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Over-the-Counter NSAIDs Carry Significant Gastrointestinal Risk
Full Title
Risk of serious upper gastrointestinal toxicity with over-the-counter nonaspirin nonsteroidal anti-inflammatory drugs.
Summary
This study assessed the risk of serious upper gastrointestinal toxicity from over-the-counter (OTC) non-aspirin NSAIDs such as ibuprofen and naproxen. The researchers recruited 359 patients hospitalized for upper gastrointestinal bleeding, perforation, or benign gastric outlet obstruction from 28 hospitals, along with 1,889 control subjects. The study found that OTC NSAID use was associated with a significantly increased risk of serious upper gastrointestinal complications. Even though OTC NSAIDs are typically used at lower doses and for shorter durations than prescription NSAIDs, they still carried meaningful risk. The risk increased with higher doses and longer duration of use. Importantly, many patients who experienced GI complications had been using OTC NSAIDs at doses that are commonly considered safe for self-medication. The study also found that the risk was elevated even with short-term use in some cases, particularly when multiple doses were taken throughout the day. These findings are particularly relevant for individuals managing soft tissue injuries, who may take OTC pain relievers for extended periods while recovering. The results support the recommendation that even over-the-counter NSAIDs should be used judiciously, taken with food, limited to the lowest effective dose, and timed to avoid periods of activity where pain masking could lead to reinjury.