Continued
Is there any way to pick the ''safest'' NSAID?
"I would say all are associated with risk," Creager says. "But it is dose related. The more you use, the greater the risk. None of them are really safe. The adverse events can happen within weeks."
"It was previously thought that all NSAIDs may have a similar risk," says Judy Racoosin, MD, of the FDA's Center for Drug Evaluation and Research. Although newer information makes that less clear, they don’t know enough to say now one is safer over another.
“The increased risk most often occurs at higher doses, so use the lowest effective dose for the shortest possible time,” Racoosin says.
Does this mean I should never use an NSAID?
No, Creager says. "We overuse these drugs today, that's the problem," he says. "I think the message here is, 'Let's be prudent in who is using [NSAIDs] and for what.'"
"I think people need to realize there is risk in using these drugs, and along with their physician they need to assess the risk and benefit," Creager says.
Quality of life has to be considered, McCarberg says. If patients are in pain, he finds, ''they become less social and have more sleep disturbances."
The FDA also advises consumers to read labels to make sure they are not taking several medications that contain NSAIDs. Higher doses carry a higher risk.
What is a safer alternative to an NSAID?
"It depends on why the drug is being used," Creager says. People who are taking NSAIDs for a headache can turn to other medicines, such as migraine meds, he says.
Those taking NSAIDs for rheumatoid arthritis, an inflammatory condition, can go on other drugs, too, but those drugs also have risks, he says. Quality of life has to be part of the decision, he agrees.
The FDA says that all medicines have potential side effects. It says consumers should talk to their doctor for advice on what medicines are best.
If I take an NSAID, what warning signs should I watch out for?