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radioactivemagic t1_ix5kkad wrote

Reply to comment by BZRich in Do NSAIDs reduce neuroinflammation? by One-Garden-1294

There's also evidence emerging that suggests NSAIDS, even OTC, carry similar cardiac risk to VIOX, which makes sense given most are COX-2 selective nonsteroidal anti-inflammatory drugs.

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mwebster745 t1_ix5w0yu wrote

Yes but also significant evidence the risk of naproxen is significantly less, and mixed evidence as to if it really breaks from placebo or not. Thought to relate to the platelet related inhibition like ASA has

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lambertb t1_ix5ui9t wrote

It’s more than just emerging. There is an FDA mandated warning on the label about increased risk of stroke and heart attack, in addition to bleeding, and kidney damage. NSAIDS are not generally safe drugs.

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Duckboy_Flaccidpus t1_ix5zeq1 wrote

All this seems to fly in the face of something like Bayer aspirin that says it helps to reduce heart attacks and can be prescribed a small dose daily to aid in continued blood flow.

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15MinuteUpload t1_ix6bo7m wrote

Aspirin has a different mechanism compared to other NSAIDs and does in fact have well-studied benefit in heart disease protection and clot risk. That being said, that benefit is likely less than previously believed due to more recent studies and evidence and it does not come without risks, but it certainly exists.

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lambertb t1_ix67fdw wrote

It’s complicated. Aspirin is an NSAID, but not Al NSAIDS are the same with respect to adverse effects. Aspirin has cardiac benefits because it’s an anticoagulant. The same basic effect is why NSAIDS can cause bleeding strokes. I can’t explain all the mechanisms. I just know it to be true.

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jaldihaldi t1_ix6ojvo wrote

Though ibuprofen might cause green in high blood pressure patients?

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55peasants t1_ix6y51o wrote

Asprin inhibts COX-1 more than COX-2, last time I read up on it, this was the theory on the difference on cardiovascular safety

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EmilyU1F984 t1_ix7kzvu wrote

Why did anyone even think that? Coxibes cause cardiovascular risk through Cox2 inhibition. All nsaids so that to some degree, or they would be useless. So all NSAID’s have cardiovascular risks associated with them, proportional to dose and duration.

Meaning they are generally save if used according to OTC ‚rules‘ over here: no more than 3 days for fever. No more than 4 days for pain, and not for frequent pain/fever without a physicians recommendation/prescription.

Selling 500 count bottles obviously doesn‘t help making them not look like candy.

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lambertb t1_ix7w4t1 wrote

Agreed that they are generally safe when used as directed. But they are contraindicated in anyone with kidney disease, and probably a poor choice for anyone with cardiac risk, bleeding risk, or stroke risk, which in the US, is a lot of people. Sadly, there are no safe pain meds. It’s all risk/benefit calculation.

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holy-reddit-batman t1_ix87zqa wrote

Holy hell. That's the recommended length of use for each of those? I've been taking naproxin probably 6 times a week for as long as I can remember. I have serious arthritis and widespread pain.

Would a person know if they were having internal bleeding? My GI is screwed up from some other conditions. Now I'm wondering if any of that is going on.

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EmilyU1F984 t1_ix8la31 wrote

Not necessarily, any GP can test for hidden blood in stool though. Black stool is indicative of a bleed higher up in the GI tract anything bright and Tim’s likely hamprrhoids.

(And on the reverse black or blood coloured vomit)

You need to talk to your physician though, daily naproxen might be the best treatment option even with all the risks, But there‘s also other treatment options for arthritis, especially if you are using OTC painkillers daily.

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Adamsmasher23 t1_ix6xj9u wrote

It's not just emerging, vioxx didn't really have much higher risk than other NSAIDs:

> The corresponding odds ratios (95% credible intervals) were 1.24 (0.91 to 1.82) for celecoxib, 1.48 (1.00 to 2.26) for ibuprofen, 1.50 (1.06 to 2.04) for diclofenac, 1.53 (1.07 to 2.33) for naproxen, and 1.58 (1.07 to 2.17) for rofecoxib. Greater risk of myocardial infarction was documented for higher dose of NSAIDs. With use for longer than one month, risks did not appear to exceed those associated with shorter durations.

> Conclusions All NSAIDs, including naproxen, were found to be associated with an increased risk of acute myocardial infarction. Risk of myocardial infarction with celecoxib was comparable to that of traditional NSAIDS and was lower than for rofecoxib. Risk was greatest during the first month of NSAID use and with higher doses.

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CabbieCam t1_ix6z4xa wrote

As someone with arthritis I miss viox greatly. It was an excellent anti inflammatory.

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Brevemike t1_ix76t1a wrote

Vioxx was amazing. I’ll take the possible cardiac risk to alleviate the guaranteed pain.

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[deleted] t1_ix7adc2 wrote

You’ll change your tune quick if you do have cardiac problems.

Seriously the scariest thing I’ve ever experienced.

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Brevemike t1_ix8pqn7 wrote

Sorry, mini-rant.

It was a terrifying event, but being in chronic pain denies me the ability to enjoy having survived. There are days I’m disappointed I wake up.

Each day I get to choose to exist somewhere between pain that renders me non-functional or drugging myself free but insensible. And the drugs are not without their own debilitating side effects and risks.

When I was on Vioxx the side effects and toll it took were unnoticeable. The current drugs leave no question that they’re beating the hell out of my body.

Everyday we risk sudden death in the most mundane of ways. Whether strapping ourselves into metal bullets and hurtling along the ground at 120kph or stepping out of a tub onto a wet tile floor.

I’ll take a 10% increased risk of sudden death in exchange for living relatively pain free.

But I haven’t got that choice. Neither do the many people who finds themselves on increasing doses of opioids for continually decreasing returns - sometimes seeking stronger unregulated drugs and risking sudden death anyway. What if those caught in an addiction cycle could’ve been stopped before they started?

Is it worth the risk?

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KaylaKoop t1_ix8euec wrote

I don't take nasaids, but I do take pot, the edible kind, for severe back pain. And it is illegal in my state. If someone told me I would have increased cardiac risk for doing so, I wouldn't hesitate to continue. Until you've had debilitating pain, you have no idea what someone is willing to do. If I got cardiac problems? I figure they would probably put me out of my pain sooner, rather than living with it for year after year.

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TZscribble t1_ix90bsr wrote

Pretty sure a day of terror will out weight daily, happiness sucking pain.

I have fatigue and it affects me daily and makes day to day life difficult. A medication that potentially gives heart problems but improves my day to day fatigue? Sign me up.

In fact, that's exactly what the stimulant I am on can do. Still worth it. I can actually do a full 8 hours of work and still make dinner or do the dishes (mind the or - it is 'or', not 'and'). It has made a huge improvement to my life.

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