Pain is part of the human condition. Sometimes it can be useful, warning us to keep our hands away from flames and sharp tools. Recurrent or chronic pain is not helpful, but it can be extremely difficult to treat. Many people who experience arthritis, bursitis or regular headaches, for example, cope with their pain by taking ibuprofen.

We have written about serious side effects of NSAIDs (nonsteroidal anti-inflammatory drugs). An article titled “Should We Ban Ibuprofen?” stirred up quite a lot of anger amongst our readers:

Should We Ban Ibuprofen?

The Other Side Responds:

Q. Ibuprofen is the only pain medication that works to stop an absolutely debilitating pain that I get. Thankfully, it does not occur all of the time but when it hits, Advil works. I have tried aspirin and Tylenol, and neither works for me. I don’t know what I would do without it.

A. There are others who feel as you do that ibuprofen makes their lives bearable.

Jane in Erie, PA agrees:

“I don’t believe in banning NSAIDs or making them Rx only. People need to read, learn, and take responsibility for what they put in their mouths! I am a celiac patient and am not asking for a ban on gluten.

“Get a grip. I am sick of Big Brother telling us what we can and cannot take! Banning NSAIDs is ridiculous! Get educated, people!”

Klara in Atlanta:

“I agree with Jane from Erie PA. LEAVE IBUPROFEN ALONE! I don’t take NSAIDs on a regular basis, but I keep them around for occasional aches and muscle pain and they’re wonderful. I hate it when Big Brother takes a perfectly good OTC medicine away from us or makes us go through gatekeepers to get it. Don’t patronize us! Let everyone decide for himself whether to take it or not.”

NSAID Dangers:

We understand that people in pain deserve relief. NSAIDs can help with pain and inflammation. But these are not fabulous drugs. Dr. Steve Nissen, one of the country’s leading cardiologists, shared results from an arthritis study he and his colleagues conducted. They reported that ibuprofen, naproxen and celecoxib were only modestly effective, lowering pain about 13 points out of 100. That’s something, but hardly a home run.

Anyone who takes ibuprofen or other NSAIDs on a regular basis should be aware of the hazards. They include heart attacks, strokes, cardiac arrest, hypertension, atrial fibrillation, congestive heart failure, kidney damage, kidney disease, liver damage, blood disorders and serious digestive tract problems.

NSAIDs and Bleeding Ulcers:

One potentially life-threatening GI complication is bleeding ulcers. A reader wrote:

“Both my mother and my mother-in-law almost died because of ibuprofen. I told the ambulance driver I thought my mother was bleeding internally; she was! She almost died. Something similar happened to my mother-in-law.”

Greg the pharmacist in Toledo, Ohio, shared his perspective:

“I friend of mine recently ended up in the hospital with ulcers up and down his esophagus from taking high doses of OTC NSAIDs over several months.

“Some doctors question if NSAIDS might do damage to cartilage and stop healing over time.

“Unfortunately Rx to OTC moves are usually done to make money and are not in the best interest of the public.”

NSAIDs and Kidney Damage:

Bob in Chapel Hill, NC, had a different problem:

“I had to stop regular use of naproxen because of kidney damage. After 40 years of practice in orthopedic surgery and stopping the prescribing of butazolidin because it caused leukemia and a number of others because those NSAIDs caused heart attacks, I had to stop what I thought was ‘Safe’!”

The People’s Pharmacy Perspective:

NSAIDs can help ease pain and it is clear that many people rely on them regularly. We also know that some people end up with heart attacks, strokes and perforated ulcers and that such side effects can come on suddenly with little, if any, warning. We hope that consumers will use good sense when taking drugs like ibuprofen: using the lowest dose for the shortest period of time.

We posed a theoretical question in our last article and we would welcome your response:

“Imagine for a moment that a popular herb or dietary supplement was linked to heart attacks, strokes, kidney damage or perforated ulcers. The FDA would announce to the world that there was a deadly herb loose in the land. Public health warnings would make headlines and the feds would almost assuredly ban the product from health food store shelves.” 

Why should there be a double standard for OTC drugs compared to herbs or dietary supplements?

To read more about ibuprofen and other NSAIDs and why people were so upset, here is a link to our previous article:

Should We Ban Ibuprofen?

Please share your thoughts below in the comment section.

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  1. Walt
    CO
    Reply

    I took NSAIDs for several years due to chronic low back pain. Later in that period of time I started to develop skin lesions on my face. These were absolutely horrible, everything from bleeding pimple-like sores to open ulcers that would not heal. I went to about five different derms, plastic surgeons, GP’s during that time and all were mystified. Yes, I filled out my history accurately but no one drew a connection between NSAID use and skin lesions. Then one day I did a search which triggered the association… do your own search, “NSAIDS and skin lesions”. It’s right there, although a rash is more commonly mentioned than lesions. Most people with this issue get them on their hands and arms, but I got them on my face. 10 days after withdrawing from NSAID use entirely my skin had cleared. The one GP I ultimately talked to about this afterwards confirmed the diagnosis and noted that he had seen this in the literature but forgotten about it. Bottom line, if you’re having unexplained skin problems and are taking NSAIDs quit immediately and give it 10 days. These are NOT benign substances.

  2. oldetimer
    Baltimore
    Reply

    Not too long ago I fell and injujred three ribs. After about a week the pain was so excruciating; I could not function. An RN who was treating me for other issues advised me to take Ibuprofen 800 mg. twice a day. It’s effect was amazing. Each dosage is effective for approximately twelve hours. There is some underlying residual remaining but I can function rather well. In life, almost everything involves a trade-off; in medicine it is the relationship between receiving effective treatment and the possibility of side-effects and longer term problems from the drug(s). Get as much information as you can (or as reasonable) from people, especially in the medical profession and other, and reach your own conclusions, If ir turns out the the cure is worse than the disease, you can always go back; discontinuing the new drug or reducing the dosage and/or trying another drug that you have reason to believe might worrk.

  3. Carl
    Charlottesville, VA
    Reply

    I am a physician in practice for 35 years. I take 400 of ibuprofen every morning for my mild low back pain (otherwise healthy), a modest dose; doing it for a decade (no GI problems). Contrary to the recently published evidence on NSAIDs in back pain, it helps a little bit (which is all i really want). I am sure that that getting up and moving is what really helps. I occasionally (every 1-4 wks) take another 200 or 400mg for different ache or pain (after running 10-miler). If i take more i notice that nicked skins bleeds a little longer. A warning on excessive doses (>800mg?) or for someone with CV disease is reasonable, but to make it a prescription item after no major problem in this country would be an excessive response. I agree that availability in only in drug stores only would be reasonable (are there laws about it being sold in truck stops, etc). Considering the opioid crisis, it is not a good time to eliminate an effective analgesic, but caution is reasonable. BTW, NSAIDs work really well for mucosal irritation (after endoscopy or cystoscopy).

  4. Sarjula
    Reply

    Ibuprofen is the only one works with my migraine headache, never think about banning. Everything has side effect, just use smaller dose and proper judgement.

  5. William
    Portland
    Reply

    As an alternative I wonder what the relative safety and effectiveness of enteric coated aspirin taken on a “chronic” basis for pain might be?

  6. KM
    Reply

    I take the generic form of Pseudaphed for my chronic allergy sinus swelling and eye weeping…I have to get it from the pharmacy counter AND it is regulated because drug abusers turn it into meth-a street drug. I refuse to use any allergy drug OTC or otherwise, as they all have too many side effects.

    I merely treat the worst of the symptoms with either the decongestant or an aspirin to reduce inflammation. I DO NOT think that Ibuprofen should be banned but, seriously, it and other OTC pain relievers need to be more regulated! People need that “pause” to remind them that they need to THINK before medicating.

  7. Peggy
    Illinois
    Reply

    I think it would be wrong-headed to make the common over-the-counter pain relievers available only by prescription. They have been in use, for the most part safely, for years, and people do not need to have to see a doctor and get a prescription every time they have aches and pains of the sort ordinarily treated with these remedies.

    It is difficult and expensive enough already, to get in to see a doctor, and some doctors are less than happy to have their valuable time taken up by minor problems we now routinely take NSAIDs for.

  8. Angela
    Portland, OR
    Reply

    It’s still the only pain reliever that works for me. After surgery I could not take the hospital’s pain reliever as it made me sick to my stomach. So Advil is my go-to pain reliever. I only use it when it’s all that will work for me. I have tried everything through the years to find another pain reliever. Most of the pain I feel I don’t take anything, if it’s manageable. Just when I don’t have a choice. I don’t know what I would do without this option. The other thing is…I don’t trust the FDA that much. Not that they are lying about this, but I would suspect most of what they say.

  9. Linda
    Reply

    My thoughts are that we have natural remedies some of which our own body makes – due to soil depletion keeps our bodies from getting the necessary requirements WITHOUT subjecting our bodies to other side effects.

    My brother in law had a liver transplant in 1996 however had extreme pain with gout and took Alleve resulting in becoming a dialysis patient due to the kidney damage around 2012.

    MSM (sulphar and our bodies require it – our nails teeth connective tissue & joints; hair all need it ) and our bodies require it to live. THE CATCH: Soil depletion prevents us getting necessary amounts which contributes to pain. A person can take huge doses of this natural element. Dr Stanley Jacob did the studies on MSM at Oregon Health Sciences University focusing on “itis” types of pain; bursitis, osteo arthritis rheumatoid arthritis

    SERRAPEPTASE which is a digestive enzyme made from a protein in stomachs of silkworms. This wonderful enzyme cleanses the body of phlegm, pain and inflammation. It also has been proven by Dr Hans Napier a famous German heart Dr to cleanse the plaque out of the veins and arteries. If you have scar tissue which usually lays around nerves the scar tissue presses on the nerves causing pain. I can personally attest that every scar on my body no longer has scar tissue clear back 65 years ago in which my appendix was removed leaving a raised scar for 61 years. The scar is barely seen now.

    ALKALINE WATER: due to the strong odors of chlorine in my house water I recently purchased a Cerra water pitcher that filters your drinking water. OMG my first discovery was I noticed a real improvement with joints. SIDE EFFECT: my house plants have gone nuts with growth.

    SOLE’ made with filtered water and Himalayan pink salt works great on healing the swelling. Look it up. There are many minerals in the salt that is required by our bodies.

    TART RED CHERRY TABLETS or Juice: excellent and tastes wonderful

    Activated B-6 (P-5-P) is really great for nerve problems in the hands and feet – carpal tunnel. Good to take with a B complex tablet

    TUMERIC (curcumin with biopurine) is having amazing research results right now with fighting cancer but also is great for pain relief.

    COLLOIDAL SILVER (I bought my own generator and make my own) really helps with joint pain when taken with curcumin with biopurine, P5P Serrapeptase MSM Tart red cherry and becomes like a healing cocktail in the body taking away pain and inflammation. I do take all in tablet form when drinking my colloidal.

    I sometimes feel my body attacking itself and it starts out with deep chills and loss of energy and bloating. Now when that happens I go take my cocktail and go to bed early waking up feeling really good.

    Maybe this cocktail costs me more than an Alleve or other NSAIDS but I know that all of the things I do take are healing ne not causing me a lot of other problems.

  10. Sharon
    USA
    Reply

    I had written in about your other articles on this subject but did not see my comment ever published. I too greatly FEAR the side effects of Advil, Motrin, Tylenol AND aspirin—think brain and stomach bleeds, sometimes fatal! I feel we ALL know how dangerous all these NSAIDS, acetaminophen and aspirin also ARE—but the question is—WHAT is the answer to people in chronic daily pain?

    If they take Rx pain meds, it can kill you. If you take the over OTC things we are talking about in this article, they can also maim or kill you? Many time alternative and natural medications just don’t touch chronic pain. So what is a person supposed to do? One thing is for sure, we are all going to die one way or another. I just don’t see what the answer can be if you are in serious pain all the time since there is really NO safe answer!

    I tried turmeric and curcumin which made me nauseated all the time and can cause bleeding. To me, there is really no safe answers to these questions……especially in advancing age. We HAVE to have something to relieve pain.

  11. Lorraine
    NH
    Reply

    I do believe that any herb, or homeopathic self-treatment showing stats found self-treating with Ibuprofen, would have a very public and negative response, as People’s Phcy states. And, yes, careful, cynical evaluation of risks and benefits are the choice of the consumer. Unfortunately, money is on the side of marketing of the product and the profit return to the manufactureres of said product. Often, until you experience the pain of a loss attributable to organ failure that can be traced to frequent regular use, and/or high doses of NSAIDS, you don’t pay attention. Common sense, careful evaluation, lowest dose.

  12. Ruth
    MD - Maryland
    Reply

    My husband was taking Motrin on a regular basis after he had back surgery because he didn’t like the way the prescribed medication made him feel. He did end up with a bleeding ulcer and was told to never take ibuprofen of any kind, again. I had shoulder surgery two months ago and never did take the prescribed medication for pain only Motrin.

    I’m still having a lot of pain after all of this time and the doctor told me to take three-four Motrin three times a day for at least a week or longer. Didn’t happen, not going to. I do take it but maybe two, sometimes three, once sometimes twice, a day and am very hesitant doing that since the incident with my husband. I have no other alternatives so I will continue to take it and certainly hope that it will not be banned.

  13. Leslie
    Chicago
    Reply

    I suffer from arthritis pain that makes it hard for me to breathe some days. NSAIDs work, but I’m definitely anxious about what I’m doing to my liver and kidneys and the risks of bleeding ulcers or cardiac problems. Over the counter status would make it necessary for a pharmacist to review the side effects and check for bad drug interactions. I don’t love the idea, but there’s merit in considering it.

  14. Gerry
    F
    Reply

    The drug czars just want something else to charge us for. They hate to think anything is out of their control.

  15. Michele
    Marietta, GA
    Reply

    I’ve been using 800 Motrin for as long as it’s been available. I remember seeing a Mayo Clinic TV Special and they used it as a first try against pain. It was their go to pain reliever. It ALWAYS helps my pain. After two shoulder surgeries I took two Hydro-condones then only 800 Motrin. Doctor couldn’t believe I wasn’t taking the Hydro-Codone. Same with my knee replacement.
    Please leave what works alone!!!

  16. Anne
    Wisconsin
    Reply

    It seems to me that almost anything can be abused. I take ibuprofen every so often for muscle pain. It was the only thing that worked for menstrual cramps when I was young, which could otherwise be debilitating. We know quite a bit about NSAIDs, and I think it’s imperative to keep the public informed of side effects. However, the problem is, they also work extremely well, as long as people understand they are only safe for short-term use.

    Herbs are not in that category, I believe. Some people think some herbs work for certain things, but they never get the intense study most OTC drugs seem to get. Also, there doesn’t appear to be any standardization for herbs. I know some people swear by them, but I can’t think of any that have ever worked for me. I’m not even aware of any the FTC has banned, and I’m betting the majority of my friends and family aren’t either. On the other hand, I think most people know it’s not safe to use NASAIDs for an extended time. If not, then maybe this is the real problem.

  17. Cheryl
    Houston
    Reply

    It seems like the powers that be are gradually banning OTC drugs that are my only option. I cannot take acetaminophen because it causes a terribly itchy rash that moves from my legs to my torso the longer I take it.

    For those infrequent times I need a pain reliever, I take ibuprofen. If that is taken away, I will have to either pay for a doctor visit to get a prescription or need to find “natural” pain relievers that work but more slowly. That is the case for me with other medications that have been banned. I am all for educating the public to be responsible rather than taking away all drugs that have side effects for some.

  18. Bonnie
    NC
    Reply

    I suffer from fibromyalgia and the only medicine that I can take to ease the pain is Ibuprofen. I will not take Opioids or any other prescription meds because of dependency. But my Drs have warned me of the side effects of Ibuprofen and I’ve had pharmacists tell me that they it can elevate blood pressure and that some brands have a high sodium content.

    Not knowing if this is true, I have still decided to curb my use of Ibuprofen. My Dr told me to use Tylenol but gave me the dosage warnings on that. So I will have to choose alternative paths for pain like water therapy, etc. My mother did suffer from a bleeding ulcer because of taking mass amounts of Ibuprofen for hip pain while she was working in a laboratory in a hospital.

    So, I know that the internal bleeding claims are grounded. But it was a huge disappointment to me to receive this news about cardiac problems because chronic pain is hard to bear otherwise.

  19. Anna
    West Virginia
    Reply

    You know what the most shocking double standard is with regard to supplements? It’s that they’re UNREGULATED to begin with and that contents do not have to be certified and that we have absolutely no clue how much damage they could do (think liver and kidneys) when we mix and match them. But natural is benign and supplement pushers are honest in the public’s mind. Pfffft.

  20. GERONAMO
    JUPITER
    Reply

    Headaches are usually caused by low blood sugar.
    (glucose) if one stops eating or skips eating or eats out of phase the digestion system stops producing sugar!! The brain must have sugar (glucose) to survive and nature (God) has endowed the human body with this alarm system (headache) to warn us our brain is in danger of damage by low glucose!!!
    When young women menstruate they sometimes feel bloated and as a result they stop eating and the menstrual headache results. The same effect ” low blood sugar (glucose) headache!!! And, there is a cure; simply eat about a level teaspoon of sugar or something sweet like honey and wait about an hour and the headache is gone!!! And the same thing sleeping late right thru breakfast!!! The Saturday or Sunday morning headache!!! And, of course, there the acetaldehyde – alcohol headache not the wine sulfites that cause the headache. Acetaldehyde is a toxic poison which is neurotoxic!!!

  21. Sherry R.
    Waxhaw, NC
    Reply

    The old adage “You can lead a horse to water but you can’t make him drink” fits this article perfectly.

    People just want to feel better so they take any drug even if it may be dangerous to another part of their body. You can tell them but they don’t care especially if their doctor says “don’t worry, it won’t harm you”!
    Please keep on writing about every drug with bad side effects! If just one person listens, you have at least saved one life!

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