When parcetamol is no longer sufficient
For aches and pains, paracetamol is the appropriate pain reliever, because this drug has the fewest side effects. However, NSAIDs are a solution for pain against which an ordinary paracetamol is no longer helpful. What is the safest variant and what are the risks of using it?
NSAIDs stand for non-steroidal anti-inflammatory drugs, or non-hormonal anti-inflammatory drugs. Examples of the active substances are ibuprofen, diclofenac and naproxen. NSAIDs are a solution for pain against which an ordinary paracetamol is no longer helpful. Pain in rheumatic diseases, for example, or in gout, a bursitis or tendonitis.
Which NSAID is the safest?
A simple question, but there is no simple answer. There is no single NSAID that is equally safe for everyone. Which pain reliever is best for you depends on your health. Much research has already been done into the effect of NSAIDs on existing disorders, but there is still no hard list to give. Experts get no further than:
• A low dose of ibuprofen (200 mg) generally appears to be the safest choice.
• Anyone who has an increased risk of serious stomach problems (including anyone over the age of 70) should take an antacid.
• If you have ever had a heart attack or are at high risk of it, it is probably best to use naproxen.
• Are you taking low-dose aspirin to protect against cardiovascular disease? In that case, avoid using ibuprofen, because it reduces the effect of aspirin.
• Consult with the general practitioner or pharmacist about the use of NSAIDs in the following cases:
if you have or have had problems with the stomach or intestines, heart problems are taking blood thinners, have kidney problems or are taking antidepressants. If you suffer from heart failure, have had a stroke or have stomach bleeding, don’t take NSAIDs in any case without talking to your doctor.
TOP 7 risks
NSAIDs are good pain relievers, but their use carries risks. Therefore, always read the instructions for use before use and adhere to the stated dosage and use period. Also watch out for:
1. Serious stomach problems: such as bleeding, a stomach ulcer or stomach perforation, also with NSAIDs that you take as suppositories. Certainly if you have ever had serious stomach problems, it is wise to consult your GP or specialist. The GP will always prescribe a stomach protector (antacid). Good to know: stomach bleeding is not always preceded by an ‘unpleasant feeling’ in your stomach. Mild stomach complaints therefore say nothing about the risk of stomach damage.
2. The combination with blood thinners: blood thinners are used relatively often by the elderly, for example after a thrombosis. But NSAIDs also have a blood-thinning effect, which can lead to (brain) bleeding.
3. Bowel problems: such as bleeding, especially if you have had bowel problems before.
4. At heart failure: NSAIDs increase the risk of heart failure or make the condition worse.
5. The combination with antidepressants: those who use NSAIDs and certain antidepressants (SSRIs) have a greater chance of gastrointestinal complications.
6. With kidney problems: who already kidney problems may incur even greater problems with the use of NSAIDs.
7. At asthma: in some asthmatics the symptoms worsen due to the use of NSAIDs.
With the cooperation of Prof. Peter de Smet, expert on medication safety at the pharmacists’ organization KNMP.
Sources):
- Plus Magazine
