Pain reliever has good and bad sides


February 01, 1994|By Joe Graedon and Dr. Teresa Graedon | Joe Graedon and Dr. Teresa Graedon,Contributing Writers King Features Syndicate

Americans are in pain. We spend more than $2 billion on such products as Advil, Anacin, aspirin, Motrin IB and Tylenol. Now a new entry is ready to muscle its way into this crowded marketplace.

For the first time in a decade, shoppers will find an over-the-counter (OTC) pain reliever different from aspirin, acetaminophen and ibuprofen. This spring, drugstore shelves will make room for Aleve, an OTC form of the popular prescription arthritis drug Naprosyn (naproxen).

If past experience is any indicator, Aleve should be a hit. People love to buy products that were once available only by prescription. Sales of ibuprofen tripled when it went OTC.

Aleve is more convenient than other pain relievers. It is taken only twice a day, morning and evening, instead of every four to six hours as with other analgesics.

But naproxen has side effects, just like all anti-inflammatory drugs. It can cause indigestion, heartburn, nausea, constipation, stomachache and ulcers. It may also produce fluid retention, itching and skin rash, dizziness, headache, drowsiness or ringing in the ears. Older people are more susceptible to side effects, especially dangerous ones like bleeding or perforated ulcers.

Is Aleve worth the greater cost? If you are looking for headache relief or a way to ease sore muscles or stiff joints, aspirin is still the gold standard.

TTC It is also the cheapest of all pain relievers and offers some extraordinary advantages.

A major new analysis of 145 studies clearly establishes the benefit of aspirin for preventing heart attacks and strokes. Doses ranging from one baby aspirin (81 mg) to a single standard tablet (325 mg) protect high-risk patients from a wide range of cardiovascular complications. The experts predict that 100,000 lives could be saved worldwide each year if aspirin were used appropriately.

This study shows that many groups believed not to benefit from aspirin therapy (women, the elderly, people with hypertension and diabetics) gain the same protection as other high-risk patients.

These results and data demonstrating that aspirin may also reduce the risk of common digestive tract cancers make the inexpensive remedy a powerhouse among pain relievers. Acetaminophen, ibuprofen and naproxen have not been shown to lower the risk of heart attack or stroke.

Of course, this information comes as no surprise to some of our readers. Emil W. Elliott wrote: "I knew about aspirin back in 1939. A doctor friend told me aspirin was a blood thinner and people who use it are safe from heart attacks. The doctors have now found out that this is a real good drug, but I've known that for half a century."

As good as aspirin is, not everyone can benefit. Each over-the-counter pain reliever can have serious side effects, especially when taken for long periods of time. All can interact with other drugs.

We welcome the addition of a new option for self-treating pain. But we urge consumers to use all such medicines with care. While these drugs can bring relief, overuse can create serious problems.

Q. My drug bills are ruining me. I am a widow and an insulin-dependent diabetic. I also need blood pressure pills, and they are so high I have to buy them on credit. Now I have such a big bill I don't know how I'll ever pay it.

Medicare doesn't cover drugs and my doctor and hospital bills from a recent back operation are about to take everything I've got. My home is up for sale, but I haven't sold it yet. It's sad when you work hard all your life and then have to give it all away. Is there anywhere I can turn for help?

A. Our heart goes out to you and the millions of others who are hit with high drug bills.

We have received many other letters from people who are skipping medicines or cutting them in half to make them last longer. This is a danger to health, but these folks are desperate.

You may qualify for free medicine from the manufacturer. Although the programs are not highly publicized, most drug companies provide assistance to patients who can't afford their medicine.

You need to enlist your doctor's help in this effort. The number for him or her to call for information on assistance programs is (800) PMA-INFO.

Joe Graedon is a pharmacologist. Dr. Teresa Graedon is a medical anthropologist and nutrition expert.

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