New information published in Circulation advises against using any nonsteroidal anti-inflammatory drugs (NSAIDs) in patients who have had a prior heart attack. These over-the-counter drugs are commonly used like Advil, Aleeve, Diclofenac, Ibuprofen. Using NSAIDs for even as little as one week was associated with a 45% increase for death or recurrent myocardial infarction (MI). The researchers could not identify a period that seemed to be safe, no matter how short.
The study used the Danish National Patient Registry and identified 83,675 patients who had a first MI between 1997 and 2006. The average age was 68 years and 65% were men. All the NSAIDs (except Naprosyn) used during the observation period were associated with an increased risk for death or new heart attack. Diclofenac (brand name Voltaren) was the worst.
Readers should not go away thinking NSAIDs cause heart attacks. This study looked at patients who had already had an MI. But for those patients, the over-the-counter pain relievers should be avoided. Many patients with heart disease also have arthritis or other pain syndromes. We need to come up with safe treatments for pain or use “safer” NSAIDs like low dose Naprosyn or Ibuprofen only when the benefit is weighed with the risk.
Just because something is sold without a prescription does not mean it is without risk. Tell your doctor every medication you take.
Bin Laden stocked pain relievers for kids living at the compound, some home remedies for nerves and gastrointestinal upset, and Avena syrup, which is an extract of wild oats that’s been associated with enhancing sexual desire. Much hay has been made from those wild oats, such as who might have been taking them.
Want to try to avoid a visit to the doctor for that cough or cold? Why not go to the pharmacy to get an over-the-counter (OTC) medicine? In this video from local TV news, I talk about the good and bad of OTC cough and cold meds. Will that medicine from the pharmacy actually help you get better faster?
For the last week I have had a cold. I usually get one each winter. I have two kids in school and they bring home a lot of viruses. I also work in a hospital, which tends (for some reason) to have lots of sick people. Although this year I think I caught my cold while traveling. I’m almost over it now, but it’s certainly a miserable interlude to my normal routine.
One thing we can say for certain about the common cold — it’s common. It is therefore no surprise that there are lots of cold remedies, folk remedies, pharmaceuticals, and “alternative” treatments. Finding a “cure for the common cold” has also become a journalistic cliche — reporters will jump on any chance to claim that some new research may one day lead to a cure for the common cold. Just about any research into viruses, no matter how basic or preliminary, seems to get tagged with this headline. (It’s right up there with every fossil being a “missing link.”)
But despite the commonality of the cold, the overall success of modern medicine, and the many attempts to treat or prevent the cold — there are very few treatments that are actually of any benefit. The only certain treatment is tincture of time. Most colds will get better on their own in about a week. This also creates the impression that any treatment works — no matter what you do, your symptoms are likely to improve. It is also very common to get a mild cold that lasts just a day or so. Many people my feel a cold “coming on” but then it never manifests. This is likely because there was already some partial immunity, so the infection was wiped out quickly by the immune system. But this can also create the impression that whatever treatment was taken at the onset of symptoms worked really well, and even prevented the cold altogether.
There is a short list of treatments that do seem to have some benefit. Nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin, ibuprofen, and naproxen, can reduce many of the symptoms of a cold — sore throat, inflamed mucosa, aches, and fever. Acetaminophen may help with the pain and fever, but it is not anti-inflammatory and so will not work as well. NSAIDs basically take the edge off, and may make it easier to sleep. Read more »
This is a guest post from Dr. Mary Lynn McPherson.
FDA Restricts Acetaminophen In Popular Pain Medications
The Food and Drug Administration (FDA) made an announcement yesterday that affects one of the most common pain medications on the market, and as a consequence may affect countless numbers of the 75 million Americans who experience chronic pain (for perspective, that’s more than the number of people suffering from cancer, heart disease and diabetes combined.) The FDA has asked manufacturers of popular prescription pain medications like Vicodin or Percocet to limit the amount of acetaminophen (also known as Tylenol, or APAP) used in these drugs to no more than 325 milligrams per tablet — the equivalent of one regular-strength Tylenol tablet.
The move came because research has shown that acetaminophen can cause liver damage when taken in higher than recommended doses. The problem is that many over-the-counter medications ALSO contain acetaminophen, and patients may take one or more of these common products (like Tylenol) to reduce their fever or get rid of a headache along with their prescription pain relievers.
Before you know it, you could be taking more than the maximum daily dose of acetaminophen which is 4,000 milligrams. I go out of my way to advise people I work with of this warning, but not everyone takes time to talk to the pharmacist and not all pharmacists make themselves readily available. That is why it is critically important that you talk to your pharmacist to make sure that you are not taking more than this amount. The pharmacist is the last stop between you and medication misuse — you could be taking a medication that contains acetaminophen and not even know it. Read more »
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