Vitamin I dangers

[Wyoming]

Everyone here probably already knows about the risks of taking large amounts of ibuprofen. That is you really should not take this stuff other than on rare occasions and definitely not daily. If you hurt so bad you can't walk without it you are broke and need to heal up a bit.

But since so many hikers take it frequently, if not several times a day, I thought I would post some links. BTW the Vioxx they talk about was the prescription ibuprofen.

http://www.counterpunch.org/2015/07/...rofen-and-die/

http://well.blogs.nytimes.com/2012/1...ofen-use/?_r=0

https://www.zocdoc.com/answers/10112...rofen-everyday

http://www.everydayhealth.com/drugs/ibuprofen

[OCDave]

... BTW the Vioxx they talk about was the prescription ibuprofen....

No Wyoming, Vioxx (Rofecoxib) was a selective COX inhibitor and an entirely different chemical from ibuprofen. Prescription Ibuprofen is identical to OTC ibuprofen simply in higher dose tablets.

[nsherry61]

If you hurt so bad you can't walk without it you are broke and need to heal up a bit.

Sorry. But I beg to differ.
I agree that taking daily NSAIDS without really needing them is not a very wise choice, and yes, there are people that take them out of fear more than need.
But, using NSAIDS to reduce mild joint inflammation that comes with extended heavy use of those joints, especially as we get older, is not just an issue of needing time off for injury recovery. We are dealing with a chronic mild joint swelling that will get worse to the point of incapacitating us (i.e. real injury) if we don't keep the mild swelling under control. It becomes an issue of either hiking with the NSAIDS or not hiking.

I'd rather die a painful and miserable death than stay alive and not live.

[burger]

I would just add that according to the new warnings, ibuprofen increases your risk of heart problems even if you are not currently at risk. That means that the warning applies to everyone.

Personally, even before this warning , I had all but stopped taking painkillers except for the worst pain and even then only briefly. While hiking, I find that I would rather know what is hurting than mask it with painkillers and risk making it worse.

[Wyoming]

No Wyoming, Vioxx (Rofecoxib) was a selective COX inhibitor and an entirely different chemical from ibuprofen. Prescription Ibuprofen is identical to OTC ibuprofen simply in higher dose tablets.

Ahh, my bad. I was prescribed it once and was pretty sure I was told it was prescription ibuprofen.

nsherry61 well you can do what you want of course. But you might read the links. Taking this stuff like many hikers and just the general population has been doing is not a good idea. When the data says the dangers start ramping up as soon as you start taking the stuff that should give one pause.

But i am not so concerned about us old guys - we hurt all the time anyway - and since we are old if we shorten our lives a bit it does not matter much. But I see 20 somethings eating vitamin I like crazy and used to caution against that long before the data on how dangerous it is came out. It is crazy for folks that age to be taking pain medication several times a day.

[Wülfgang]

I prescribe NSAIDS almost daily. There are risks, like any other drug.

Taking an Aleve a day or 600-800mg Ibuprofen a day for a few weeks is unlikely to pose any overt detriments to your health, UNLESS you have a preexisting condition like an ulcer, renal dysfunction, bleeding problem, etc that would be complicated by NSAID use.

For longer duration OTC NSAID use, there are concerns about not only GI problems like ulcers and bleeding, but also an increased incidence of CV events. By long term I mean daily use of higher dose NSAIDS for months or even years.

There is no magic number of weeks or months you can "safely" take NSAIDS. Most physician's "working opinion" is that infrequent use or shorter-term use will probably not confer any additional risk, but again, it depends on the individual and the dose.

Vioxx was a selective COX-2 inhibitor, while Ibuprofen is nonselective. Ibuprofen can potentially have some of the same risks as Vioxx did, but we don't really know how much or how long this would take to materialize. Keep in mind Vioxx was much more potent than "Vitamin I" and the manufacturer did not disclose certain safety concerns out of the gates.

Lastly, those links the OP posted are mostly tabloid garbage and don't tell the whole story. The FDA is covering it's as$, like it always does. We are seeing some new data that suggest SOME, but not all, NSAIDS confer significant cardiovascular risks. And some of the studies contradict each other. It's too soon to say what drug and how much is "bad". We just don't know yet. In the meantime, it's best to be judicious with your use of NSAIDS and ask your physician or PA if there are any risks specific to you.



[Disclaimer: this is my opinion only and should not replace the medical advice of your personal physician.]

[Coffee]

Personally, even before this warning , I had all but stopped taking painkillers except for the worst pain and even then only briefly. While hiking, I find that I would rather know what is hurting than mask it with painkillers and risk making it worse.

Exactly my sentiments. I've observed many people taking pain killers like candy as if there is no downside.

[Wyoming]

I prescribe NSAIDS almost daily. There are risks, like any other drug.

Taking an Aleve a day or 600-800mg Ibuprofen a day for a few weeks is unlikely to pose any overt detriments to your health, UNLESS you have a preexisting condition like an ulcer, renal dysfunction, bleeding problem, etc that would be complicated by NSAID use.

For longer duration OTC NSAID use, there are concerns about not only GI problems like ulcers and bleeding, but also an increased incidence of CV events. By long term I mean daily use of higher dose NSAIDS for months or even years.

There is no magic number of weeks or months you can "safely" take NSAIDS. Most physician's "working opinion" is that infrequent use or shorter-term use will probably not confer any additional risk, but again, it depends on the individual and the dose.

Vioxx was a selective COX-2 inhibitor, while Ibuprofen is nonselective. Ibuprofen can potentially have some of the same risks as Vioxx did, but we don't really know how much or how long this would take to materialize. Keep in mind Vioxx was much more potent than "Vitamin I" and the manufacturer did not disclose certain safety concerns out of the gates.

Lastly, those links the OP posted are mostly tabloid garbage and don't tell the whole story. The FDA is covering it's as$, like it always does. We are seeing some new data that suggest SOME, but not all, NSAIDS confer significant cardiovascular risks. And some of the studies contradict each other. It's too soon to say what drug and how much is "bad". We just don't know yet. In the meantime, it's best to be judicious with your use of NSAIDS and ask your physician or PA if there are any risks specific to you.



[Disclaimer: this is my opinion only and should not replace the medical advice of your personal physician.]

Informative comment. I would ask then about this. Many of the thru hikers are taking a lot more than 3 or 4 ibuprofens a day. From my conversations many are taking 8-10. On top of that many are not taking them for a week or two but more like 2-3 months with many pills a day. How would you address that?

[MuddyWaters]

When you need pain killers/anti inflamatories/fever reducers, you need them.

Theres tradeoffs in everything. Including sitting on the sofa.

[Wülfgang]

Informative comment. I would ask then about this. Many of the thru hikers are taking a lot more than 3 or 4 ibuprofens a day. From my conversations many are taking 8-10. On top of that many are not taking them for a week or two but more like 2-3 months with many pills a day. How would you address that?

Well its not without risk. A young body may bounce back just fine....or they could develop gastritis. People do some crazy things with meds either due to ignorance or just plain rebellion. If it was my own patient i would counsel them pretty strongly about the renal and bleeding issues, and the emerging cardiac concerns.

But ultimately many will take them rather than live with the pain, and i can understand that. All i can do is inform them carefully and be judicious in my prescribing.

Sent from my SM-G900V using Tapatalk

[Wyoming]

When you need pain killers/anti inflamatories/fever reducers, you need them.

Theres tradeoffs in everything. Including sitting on the sofa.

I would say that defining that 'need' could generate 20 pages of posts. I for one do not believe at all that most of the pain killers being taken are 'needed' at all. People tend to become dependent on them and often use them long after any physical need has been resolved. Our society through advertising and such promotes the widespread use of painkillers as in training people to think they should never feel any pain or discomfort. Many people are taking pain medication who only have minor issues and like coffee and burger mentioned it is often possible to do without them. I have had 4 broken vertebrae and a number of crushed disks. I hurt everyday. But I don't take any medication at all for it. I still hike (over 250 miles in the last month) and backpack (2 days this week).

I fully realize that some people must have them to remain functional. I just thought this post might be useful for some to generate some thought on whether they really should take them or whether they really 'need' them after considering the risks. Many don't seem to recognize that the risks are often substantial. I read the info on side effects and dangers on anything I am prescribed or consider buying. Most times I just put the stuff back on the shelf or don't use the prescription as the risks seem to outweigh the benefits quite often. I was so concerned about the Oxy prescription I was given when I left the hospital (especially since I was given the stuff via IV for a week in the hospital) I started cutting them down immediately and went cold turkey in about 10 days. Hurt like hell for a time but I adapted and got better. Some days I have to lay on the floor to be able to get my socks on and tie my shoes before I take off hiking.

[Bronk]

I have a friend who was on Vicodin for years due to joint and back pain. Recently the VA took him off of it and switched him to methodone because Vicodin has ibuprofen in it and they said the VA was taking everybody off of it because of the risks of taking NSAIDS long term.

[nsherry61]

Vicodin contains Acetamenophen, NOT ibuprofen. Acetamenophen is NOT an NSAID, so Bronk, there is a disconnect somewhere in the story about your friend.

[Another Kevin]

Vicodin contains Acetamenophen, NOT ibuprofen. Acetamenophen is NOT an NSAID, so Bronk, there is a disconnect somewhere in the story about your friend.

And that's an example of failed drug policy at its finest. The reason that Tylenol3, Vicodin, Lortab, Percocet, and so on are popular prescriptions is that they're on a lower rung of the controlled substance schedule - precisely because acetaminophen (Tylenol) is so dangerous. There's a very thin line between an adequate dose of acetaminophen and an overdose. And why are these drugs on a lower rung of the controlled substance schedule? Because they're so likely to poison an abuser. Of course, a lot of addicts don't know that or are desperate, so every ER gets its share of cases of acetaminophen poisoning.

Back on the subject of ibuprofen. I read at least one of the studies. The effect (an increase in cardiovascular events) was "significant," which means that it is highly unlikely that it can be ascribed to chance. It was also small in magnitude - the absolute difference in the number of events between the two groups was small, and the only reason that such a small difference could be significant was that the groups were so large. In short, I don't worry all that much. Remember that unrelieved pain is also a significant cardiovascular risk.

I'm not a believer in toughing things out, because reducing inflammation can help speed healing and reduce some collateral damage. Of course I'm writing this as someone who's been taking 2400 mg of ibuprofen a day, for the last three weeks or so. (On medical advice, for a knee sprain.) And I've been following the advice of taking it with food, suppressing stomach acid with an H2 blocker, and dividing into four doses of 600 mg rather than three doses of 800. I'm really looking forward to getting off it again, because that'll also be paired with not having to wear this Gottverdammt knee brace, and getting back to hiking.

[Ankle Bone]

Exactly my sentiments. I've observed many people taking pain killers like candy as if there is no downside.

Ditto on that. Pain is there for a reason. You either rest if needed or work through it.

I won't make it far without a heart, or a liver, or kidneys.

[colorado_rob]

I prescribe NSAIDS almost daily. There are risks, like any other drug.

...Lastly, those links the OP posted are mostly tabloid garbage and don't tell the whole story. The FDA is covering it's as$, like it always does. We are seeing some new data that suggest SOME, but not all, NSAIDS confer significant cardiovascular risks. And some of the studies contradict each other. It's too soon to say what drug and how much is "bad". We just don't know yet. In the meantime, it's best to be judicious with your use of NSAIDS and ask your physician or PA if there are any risks specific to you...

Thank you for being the Voice of Reason is this constantly debated subject. Even though I try to heavily discount such internet nonsense, I was slightly concerned when this was same exact subject was just recently "discussed", so I actually asked my sports doc (had appt. for physical therapy on an injury), and she said pretty much the exact same thing.

[Ankle Bone]

[QUOTE=Wülfgang;1991663] There are risks, like any other drug.

Exactly. Less drugs, less risk.

Rx free, that be me

[nsherry61]

Exactly. Less drugs, less risk.

Sorry, I can't resist the bait . . . B.S.

As a broad, all encompassing, statement, that is patently false!!
It may be true for you at this moment in your life, BUT, my type-1 diabetic son would be dead in a few days without multiple daily injections of insulin.

Also, there is positive feedback loop of minor inflamation leading to more severe inflamation and eventually genuine joint damage that can be mitigated by the responsible use of NSAIDS. To suggest that there is a one size fits all behavioral absolute (instead of a responsible range of effective behaviors) regarding the regular use of NSAIDS on the trail is, in itself, irresponsible, or at least naive.

Life is too short to spend it in bed recovering from minor injuries when many times you will even heal faster by taking a few anti-inflammatories and hiking on!

[Ankle Bone]

Sorry, I can't resist the bait . . . B.S.

As a broad, all encompassing, statement, that is patently false!!
It may be true for you at this moment in your life, BUT, my type-1 diabetic son would be dead in a few days without multiple daily injections of insulin.

Also, there is positive feedback loop of minor inflamation leading to more severe inflamation and eventually genuine joint damage that can be mitigated by the responsible use of NSAIDS. To suggest that there is a one size fits all behavioral absolute (instead of a responsible range of effective behaviors) regarding the regular use of NSAIDS on the trail is, in itself, irresponsible, or at least naive.

Life is too short to spend it in bed recovering from minor injuries when many times you will even heal faster by taking a few anti-inflammatories and hiking on!

There's a major difference between taking drugs for Type 1 or seizure prevention, etc. I get that.
To take convenience meds like NSAIDs to mask pain is pure BS in my book.
If you wish to take the risk, by all means do

[Wyoming]

Sorry, I can't resist the bait . . . B.S.

As a broad, all encompassing, statement, that is patently false!!
It may be true for you at this moment in your life, BUT, my type-1 diabetic son would be dead in a few days without multiple daily injections of insulin.

Also, there is positive feedback loop of minor inflamation leading to more severe inflamation and eventually genuine joint damage that can be mitigated by the responsible use of NSAIDS. To suggest that there is a one size fits all behavioral absolute (instead of a responsible range of effective behaviors) regarding the regular use of NSAIDS on the trail is, in itself, irresponsible, or at least naive.

Life is too short to spend it in bed recovering from minor injuries when many times you will even heal faster by taking a few anti-inflammatories and hiking on!

Well I must admit I am always surprised how easy it is here on WB to get folks all nasty and riled up. Sure seems worse than the typical website. Maybe hikers are just nastier than the general population. Guess it is good they are out in the woods most of the time.

I just thought it was a valid topic.

btw you conflated insulin with drugs to make an example. But most would not classify insulin as a drug at all.

And the discussion was about abusing 'pain' medications anyway and was not about all drugs.