NSAIDs Side Effects --
A Heart Wrenching Price to Pay for Pain
Conclusive evidence that NSAIDs side effects are worse than previously thought is scary news for millions of American arthritis sufferers who depend on these drugs for chronic pain
relief. Non-steroidal anti-inflammatory drugs (NSAIDs) include household names like Advil, Motrin, Aleve and Celebrex. Studies now link all non-aspirin NSAIDs to strokes and cardiac arrest, yet consumers are often unaware of these and other health risks, according to the Food and Drug Administration (FDA).
Growing in the shadows of this “silent epidemic” is increased arthritis consumer choice for drug-free natural pain relief supplements, especially those containing the herb Boswellia and natural glucosamine.
Traditionally, NSAIDs side effects of GI bleeding, ulcers and liver failure have long been documented for causing 100,000 hospitalizations and 17,000 deaths annually in the U.S. Yet the toxic effects of this medical predicament have been given scant publicity. No one appears to be tracking the numbers, leaving many physicians and most patients unaware of the magnitude of the problem, according to a 1999 study in The New England Journal of Medicine.1
2015: FDA strengthens heart-related warnings concerning NSAIDs side effects
The risk from NSAIDs of heart attack and stroke, either of which can lead to death, was initially addressed by the FDA in
2005 in the Boxed Warning and Warnings and Precautions section of prescription drug labels.
Influenced by mounting evidence from subsequent studies, the FDA made those warnings much stronger on July 9, 2015 for all non-prescription and prescription non aspirin NSAID labels.2.
The updated heart-related warnings included, but are not limited to, the following:
- The risk of heart attack or stroke can occur as early as the first weeks of using an NSAID
- The risk may increase with longer use
- The risk appears greater at higher doses
- The risk occurs in patients with or without heart disease or risk factors for heart disease
- Patients with heart disease or risk factors for it, have a greater likelihood of heart attack or stroke following NSAID use than patients without these risk factors because they have a higher risk at baseline
- Patients treated with NSAIDS, such as ibuprofen, following a first heart attack were more likely to die in the first year after the heart attack, compared to patients who were not treated with NSAIDs after their first heart attack.
- There is an increased risk of heart failure with NSAID use
Plant-based natural supplements provide safe, effective pain relief alternative
Natural pain management is nothing new. For centuries, nature’s medicine cabinet has contained the answers for pain relief. There are many botanical and herbal substances that have proven effective, safe and free of NSAIDs side effects.
Here are three trusted high quality natural products helpful in attaining pain relief from arthritis, joint pain, injury or surgery:
- A complex for pain: Dietary supplement caplets consisting clinically-proven boswellia extract and patent-pending safflower extract Contains no aspirin and is gentle on the stomach. Use as a complement or potential replacement to existing medications as it’s a natural anti-inflammatory with minimal side effects and without NSAIDs side effects of GI bleeding or stroke/heart risk. More important, perhaps, is its safety for long-term pain management required for chronic conditions like osteoarthritis.
- An advanced joint health tablet: Contains natural, fast-acting key joint nutrients to help bring joint comfort and mobility. Two coated caplets daily help build cartilage to promote joint health and flexibility, consisting of glucosamine hydrochloride and clinically-proven patent-pending Boswellia extract for faster relief in as few as five days.
- A deep penetrating pain relief cream: A natural blend of plant extracts with pain-relieving, cooling menthol that provides temporary but a very deep pain relief rub for pain associated with arthritis, bruises, muscle strains and sprains. This product alone may reduce your dependency on NSAID dosage as its relief is immediate and lasts up to four hours.
For complete background information and our personal testimonies on each, click on the following link: Three natural pain products.
Study: people not aware of harmful effects of painkillers
Over-the-counter and prescription painkiller drugs are often used inappropriately and there’s a substantial number of people who are not aware of the potential side effects, according to a study published in the November 2005 issue of the Journal of Rheu-matology.5
The study, People Unaware of Harmful Effects of Painkillers, is the first to look at the characteristics, attitudes and behaviors of the population who frequently use non-prescription and prescription NSAIDs.
“This study shows just how common these medications are used and highlights the lack of insight into their potential dangers,” said C. Mel Wilcox, MD, lead study author from the University of Alabama at Birmingham. “The findings paint a clear picture of the need for patient and physician education efforts and interventions to help prevent un-necessary complications from painkillers.”
More than half (fifty-four percent) of the 807 people surveyed in the study were not aware of the potential side effects of these drugs and 18 percent had previously expe-rienced side effects. Those who used over-the-counter painkillers commonly experi-enced side effects such as stomach pain, internal bleeding and ulcers.
Nearly 30 percent of these people did not consider themselves at risk for any NSAIDs side effects associated with painkiller use. The study found similar numbers in people who exclusively used prescription painkillers.
AGA: 36 million take NSAIDS, 25% exceed recommended dosage
The above study was supported by the American Gastroenterological Association (AGA), which estimates that every day more than 36 million people take over-the-counter and prescrip-tion NSAIDs for pain relief, headaches and arthritis, with nearly 25 percent exceeding the rec-ommended dosage.5
The AGA observed that long-term use of NSAIDs in high doses can provide great benefit in terms of anti-inflammatory effects, pain relief and cardio-protective effects (with aspirin only) but the risk can be great.
With increased dosage, there’s increased risk of gastrointestinal complications ranging from stomach pain to ulcers, hemorrhage and severe and potentially deadly gastrointestinal problems.
Side effects issues for people who take NSAIDs several times a week
For many people, pain relievers are wonder drugs, allowing them to carry on with their lives despite disabling arthritis, for instance, and other chronic pain issues. All NSAIDs, whether sold over the counter or by prescription, have potential risks.
The following NSAIDs side effects relate primarily to people who take pain relievers at least several times a week, according to Berkeley Wellness online publication Reducing Pain Reliever Risks:3:
- Cardiovascular risk: Over the years studies have linked NSAIDs to an increased risk of heart attacks and strokes, especially when taken long term, at higher doses, or by people who had previously had a heart attack (or had cardiac risk factors). Over-the-counter NSAIDs have been required to warn about this in the small print, as have prescription NSAIDs such as celecoxib (brand name Celebrex) and diclofenac. The tougher 2015 FDA warning is based on a review of newer research and appears on all NSAIDs except aspirin. It strengthens the old warning and adds, among other things, that the risks include heart failure and that they can occur as early as the first weeks of NSAID use.
- Blood pressure: NSAIDs can raise blood pressure. This may be at least partly responsible for the increased risk of heart attack and stroke.
- Gastrointestinal (GI) bleeding: NSAIDs can damage the stomach lining and cause bleeding and ulcers. This has long been considered their major drawback, as the labels warn. The risk is greatest in long-term users, those over 60, heavy drinkers, those with a history of GI bleeding or ulcers and those taking certain medications, such as blood-thinning drugs or steroids.
- Liver damage: Acetaminophen (Tylenol) is not an NSAID. But as the leading non-prescription pain reliever, it is often lumped into the same category. Unlike NSAIDs side effects, it does not cause GI bleeding. But long-term frequent use of acetaminophen or even large single doses can cause severe liver damage. In fact, acetaminophen overdosing is the most common cause of acute liver failure in the U.S., often as the result of suicide attempts. Most people are unaware of this risk and don’t realize that acetaminophen is in hundreds of over-the-counter cold, allergy and headache products and some prescription pain relievers. Check labels for acetaminophen, and don’t take more than 4 grams—equal to eight Extra Strength Tylenol tablets—a day from all sources. Three alcohol drinks or more at a time and certain other drugs increase the risk. Heavy drinkers and those with liver disease should avoid, or at least limit, acetaminophen. Taking the drug while fasting also increases the risk.
- Kidney damage: NSAIDs (and acetaminophen to a lesser extent) can damage the kidneys. If you have kidney disease, talk to your doctor about pain reliever safety.
Never use NSAIDs for more than three days for fever and 10 days for pain
NSAIDs are effective pain-relievers, but they are intended for short-term use. The Cleveland Clinic cautions never use an over-the-counter NSAID continuously for more than three days for fever, and ten days for pain, without talking to your healthcare provider.4
When taking NSAIDs for long periods of time, you should be carefully monitored by a healthcare provider so he or she can monitor NSAIDs side effects, and change treatment protocol, if necessary.
Depending on the NSAID and the condition being treated, some may work within a few hours, while others may take a week or two before most benefit are achieved. For acute muscle injuries, the Cleveland Clinic recommends NSAIDs that work quickly, however, these may need to be taken as often as every four to six hours because of their short action time.
For osteoarthritis and rheumatoid arthritis that require long-term treatment, they usually recommend NSAIDs that need to be taken only once or twice a day. However, it generally takes longer for these drugs to have a therapeutic (healing) effect.
What are the common NSAIDs side effects?
Side effects may occur if you are taking large doses of NSAIDs, or if you are taking them for a long time. Some side effects are mild and go away, while others are more serious and need medical attention.
Please note: The side effects listed below are the most common. All possible side effects are not included. Always contact your healthcare provider if you have questions about a particular medication.
The most frequently reported side effects of NSAIDs are gastrointestinal symptoms, such as:
- Feeling bloated
- Stomach pain
- Diarrhea and/or constipation
- Feeling lightheaded
- Problems with balance
- Difficulty concentrating
- Mild headaches
These side effects can generally be relieved by taking the drug with adequate amounts of food. NSAIDs may also be taken with milk or antacids (such as Maalox® or Mylanta®) to prevent gastrointestinal symptoms.
If the symptoms continue, the NSAID may need to be stopped. You should contact your healthcare provider if the symptoms listed above do not stop after a few days of taking the NSAID with food, milk, or antacids.
What NSAIDs side effects should I tell my healthcare provider about right away?
If you have any of the following NSAIDs side effects, it is important to call your healthcare provider right away:
- Fluid retention (recognized by swelling of the mouth, face, lips or tongue, around the ankles, feet, lower legs, hands, and possibly around the eyes)
- Ringing in the ears
- Severe rash or hives or red, peeling skin
- Unexplained bruising and bleeding
- Unusual weight gain
- Black stools – bloody or black, tarry stools
- Bloody or cloudy urine
- Severe stomach pain
- Blood or material that looks like coffee grounds in vomit (bleeding may occur without warning symptoms like pain)
- Blurred vision
- Wheezing, trouble breathing, or unusual cough
- Chest pain, rapid heartbeat, palpitations
- Acute fatigue, flu-like symptoms
- Photosensitivity (greater sensitivity to light)
- Change in strength on one side is greater than the other, trouble speaking or thinking, change in balance
- Inability to pass urine, or change in how much urine is passed
- Very bad back pain
- Very bad headache
- Feeling very tired and weak
Who should not take NSAIDs?
NSAIDs can raise blood pressure in some people. Some people with high blood pressure (hypertension) may have to stop taking NSAIDs, if they notice that their blood pressure increases even if they are taking their blood pressure medications and following their diet. If you are taking blood pressure medication, talk to your healthcare provider before taking NSAIDs.
People who have the following conditions or circumstances should not use any type of NSAID until they are first evaluated by their healthcare provider, according to the Cleveland Clinic
- Children and teenagers with viral infections (with or without fever) should not receive aspirin or aspirin-containing products due to the risk of Reye's syndrome.
- Those who have an upcoming surgical procedure, including dental surgery
- Diabetes that is difficult to control
- Known kidney disease
- Known liver disease
- Known allergies to medications, especially aspirin, other NSAIDs, and sulfa drugs
- Nasal polyps (linked to a greater chance of NSAID allergy)
- Active peptic ulcer disease (stomach ulcers or previous history of stomach ulcer bleeding)
- Gastroesophageal reflux disease, also known as GERD
- Crohn’s disease or ulcerative colitis
- Bleeding problems (people who have a history of prolonged bleeding time or who bruise easily)
- People who have three or more alcoholic beverages per day
- High blood pressure that is difficult to control
- Active congestive heart failure
- Asthma that gets worse when taking aspirin
- Pregnancy in the third trimester
- History of stroke or heart attack
- If you are 65 years of age or older
- Simultaneous use with certain medications such as warfarin (Coumadin®), clopidogrel (Plavix), corticosteroids (for example, prednisone), phenytoin (Dilantin®), cyclosporine (Neoral®, Sandimmune®), probenecid, lithium (Lithobid®) and drugs used for various disease states such as arthritis, diabetes, high blood pressure, heart disease, and vitamins and other dietary/herbal supplements
- Phenylketonuria (PKU). Some nonprescription NSAIDs are sweetened with aspartame, a source of phenylalanine.
Before you start taking over-the-counter NSAIDs, have your physician or pharmacist evaluate all of your current medications to see if there would be any potential interactions.
Can NSAIDs side effects include allergic reactions?
Very rarely, a nonsteroidal anti-inflammatory agent can cause a generalized allergic reaction known as anaphylactic shock. If this happens, it usually occurs soon after the person starts taking the NSAID.
The symptoms of this reaction include:
- Swollen eyes, lips, or tongue
- Difficulty swallowing
- Shortness of breath
- Rapid heart rate
- Chest pain
- Decrease in sedation
If any of these symptoms occur, call 9-1-1 or have someone drive you to the nearest emergency room immediately.
This information is a summary only. It does not contain all information about these medicines. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other healthcare provider.
NSAIDS side effects beg natural pain relief alternatives
The above lists of NSAIDS side effects are a source of great
concern to people who suffer with pain. Many have switched to plant-based pain relief supplements because they are safe, clinically-proven to work and virtually side-effect free.
The #1 natural nutrition company in the U.S. manufactures the three products outlined, in the third paragraph above (Plant-based natural supplements provide safe, effective pain relief alternative).
Please click this Pain Trio link for more information or to access each product’s buying page.
The threat to your health from NSAIDs side effects is real. Especially if you are a frequent, consistent user of painkillers, or if you have to exceed daily dose limits to manage pain.
1. Wolfe M. MD, Lichtenstein D. MD, and Singh Gurkirpal, MD, "Gastrointestinal Toxicity of Nonsteroidal Anti-inflammatory Drugs", The New England Journal of Medicine, June 17, 1999, Vol. 340, No. 24, pp. 1888-1889
2 Drug Safety Announcement, FDA strengthens warning that non-aspirin NSAIDs can cause heart attacks or strokes. Food & Drug Administration, July 9, 2015. https://www.fda.gov/Drugs/DrugSafety/ucm451800.htm
3 Article: Reducing pain reliever risks; Published August 4, 2015, updated January 2017, Berkeley Wellness. Accessed online May 29, 2018. http://www.berkeleywellness.com/self-care/over-counter-products/article/reducing-pain-reliever-risks
4 Article, Non-steroidal anti-inflammatory medicines (NSAIDs), accessed May 31, 2018, Cleveland Clinic, April 27, 2016.
5 C. Mel Wilcox, MD, People Unaware of Harmful Effects of Painkillers, Journal of Rheumatology, Nov. 2005. Study supported by American Gastroenterology Association (AGA). http://www.sciencedaily.com/releases/2005/11/051121165432.htm
NSAIDs Side Effects Disclaimer: Health statements on this MSAIDs side effects page have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease
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