I have been reporting on the side effects of NSAID drugs like Ibuprofen for a while. While many patients cannot live without it, it is still prudent to consider alternatives to pain therapy, especially when these drugs have not been started. The least we could do is warn patients about these drugs readily available without a prescription.
To recap, NSAIDs have been associated with kidney, liver, cardiovascular, hematologic, neurologic, and gastrointestinal problems in addition to many other less serious problems. Other than that, they are OK. Other than that, how was Dallas, Jackie?
Knowing that our male-dominated society often confuses the gonads for the brain, perhaps this article will lead to changes in the way we view these drugs:
Ibuprofen may have negative impact on testicular health
“NBC Nightly News (1/8, story 11, 0:25, Holt) reported, “A new study finds that men who take high doses” of ibuprofen “for months at a time may be at greater risk of fertility problems and other health issues.”
CNN (1/9, Scutti) reports that in the study, 31 male patients received either 600 milligrams of ibuprofen two times per day or a placebo. Among the participants given “ibuprofen, within 14 days, their luteinizing hormones – which are secreted by the pituitary gland and stimulate the testicles to produce testosterone – became coordinated with the level of ibuprofen circulating in their blood.” Meanwhile, “the ratio of testosterone to luteinizing hormones decreased, a sign of dysfunctional testicles.” According to CNN, “This hormonal imbalance produced compensated hypogonadism, a condition” linked to “impaired fertility, depression and increased risk for cardiovascular events, including heart failure and stroke.” The research was published in the Proceedings of the National Academy of Sciences.”
Non-steroidal anti-inflammatory drug use in chronic pain conditions with special emphasis on the elderly and patients with relevant comorbidities: management and mitigation of risks and adverse effects
European Journal of Clinical Pharmacology 2014;70:1159–1172
“NSAIDs are a leading cause of drug-related morbidity, especially in the elderly and patients with comorbidities. Most adverse effects are related to generalized inhibition of the major targets of NSAIDs: cyclooxygenases I and II. These enzymes are not only involved in pain and inflammation pathogenesis but are also required in the gastrointestinal (GI) tract for mucosal protection and gut motility, and in the kidneys for functional integrity. Thus, the mechanisms of NSAID toxicity are well understood, but the consequences are largely uncontrolled in clinical practice. GI ulcers, including bleeding ulcers, may occur in several percent of all chronic unprotected, high-dose NSAID users. Renal side effects may precipitate renal failure, resulting in acute dialysis and chronic retention. This includes sodium retention, resulting in arterial hypertension, heart failure, and atherosclerotic events. Cardiovascular risk may be tripled by chronic high-dose NSAID use in long-term clinical trials though “real-life studies” indicate lower risk ratios. Off-target side effects include allergic reactions, drug-induced liver injury, and central nervous system effects.”