Are Anti-Inflammatory Pain Relievers Safe for You?
Here's help weighing the benefits and risks of NSAIDs, from aspirin to Celebrex
The Benefits of Anti-Inflammatory Pain Relievers
Some experts feel that the risks of NSAIDs have unfairly overshadowed their
"We talk a lot about the risks of these drugs," says Klippel. "I
think we also need to talk about the benefits. Every medicine has risks. But
the focus on the side effects of NSAIDs has made people lose confidence in a
very valuable category of drugs."
In fact, most painkillers are NSAIDs. And other types of painkillers have
their own drawbacks:
- Tylenol is not an NSAID, but it doesn't reduce inflammation, which is a
common problem in many people with arthritis or aching joints.
- Prescription narcotics, like OxyContin, Percocet, and Vicodin, are powerful
painkillers, but they can be addictive.
Almost every doctor would agree that it's better to treat pain than to
suffer through it. In fact, treating pain is the crucial first step toward
recovery from many conditions.
"If we have a sick person who needs rehabilitation or exercise, they
need to be physically comfortable enough to get through it," says Goldberg.
Sometimes pain medicine, like NSAIDs, is necessary for recovery.
Aspirin, the wonder drug, has the best-known benefits. It obviously eases
pain and reduces swelling. And in low doses it can reduce heart risks. But it
does pose gastrointestinal risks for anyone who takes it regularly, especially
at doses needed to treat arthritis. For this reason, Klippel believes that
Cox-2 inhibitors haven't been given a fair shake.
"In all fairness," says Klippel, "I think that the risks of
Cox-2 inhibitors have been distorted," he says. "By no means am I
discounting the serious risks of cardiovascular disease. It's just that the
benefits of these drugs are being missed."
Cryer points out that in the study that showed Celebrex more than doubled
the risk of heart attacks -- the National Cancer Institute's 2004 APC study --
researchers used 400mg per day, which is double the normal dose.
"It's not clear that Celebrex at normal doses is actually more dangerous
than other NSAIDs," he tells WebMD.
Experts say that people need to consider the risks of NSAIDs in the context
of their personal health. For instance:
- If you have a history of ulcers, drink heavily, are older, or take steroids
for asthma or rheumatoid arthritis, a standard NSAID like aspirin or ibuprofen
may put you at higher risk of gastrointestinal problems.
- If you have heart disease or have had a stroke, Celebrex and other
prescription NSAIDs may put you at higher risk of having further problems.
Klippel says that people have very individual reactions to these drugs.
"Any rheumatologist will tell you that certain people respond better to
certain NSAIDs," Klippel tells WebMD. "We don't know why, but it's a
Sorting Through Conflicting Advice
Trying to sort through the benefits and risks of NSAIDs can be bewildering
for a patient. You may see news reports that frighten you while your doctor
tells you not to worry. It's especially difficult if a person has multiple