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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 benefits.

"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 fact."

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 medical conditions.

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