Are OTC Painkillers Safe?
OTC Pain Med Misuse
Like most women who work out regularly, Jennifer Null is no stranger to feeling sore. And like many of the walking wounded, she relies on over-the-counter meds for relief. "When I'm hurting, I'll just pop a couple of ibuprofens," says Jennifer, 28, a marketing coordinator in Baltimore. She does this at least three or four times a week -- a habit that started in college. Jennifer isn't at all worried about the safety of the pills. "They're harmless," she says.
This attitude, shared by many exercisers, could put your health at risk. While over-the-counter pain relievers such as ibuprofen (Advil and Motrin, for example), naproxen (Aleve and others), and acetaminophen (Tylenol and others) have become medicine cabinet fixtures -- used, according to a survey from the National Consumers League (NCL), by 175 million Americans yearly -- the meds are hardly innocuous. When taken incorrectly, as Jennifer and other active women are doing, the little pills can cause real damage.
Modern-day miracle workers for easing the discomfort of strained muscles, stiff joints, swelling, and soreness, OTC painkillers have safely helped countless women stick with their exercise routine instead of seeking refuge on the living room couch. The affordability and accuracy with which these drugs can now address specific pains has changed the way we recover from tough workouts, making it easier than ever to get back on the proverbial horse. And it's tempting to think that if a little pain relief works this well, a lot of pain relief must work even better. Not true.
"Overuse of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, aspirin, and naproxen, can cause bleeding ulcers, raise blood pressure, damage the esophagus, and lead to problems with the kidneys," says Jan Engle, PharmD, a pharmacist at the University of Illinois College of Pharmacy in Chicago and a past president of the American Pharmacists Association. The NCL reports that 3,200 to 16,500 people die each year from NSAID-related GI bleeding and up to another 107,000 are hospitalized for NSAID-related complications. Although those who suffer from NSAID damage are typically older or have conditions such as kidney problems or ulcers that make them more vulnerable, "young, healthy women who continually use painkillers can also harm themselves," Dr. Engle says.
Acetaminophen can be equally lethal. In fact, overuse of this drug is one of the leading causes of liver failure in the United States, with overdoses resulting in more than 56,000 injuries, 26,000 hospitalizations, and an estimated 458 deaths a year, according to the U.S. Food and Drug Administration (FDA). "More than two-thirds of the cases are women, though we don't know if women are more susceptible or if it's just that they take more medication," says William M. Lee, MD, a liver specialist at the University of Texas Southwestern Medical Center in Dallas and a principal investigator for its Acute Liver Failure Study Group.
And yet, ask for a show of hands of people who've popped three pills instead of two for a bad headache or doubled up on the recommended amount after pulling a muscle at the gym and the pervasiveness of overuse becomes clear. Many people are convinced OTC pain relievers are helpful -- and harmless -- in any quantity. It's so common for consumers to take too much that last year, advisers to the FDA called for significant changes -- including stronger warnings on labels, which have since appeared. They also suggested lower maximum daily dosages for OTC acetaminophen products, but if and how the FDA will proceed is still unknown.
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