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Healthy Living - WABI

 

NSAIDs

We've heard that Vioxx is bad for you. Now we are hearing that Naprosyn is bad for you. The questions to ask are why are they bad, how are they different, and what is good for me?

NSAID's (NonSteroidal Anti-Inflammatory Drugs) are used to treat pain, fever, and swelling/inflammation. This class includes aspirin, ibuprofen (Advil), naproxen (Aleve), ketorolac (Torodol), and many more. These drugs have their effects by blocking an enzyme called cyclo-oxygenase. There are two forms of this enzyme known by their nick-names as Cox-1 and Cox-2. NSAID's block both Cox-1 and Cox-2. By doing this these drugs reduce inflammation which reduces pain. However, they also cause side-effects such as bleeding of the stomach. By developing a drug that blocks only Cox-2, we are able to reduce the risk of bleeding in the stomach (GI bleeding). This is what some drug companies did. These drugs are known as Cox-2 inhibitors.

Vioxx is one of the Cox-2 inhibitor drugs and is related to Celebrex and Bextra. It was marketed for people with arthritis who needed an anti-inflammatory that they could take long term and would reduce the risk of GI bleeding. Unfortunately, it was withdrawn from the market because of an association with heart attacks. Cox-2 inhibitors increase the risk of heart attacks because they can increase blood pressure. However, all NSAID's can cause a rise in blood pressure. Therefore, if a Cox-2 inhibitor or NSAID is indicated, then it would be prudent to follow your blood pressure. If you develop hypertension, then either the drug can be stopped or you can start a drug to lower blood pressure.

Aspirin is an NSAID but it is quite different from the other NSAID's. This is probably why aspirin works so well at protecting the heart. It also reduces the risk of colon cancer.
Naprosyn and Aleve are in the same class of NSAID's and are closely related.

All NSAID's have varying degrees of reducing inflammation, pain, and fever. They also may cause fluid retension, hypertension, GI bleeding, kidney problems, rashes, delayed wound healing, platelet problems, strokes, etc. Not every person will have the same effect from all drugs.

In summary, it is probably safe to say that all of these drugs are safe for short term use in healthy people. They may also be safe for long term use in unhealthy people with close physician supervision. That is a decision that can only be made with consultation between you and your physician weighing the risks and benefits.

One last note, acetaminophen (Tylenol) is not all related to any of the above drugs and does not cause any cardiovascular effects or affect the kidneys or reduce inflammation.




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