects. Look for side

effects on the label or box of every medication bottle.

Never use prescription and over-the-counter pain relievers at the same time

unless directed by your doctor.

Write down all medications and dietary supplements that you are taking. Be sureto include all vitamin, mineral and herbal supplements. Share the list with your

doctor; they can help you avoid drug interactions or ingredient duplications.

Avoid or limit use of alcohol when taking any pain medication.

All NSAIDs can cause serious stomach problems but studies have shown there is

a range of risk. Some NSAIDs, such as celecoxib, may be tolerated better than

others by some people. You should talk to your doctor or pharmacist for more

information and about which NSAID is best for you.

Additional information about NSAIDs can be found at:


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www.fda.gov/CDER/drug/infopage/COX2/NSAIDmedguide.htm

Back to Top

Webcasts and Videos

Videos

What are NSAIDs and what are some of their side effects?

How frequently do these side effects occur?

Who is at the greatest risk for GI side effects from NSAID use?

How long does it take for GI symptoms to present themselves?

How can patients reduce their risks for GI s ide effects from NSAID use?

What are GI p rotective therapies and how might t hey help?

What is the most important t hing for patients taking NSAIDs t o remember?

How alarmed should I be about developing gastrointestinal problems if I take an NSAID?

What are the sy mptoms of severe gastrointestinal side effects from NSAIDs and what should I do if I

have any of them?

Does taking low-dose aspirin daily along with another NSAID increase my risk of gastrointestinal

problems?

Im taking an herbal medicine. Can I take an NSAID?

Can I take an NSAID if Im already taking low-dose aspirin to reduce my risk of heart attack or

stroke?

Webcasts

Listen to a patient discuss her first-hand experience with complications from chronicNSAID use.

Taking Low Dose Aspirin and NSAIDs? Know Your Risk .

Gastrointestinal Risk with NSAIDs .

Back to Top

The content of this program has been developed and is solely controlled by the AGA

Institute. Byron L. Cryer, MD, associate professor of medicine at the SouthwesternSchool of Medicine, Dallas TX and Lauren B. Gerson, MD, MSc, associate professor

of medicine, Stanford School of Medicine, Stanford, CA, were appoitned by the AGA

Institute to oversee the medical content of this program.

Certain videos, brochure, certain Webcasts and content provided above has been made

possible by a grant from Pfizer Inc.

Certain videos, Webcasts and various links listed above have been made possible by a

grant from Horizon Therapeutics.
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