Non-Steroidal Anti-Inflammatory Drugs, or NSAIDs, are commonly used in Pakistan as pain killers. The doctors often prescribe them, but that’s not all. Many people also self-prescribe NSAIDs because they are readily available over-the-counter. In some circles, this medicine is also referred to as a magic drug for every pain (hardardkidawa).
Most of the time, NSAIDs, like Ibuprofen, Piroxicam, Nimesulide, are used for toothache, back pain, joint pain, menstrual cramps etc. Dentists frequently prescribe them and the pharmacists routinely give them away to the patients experiencing pain. NSAIDs are not only one of the most sold over-the-counter medicines in Pakistan; they also have no monitoring or oversight.
But, as they say, excess of anything is bad. There is a rising trend of increasing heart patients in Pakistan. While our lifestyle, food intake, and pollution are among the critical factors for this trend, one cannot deny the role NSAID drugs play in perpetuating specific heart issues. Many of our beloved ones may end up in the ER with a high blood pressure crisis at a range (above 180 Systolic / 110 Diastolic) that may adversely affect vital organs.
“We see too many patients with renal failure or exacerbating heart disorders because of unmonitored usage and self-prescription of NSAID drugs.” Says Dr IbtisamAli,who works at emeds pharmacy, “I would urge caution to the patients. Please do not take them without your physician’s advice. They are not to be self-prescribed.”
The risks with extended use of NSAIDs is high in the longterm. They are frequently associated with renal disease, increased blood pressure, heart disorders, and peptic ulcer disease.
1.Cardiovascular Disorders
Other than aspirin, all NSAID drugs increase the risk for heart attack, stroke, or high blood pressure. Platelets are blood cells that prevent bleeding by helping the blood clot. NSAID drugs prevent the platelets from working correctly, leading to an increase in adverse cardiovascular events.
There is growing evidence that non-aspirin NSAIDs increase the potential for specific heart issues, such as heart attack, heart failure, stroke, and atrial fibrillation. Please keep in mind that the risk is minimal for people without an existing heart condition. If you take this medicine in moderation, you will be just fine.
Due to their thinning effect on the blood, people taking blood thinners must also avoid using NSAIDs.
2.Hypertension
Prolonged NSAID use may cause water and sodium retention, which may lead to alterations in blood pressure. All NSAID medications increase blood pressure, whether you have a pre-existing condition or not. They may also decrease the usefulness of some blood pressure medicines. Typically, NSAIDs increase blood pressure by 5mmHg.
3.Kidney Disorders
NSAID drugs can restrict the amount of blood reaching the kidneys. Lack of sufficient blood slows down kidney function. NSAID effect on the kidneys has links to Electrolyte imbalance, high blood pressure, and salt and fluid retention. Fluid retention is the most common NSAID kidney problem compared to the others.
A 2019 scientific study on NSAIDs found a slight but noticeable increase in the risk of kidney issues. This increase was dependant on the dose taken by the patient. Various studies have shown that NSAIDs may increase the risk of kidney damage or outright failure. It is better to seek alternative medicine if you have a pre-existing kidney condition.
4. Stomach Disorders
Various stomach problems can result from the reckless use of NSAIDs. In fact, stomach problems are the most typical side effect of NSAID drugs. They include;
- Diarrhoea
- Irritation or pain
- Flatulence
- Nausea
- Heartburn
- Bleeding and ulcers
Patients with existing ulcers or a sensitive stomach must avoid taking NSAIDs. If they do, they may exacerbate their condition. People above 65 are particularly at risk of stomach problems from NSAID, especially if they are also taking blood thinners or corticosteroid drugs.
As a precaution, you can take NSAID drugs with food, milk or antacids. These may help lessen the risk of side effects. Moreover, please avoid drinking alcohol with NSAIDs to lower the risk of internal bleeding.
Something to look forward to: NSAIDs that release nitric oxide are under development. They may minimise stomach problems associated with NSAID use.
How To Minimise The Risks?
- Do not self-medicate.
- Take the least effective dose for the shortest duration of time.
- Patients with pre-existing heart, kidney, or high blood pressure condition must inform their physician beforehand. Take the dose exactly as prescribed in the precise quantity.
- Ask your physician for an alternative medicine if you feel uncomfortable with NSAIDs.
- Despite the risks, long-term consumers must not stop taking NSAIDs immediately.
Interesting Facts About NSAIDs
A study in 2018 indicates that NSAIDs are some of the most commonly prescribed medications in the world for pain and inflammation. They make up from 5 to 10 per cent of all prescriptions filled every year. It also notes that close to 7.3% of elderly patients (above 60) filled at least one NSAID prescription in the last year alone.
How NSAIDs Work?
Non-steroidal anti-inflammatory drugs work by blocking the production of a specific chemical that causes inflammation in the body. They help treat pain caused by arthritis, menstrual cramps, migraine, etc. In their work, NSAIDs are pretty similar to the class of drugs known as corticosteroids. Except, they do not cause as many side effects. NSAIDs are especially effective in dealing with the pain associated with joint and muscle disorders and injuries.
How Long is it Safe to Use NSAIDs?
Unless your doctor says otherwise;
- Do not use NSAID to treat fever for more than three days.
- Do not use NSAID to treat pain for more than ten days.
NSAID drugs are available for purchase over-the-counter. However, they are meant for short term use only. If your doctor prescribes NSAIDs for a more extendedperiod, you should still watch for side effects. You can insist upon an alternate treatment from your doctor if you do not feel comfortable with it.
What Have You Learned?
NSAIDs are excellent drugs to bring relief from chronic pain. But like other medications, they also have some side effects. Be very careful when self-prescribing. Seek an alternative treatment if you have an existing heart, high blood pressure, stomach or kidney condition.
Discuss all your ailments and medications with your doctor. Do not take for more than 3 days for fever and 10 days for pain. Finally, NSAIDs are well-researched drugs and very commonly used. There is no need to be paranoid. As long as you follow the precautions and buy original medicine from a reputed outlet, like emeds.pk, you will be fine.