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Safe Pain Relief With Aspirin Therapy

On aspirin therapy? Aspirin can interact with other drugs, causing side effects. Know your risks.

Compounding Aspirin's Risks

Aspirin is in a class of medicines called nonsteroidal anti-inflammatory drugs (NSAIDs.) This includes pain relievers like:

  • Ibuprofen (Advil, Motrin IB)
  • Ketoprofen (Ordus KT)
  • Naproxen sodium (Aleve)
  • Prescription medicines like Celebrex, Daypro, Indocin, Lodine, Relafen and Voltaren

While other NSAIDs do not have aspirin's cardiovascular benefits, they share the same risks. Aspirin and other NSAIDs can:

  • Raise the risk of certain strokes. While most strokes are caused by clots, some are caused by bleeding in the brain. Thinning the blood increases this risk.

  • Raise the risk of damage to the kidneys and liver. In general, kidney or liver damage is only a risk when using high doses of NSAIDs regularly. But people who already have kidney or liver disease should talk to their doctors before using them.

  • Trigger allergic reactions. Many people are allergic to NSAIDS. People with asthmaare especially at risk.

But the most common risk from NSAIDs is damage to the gastrointestinal tract. According to the American Gastroenterological Association, 103,000 people are hospitalized every year because of these side effects; 16,500 people die. And of all the people who are diagnosed with GI bleeding from an NSAID, a whopping 40% are taking low-dose aspirin, says Cryer.

What's worse, if you take aspirin and another NSAID regularly, you greatly increase the risk.

"Taking two NSAIDs -- like baby aspirin for heart protection and ibuprofen for pain relief -- increases your risk of gastrointestinal bleeding by nine times," says Cryer.

Safe Pain Relief When You're on Aspirin Therapy

So if you do take daily aspirin, what are your options the next time you pull a muscle or get a headache? Luckily, you don't have to grin and bear it.

One over-the-counter option is acetaminophen, which is sold as Panadol and Tylenol. It is not an NSAID: it works differently and has different risks.

For more severe pain, Cryer says that you could turn to prescription narcotics. These include drugs like OxyContin, Percocet, and Vicodin.

However, these drugs have drawbacks as well. First of all, none of them will help with swelling. High doses of acetaminophen regularly can cause serious liver damage. Narcotics taken regularly have other side effects, including constipation and a risk of addiction.

But what if you have arthritis and a risk of heart attack? What if you need both a daily aspirin and an NSAID for pain and swelling?

Then there's another option, says Cryer. You could also take a proton pump inhibitor. These drugs -- like prescription Aciphex, Nexium, Prevacid, Prilosec, and Protonix and the over-the-counter Prilosec OTC -- reduce the amount of acid in your stomach. This lowers the risk of ulcers or bleeding, even if you are taking aspirin and another NSAID.

Aspirin Therapy: Working With Your Doctor

Cryer and Barr both say that we should not lose sight of aspirin's benefits.

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