NSAID drugs like Motrin, Ibuprofen, Aleve and Celebrex are so commonly used that they may as well be put in the water supply. Grocery store shelves are lined with them and physicians are taught that they are an important part of controlling pain after an injury. However, what if these drugs were also dangerous? Well, despite their wide use, evidence continues to mount that this is likely the most dangerous thing you put in your mouth that you can buy off the shelf at Walgreen’s.
Most patients look like I just told them their mother died when I let them know that the Motrin they’ve been popping like M & Ms is tripling their risk of dropping dead from a heart attack. It’s a mixture of disbelief and horror, with a healthy dose of skepticism thrown in. Despite this reaction, big groups like the American Heart Association have gotten behind a campaign to reduce or stamp out the use of NSAID drugs, because it’s the cardiologists who see the heart attacks and strokes caused by these drugs in otherwise healthy patients.
This past week has been a bad one for NSAIDs. First there was a lawsuit by a football player for USC against a team physician for using Tordol shots to keep the kid playing. This high dose NSAID pain reliever eventually gave this young and fit kid a heart attack in his 20s, so now he’s suing for off label use of the drug and the fact that he wasn’t told that this drug might raise his heart attack risk. Even the monolithic NFL is being sued by players for the use of the same drug. However, this suit is over how the drug was used to get players with concussions back on the field and their subsequent memory and concentration issues years later. The NFL players association might have interest in a new European study showing the effects of NSAIDs on the brain and stroke.
The new study looked at more than 100,000 Danes in their medical care system that were admitted to the hospital for stroke over an 8 year period. If the patient was taking NSAIDs, they had a 19% increased risk of dying from the stroke. If the patient was taking the drug Etodolac (Lodine SR) or Diclofenac (Voltaren) there was a 53% and 28% increased risk of death!
The upshot? Between Motrin stroke risks and it’s heart attack and risks, there doesn’t seem to be a pressing reason that NSAIDs are included in family practice and sports medicine guidelines for the treatment of acute pain. If the lawsuit against a sports physician is successful, given the mounting evidence of how dangerous these drugs are, I wouldn’t be surprised to see other suits follow against physicians recommending or prescribing these drugs for common musculoskeletal pain. In the meantime, if you’re a patient who’s taking them, do yourself a favor and explore natural anti-inflammatory alternatives!