Posted on December 1, 2005 at 3:21 p.m.
BIRMINGHAM, AL — Over-the-counter (OTC) pain relievers are often used inappropriately by consumers, who show “an alarming rate of ignorance” regarding their potentially dangerous side effects, according to a University of Alabama at Birmingham (UAB) specialist and colleagues writing in the current issue of The Journal of Rheumatology.
Lead author C. Mel Wilcox, M.D., director of the UAB division of gastroenterology and hepatology, said the study’s findings “strongly underscore the need” for public and physician educational interventions. He said gastrointestinal toxicities from both OTC products and prescription non-steroidal anti-inflammatory drugs (NSAID) are increasingly reported in conjunction with cardiovascular, liver and kidney complications.
Most frequent side effects include stomach pain, upset stomach, nausea, internal bleeding and bleeding ulcer — with a significant percentage of people saying that neither their doctor nor their pharmacist warned them of the potential side effects.
Wilcox; Bryon Cryer, of the University of Texas Southwestern, Dallas; and George Triadafilopoulos, M.D., of Stanford University, summarized findings from two sizeable surveys on OTC pain relief use. The study looked principally at the use of NSAIDs. Ibuprofen-based drugs were the most frequently used OTC analgesic in the surveys.
The data suggest that 36 million Americans are using OTC pain medications daily, of which 23 million use NSAIDs. A significant percentage was unknowledgeable about potential drug interactions, and did not recognize that NSAID use could have dangerous interactions with hypertension and other prescription medications and with alcohol. People who used alcohol heavily (defined as three or more drinks per day) were more likely than non-heavy drinkers to take more than the recommended dose of OTC analgesics and to be unconcerned about potential interactions.
Fully one-fourth of users surveyed exceeded the recommended dose of OTC medication, and the belief that OTC drugs are safer than prescription doses was common. “More disturbing is that about half of the interviewees either were unaware of the potential toxicity of these agents or were unconcerned,” the article stated.
“Collectively, these studies support the findings of our report showing the high rates of OTC NSAID use and lack of understanding of the toxicity of these drugs among a wide spectrum of the population…. These findings underscore the need for educational interventions directed to the general public as well as physicians,” it stated.
The two surveys analyzed for the study involved 9,062 Americans. The Roper survey (1997) and the National Consumers League survey (2002) were intended primarily to assess the public’s use of and attitudes toward NSAID and OTC analgesics.
The American Gastroenterological Association supported the study.