Are Anti-Inflammatory Pain Relievers Safe for You?
Here's help weighing the benefits and risks of NSAIDs, from aspirin to Celebrex
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.
"We act as if heart disease, gastrointestinal problems, and chronic pain are all completely unrelated conditions," says Cryer. "But there's a lot of overlap, especially in older people."
If you're seeing a number of experts, you might be getting a lot of contradictory advice. Cardiologists who treat heart problems tend to focus on the risks of NSAIDs. Rheumatologists who treat arthritis tend to focus on the benefits.
"We don't have the same perspective as cardiologists and other specialists," says rheumatologist Klippel.
The problem is that your body can become the battleground for these specialist skirmishes.
"I'll have patients with heart failure who are doing fine for months," says cardiologist Goldberg, "and then all of a sudden, their symptoms get worse. Their blood pressure goes up or their ankles are swollen. And we eventually figure out that it's because their orthopedic specialist prescribed an NSAID."
"Getting these people the correct medicine requires a careful balancing act," says Goldberg.
The Bottom Line: Coordinate Your Treatment
Because specialists have different perspectives on your health, it's important to get them all on the same page.
"If you're confused by conflicting advice about NSAIDs from specialists, get them to talk to each other about your case," says rheumatologist Scott Zashin, author of Arthritis without Pain and Clinical Assistant Professor at the University of Texas Southwestern Medical School.
You might ask your primary care physician to coordinate the advice from all the different specialists. If your primary care doctor does not have the time, keep a list in your wallet of all the medications you take, and show the list to every doctor at every appointment. In a rush? Just throw the bottles in a bag and bring them along, says Goldberg.
Once your doctors understand the bigger picture, there are ways that they can collaborate to avoid or reduce the side effects from NSAIDs.