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A Closer Look at Over-the-Counter Painkillers
Talking a low daily dose of aspirin has been a long time recommendation for heart health, and many of us pop a Tylenol or an Advil to knock out a headache, muscle ache, arthritis pain, or menstrual cramps. Because of the accessibility of over-the-counter (OTC) medications like aspirin, acetaminophen, and ibuprofen, many may think nothing of grabbing a pill to ease what ails us, or, in the case of aspirin, to actually improve our long term health and reduce our risk for disease.
Newer research is demonstrating a downside of OTC painkillers. Some studies suggest that taking these medications over the long run – even in low doses – may be associated with more health risks than benefits. And some can be serious. Here we’ll outline the new studies that have suggested that, while the risks may be rare, OTC medications are not as gentle and safe as we may be tempted to think.
Weighing Aspirin’s Bleeding Risks Against Its Heart Benefits
Organizations like the American Heart Association recommend aspirin for people who are at higher risk of cardiac issues such as heart attack or stroke. But since it is a blood thinner, aspirin is known to elevate risk of bleeding, which can be serious and could potentially outweigh its benefits.
Doctors agree that not everyone should take aspirin as a preventative measure to reduce heart risk, according to the authors of a new study, but there is little consensus about the point at which the benefits outweigh the risks, even for those at higher likelihood of having a cardiovascular event.(1) A team of researchers looked at whether low dose aspirin taken over the long term reduced the risk of cardiac events in women above and beyond the risks it posed.
The study set out to determine this balance point, by tracking the heart health over a decade of almost 28,000 women who had taken part in the Women’s Health Study. Half of the participants took an average of 100 mg of aspirin every other day; the other half took a “dummy pill” (placebo).
Overall, the risk of having a stroke, heart attack, or dying of a cardiac issue was reduced from 2.4 to 2.2% in the women who took aspirin, compared to the control group. This reduction is not huge. And some of the participants in the aspirin group suffered from bleeding problems, like gastrointestinal bleeding, peptic ulcers, or easy bruising.
Acetaminophen: Slow and Steady Doesn’t Always Win
It’s not only aspirin that’s under the magnifying glass. Many of us think that acetaminophen, such as Tylenol, is far safer than aspirin. But a recent study found that even low dose acetaminophen over the long term can be even more damaging to the body than a high single dose.(2)
When researchers analyzed the records of 663 patients who had been treated for liver toxicity at a Scotland hospital, they found that 161 of them had taken a “staggered overdose,” a low, chronic amount, usually to deal with recurrent aches and pains like muscle aches, headache, and toothache. The continual use had damaged their livers, as their bodies struggled to remove the chemical day in and day out.
Staggered overdose patients were also more likely to suffer brain and kidney as well as liver problems compared to patients who had taken a large single dose of acetaminophen. They were also at higher risk of having to be on a breathing machine – and, surprisingly, they had a greater risk of dying.(2)
Appropriately, earlier this year the FDA urged all makers of acetaminophen to reduce capsule strength to 325 mg of the drug, and to display a Boxed Warning on the packaging, outlining the risk of liver damage. Considering the number of people who use acetaminophen for common aches and pains such as arthritis, rethinking the dosing and marketing of the drug is likely a wise move.