Risks From Common Pain Relivers for Those 50 and Over

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Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Also known as ibuprofen (brand names Advil, Motrin) and naproxen (Aleve)

NSAIDs are another class of pain relievers sold over the counter. They’re helpful at reducing pain caused by inflammation — like arthritis or an athletic injury — and can also aid with fevers and mild pain from headaches and muscle aches.

But NSAIDs are not recommended for everyone, and older adults are often advised to avoid them, or at least use them with caution. That’s because they can come with a list of increased risks for people age 50-plus.

Bleeding, heart problems and other hidden dangers

Use of NSAIDs can cause bleeding in the stomach or in the digestive tract, which can come on without warning signs and can be serious. People who take NSAIDs every day or regularly are at increased risk for these adverse events, according to the FDA. The risk is also higher for adults older than 65, people with a history of stomach ulcers, and people who take blood thinners like warfarin or corticosteroids, such as prednisone.

Adults with blood pressure problems should know that NSAIDs can raise blood pressure. And all NSAIDs, except for aspirin, can increase chances of heart attack or stroke, even after the first few weeks of use. People who have cardiovascular disease are at highest risk.

NSAIDs have also been linked to kidney injury in older adults, “which is something I really worry about, too,” Thompson says. “As we age, we really depend on [lipids in the body called] prostaglandins to keep the blood flow to our kidneys. And the way [NSAIDs] work is they inhibit those prostaglandins,” causing the blood vessels to constrict, which can result in kidney injury.

Finally: NSAIDs carry the risk of potential skin reactions, the FDA warns. Patients should be on the lookout for symptoms of skin reddening, rash or blisters.

“So you really want to leave [NSAIDs] as kind of your last choice, which is interesting, because most people go to these first. But when you’re over 50, this one needs to start moving down the list, versus something like a Tylenol,” Garling says.

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