Nsaids
 

Snipped from the local paper this morning: If they really get serious about pulling these off the market most of us FOGs that depended on "Ranger Candy" just to keep moving would never have made it thru the day :)
Study raises concerns about more pain relievers

April 19, 2005

By Marilyn Marchione Associated Press

"ANAHEIM, Calif. — With prescription drugs Vioxx and Bextra already pulled from the market, a study has raised disturbing questions about the heart safety of long-term use of over-the-counter pain relievers such as Advil, Motrin and Aleve."

"Smokers in Norway who took such drugs for at least six months had twice the risk of dying of a heart attack, stroke or other heart-related problem."



"The study was relatively small — 908 people — and involved people prone to heart problems and cancer because they smoked. But specialists said it supports the Food and Drug Administration's recent decision to warn about long-term use of all such painkillers except aspirin."

"The findings add to the suspicion that the heart risk extends beyond the so-called cox-2 drugs — Bextra, Vioxx and Celebrex — to the larger family of medications known as non-steroidal anti-inflammatory drugs, or NSAIDs, which include naproxen, ibuprofen and virtually all other over-the-counter pain relievers except acetaminophen or Tylenol."

"In recent months, many doctors have switched patients to these over-the-counter medications, believing them to be safer alternatives."

"To the best of our knowledge, these are the first data to support putting a box warning on NSAIDs, not just cox-2s," said Dr. Andrew Dannenberg, a Cornell University scientist who helped do the Norway study.


"Some results from the Norway study were presented in February hearings at the FDA, but consisted of only one summary slide and "nobody really picked up on it," said Dr. Raymond DuBois, a Vanderbilt University cancer expert who had no role in the work."

"The fresh information presented on Monday should persuade others to study these over-the-counter drugs in more depth, DuBois said."

"Oral cancer is a deadly and disfiguring disease that is an especially big problem in Asia. Worldwide, about 275,000 cases and 127,000 deaths occur each year. In the United States, about 29,370 new cases and 7,320 deaths are expected this year."

"Dr. Jon Sudbo of the Norwegian Radium Hospital in Oslo, who led the research, and others wanted to see if NSAIDs could prevent oral cancer, since studies showed they could help ward off other types of cancer. They chose more than 3,000 people at high risk for oral cancer because of their smoking habits from the Norwegian Cancer Registry, a database of more than 123,000 people."


"A deeper look revealed that the NSAID users were dying at twice the rate of the others from heart-related problems. There were 42 cardiovascular deaths among the 263 painkiller users and 41 deaths among the much larger group of 562 people who had never taken such drugs."

"Risk was highest among ibuprofen users, who were nearly three times more likely to die of cardiovascular disease than non-NSAID users. Aspirin was the only NSAID that did not seem to raise the risk, but the numbers of aspirin users in the study were small."

"Doctors said the NSAID dose made no difference in risk, but others said this should be studied in future experiments."


""There are important uncertainties. One of them is the doses and one is what the effect would be in the larger population," said Dr. Michael Thun, chief of epidemiology for the American Cancer Society, who had no role in the study."

"Thun said he would propose a larger study on over-the-counter NSAIDs using the cancer society's huge database, which contains information on more than 1.2 million Americans."


Jack Moroney-finding out as a FOG that sneaking up on anyone anymore is a challenge cause all the pills in my gut make me sound like a damn marraca

That will hurt. I live off those things.

Shocking study reveals that double above-the-knee amputees that take NSAIDs are less likely to run a marathon than people with legs! News at 11. :rolleyes: Is all that kippered herring starting to affect the Norgies' thought processes?

I also rolled my eyes when I read the sample size of 908 people, but then I realized that was half the population :)

Jack Moroney-Norway great people, lousy food unless you can live on fish and strawberry jam.

Nothing in life is "free" ....it all comes with a cost. Weighing risk vs. benefit is what the art of medicine is all about.
Talking to patients today in the office : the use of NSAIAs vs the potential risks, not one of the 20 patients are willing to give them up. They would sooner die of a heart attack than bear the chronic or acute pain they were having. PAIN SUCKS, end of story. It's like the cholesterol controversy, : will you live a day or week longer if your cholesterol is lowered by a drug when it is more to do with your genes than the diet you maintain.
I for one, as a prescribing doc for acute and sub-chronic pain for patients and also the victim of pain myself refuse to give up on NSAIAs.

ss

swatsurgeon:

Good post, for years while on active duty, and beyond I was prescribed Ibuprofen 800 mg 4 X daily. Nancy tells me that this is an illegal dose, 800mg 3 X daily is the upper limit, I may go back to the original dosage.

Terry

Unless my memory is failing me, 800mg 4x daily was what I was prescribed for back pain. After ibuprofen was available OTC I certainly had periods where I was taking something on this order. I remember reading of a player for the Seahawks who suffered catasptrophic kidney failure from excessive ibuprofen consumption, IIRC he was taking 6400mg daily. This was what made me wean myself from ibuprofen, I've since gone back to taking it if the pain is bad enough and inflammation plays a role, though not in these dosages and only for a few days at a time. Hopefully, this won't do too much damage to my system.

Risk versus benefit as stated above.

Doc

the daily limit for ibuprofen is 3200mg.... but the suggestion is that you take less if it is as effective due to possible side effects. In some studies, 2400mg was as effective as 3200mg with decreased GI bleeding, etc...

but Nothing illegal or wrong about four times daily dosing of 800mg.

doc t.

doc t:

Gracias.

I rarely have ammunition to argue with Nancy, esp re medical concerns.

Terry

anytime.... : )

I owe you a dinner, sometime.

Terry

Just invite her and the TS to your wine cellar! :lifter

Now there's an idea, that might fly.

hey,,,what about my invite to the wine celler?????????????????????