An acetaminophen long-term use clinical study showed no clinical evidence of liver dysfunction, even when dosed at 4000 mg/day for up to 1 year.18

Patients with osteoarthritis may have a higher prevalence of cardiovascular risk factors, including heart disease.

TYLENOL® has proven analgesic efficacy in OA.15,16

People who exercise can reduce their risk of OA-related disability17

Tylenol.com/KeepMoving

If your patients take aspirin for their heart,

recommend TYLENOL® for their pain

When matters of the heart matter most

Inside:Cardiovascular disease prevalence

Ibuprofen interference with aspirin heart therapy

Osteoarthritis (OA) and heart disease

Support program for patients with OA

Acetaminophen Long-Term Use Clinical Study

Osteoarthritis and Cardiovascular Disease

The Keep Moving® Program is specially designed to help patients reduce pain in arthritic knees and hips

• Targeted exercises for knees and hips

• Weight loss and joint protection tips

• OA symptom checklist

Use only as directed

REFERENCES (cont): 13. Kalafutova S, Juraskova B, Vlcek J. The impact of combinations of non-steroidal anti-inflammatory drugs and anti-hypertensive agents on blood pressure. Adv Clin Exp Med. 2014;23(6):993-1000. 14. Horn JR, Hansten PD. NSAIDs and antihypertensive agents. Pharmacy Times. http://www.pharmacytimes.com/publications/issue/2006/2006-04/2006-04-5484. Published April 2, 2006. Accessed January 5, 2017. 15. Bradley JD, Brandt KD, Katz BP, Kalasinski LA, Ryan SI. Comparison of an antiinflammatory dose of ibuprofen, an analgesic dose of ibuprofen, and acetaminophen in the treatment of patients with osteoarthritis of the knee. N Engl J Med. 1991;325(2):87-91. 16. Bradley JD, Brandt KD, Katz BP, Kalasinski LA, Ryan SI. Treatment of knee osteoarthritis: relationship of clinical features of joint inflammation to the response to a nonsteroidal antiinflammatory drug or pure analgesic. J Rheumatol. 1992;19(12):1950-1954. 17. Penninx BWJH, Messier SP, Rejeski WJ, et al. Physical exercise and the prevention of disability in activities of daily living in older persons with osteoarthritis. Arch Intern Med. 2001;161(19):2309–2316. 18. Temple AR, Benson GD, Zinsenheim JR, Schweinle JE. Multicenter, randomized, double-blind, active-controlled, parallel-group trial of the long-term (6-12 months) safety of acetaminophen in adult patients with osteoarthritis. Clin Ther. 2006;28(2):222-235.

© Johnson & Johnson Consumer Inc. 2018 EST-414462

ALT over time for patients receiving acetaminophen 4000 mg/day for up to 1 year

ULRR = Upper limit of reference range Adapted from Temple AR, et al. Clin Ther. 2006;28(2):222-235.

Baseline Month 1 Month 3 Month 6

ULRR

2x above ULRR

3x above ULRR

Month 9 Month 12A

LT v

alue

, IU

/L

0

10

20

30

40

50

60

70

80

90

100

110

120

130

140

150

160

170

180

ULRR = Upper limit of reference rangeAdapted from Temple AR, et al. Clin Ther. 2006;28(2):222-235.

ALT over time for patients receiving acetaminophen 4000 mg/day for up to 1 year37

An acetaminophen long-term use clinical study showed no clinical evidence of liver dysfunction, even when dosed at 4000 mg/day for up to 1 year.37

Questions? Call our Customer Care Center for Healthcare

Professionals at 1-866-948-6883

Overall Stanford Health Assessment Questionnaire pain scores have a range of 0 to 3.By one-way analysis of variance among the three groupsNo significant di�erences were observed between the three treatment groups

Adapted from Bradley JD, et al. N Engl J Med. 1991;325(2):87-91.

Bas

elin

e

Bas

elin

e

Bas

elin

e

Pat

ien

t-as

sess

ed p

ain

sco

res

P=0.93

Acetaminophen4000 mg/day

n=60

OTC Ibuprofen1200 mg/day

n=61

Rx Ibuprofen2400 mg/day

n=61

In one study, at 4 weeks, the efficacy of acetaminophen was similar to that of ibuprofen for short-term symptomatic

treatment of OA pain of the knee15

Overall Stanford Health Assessment Questionnaire pain scores have a range of 0 to 3. By one-way analysis of variance among the three groups. No significant differences were observed between the three treatment groups.Adapted from Bradley JD, et al. N Engl J Med. 1991;325(2):87-91.

*Study defines cardiovascular disease as hypertension, myocardial infarction, angina pectoris, heart failure, and stroke.

REFERENCES: 1. Benjamin EJ, Blaha MJ, Chiuve S, et al. Heart disease and stroke statistics—2017 update: a report from the American Heart Association. Circulation. 2017;135;e146-e603. 2. Antman EM, Bennett JS, Daugherty A, Furberg C, Roberts H, Taubert KA. Use of nonsteroidal antiinflammatory drugs: an update for clinicians: a scientific statement from the American Heart Association. Circulation. 2007;115(12):1634-1642. 3. Catella-Lawson F, Reilly MP, Kapoor SC, et al. Cyclooxygenase inhibitors and the antiplatelet effects of aspirin. N Engl J Med. 2001;345(25):1809-1817. 4. Elliott WJ. Drug interactions and drugs that affect blood pressure. J Clin Hypertens. 2006;8(10):731-737.

5. Radack KL, Deck CC, Bloomfield SS. Ibuprofen interferes with the efficacy of antihypertensive drugs: a randomized, double-blind, placebo-controlled trial of ibuprofen compared with acetaminophen. Ann Intern Med. 1987;107:628-635. 6. Rahman MM, Kopec JA, Cibere J, Goldsmith CH, Anis AH. The relationship between osteoarthritis and cardiovascular disease in a population health survey: a cross-sectional study. BMJ Open. 2013;3(5):e002624. 7. American Geriatrics Society Panel on Pharmacological Management of Persistent Pain in Older Persons. Pharmacological management of persistent pain in older persons. J Am Geriatr Soc. 2009;57(8):1331-1346. 8. Campbell CL, Smyth S, Montalescot G, Steinhubl SR. Aspirin dose for the prevention of cardiovascular disease: a systematic review. JAMA. 2007;297(18):2018-2024.

9. Bhatt DL, Scheiman J, Abraham NS, et al. ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. Circulation. 2008;118(8): 1894-1909. 10. American Heart Association News. Nearly half of US adults could now be classified with high blood pressure, under new definitions. https://news.heart.org/nearly-half-u-s-adults-now- classified-high-blood-pressure-new-definitions/. Published November 13, 2017. Accessed January 9, 2018. 11. Bugge JF. Renal effects and complications of NSAIDs for routine post-operative pain relief: increased awareness of a real problem is needed. Bailliere’s Clinical Anesthesiology. 1995;9(3):483-492. 12. Weir MR. Renal effects of nonselective NSAIDs and coxibs. Cleve Clin J Med. 2002;69 Suppl 1:SI53-SI58.

TYLENOL® is an appropriate analgesic choice to consider for:

• Cardiovascular disease patients who are on aspirin or certain antihypertensives3,4

• OA patients who have other comorbidities7

Ibuprofen can interfere with aspirin’s ability to exert its antiplatelet effects by competing for the same binding site on the cyclooxygenase-1 (COX-1) enzyme.3

Through their renal effects, NSAIDs may also interfere with the blood pressure-lowering efficacy of certain antihypertensive medicines, such as diuretics and ace inhibitors.13

TYLENOL® may be an appropriate analgesic choice for patients with hypertension.4,14

Cardiovascular Disease Aspirin Heart Therapy Hypertension

Over 92 million American adults have at least 1 type of cardiovascular disease.1*

~92.1 MILLION

The American Heart Association has identified acetaminophen as a first-line pain relief option for patients with, or at high risk for, cardiovascular disease because of its safety and analgesic efficacy.2

50MILLION

50 million American adults are on aspirin heart therapy.8

PLATELET IBUPROFEN ASPIRIN

COX-1

RENAL DISTAL TUBULE (COX-2) RENAL ARTERIOLE (COX-1)

Nearly half of all US adults have high blood pressure.10~½

NSAIDs, like ibuprofen, can increase blood pressure and the risk of heart attack or stroke.4

In the kidneys, NSAID inhibition of COX-1 can constrict blood flow and result in reduced renal perfusion. NSAID inhibition of COX-2 can promote sodium and fluid retention.11,12

Visit TylenolProfessional.com/CV to watch ibuprofen interfere with aspirin’s cardiovascular benefits.

Use only as directed

NSAIDs can interfere with certain antihypertensives commonly used by patients with cardiovascular disease.3-5

Plus, adding an NSAID to aspirin can increase the risk of stomach bleeding.9

TYLENOL® does not interfere with aspirin the way ibuprofen can.3

Many of your patients with cardiovascular disease may also have osteoarthritis (OA).6