Health Warning for Ibuprofen, Naproxen and Aspirin Users Over Potentially Serious Risks

Medicines come with risks, even over-the-counter types. These include ibuprofen, naproxen, and aspirin, all non-steroidal anti-inflammatory drugs (NSAIDs). Ibuprofen is commonly known under brand names, such as Advil, Motrin, and Nurofen; Naproxen is known under the brand name Aleve. Most people don’t think twice about popping these pills to fix a headache or taking them regularly for chronic pain. However, they can cause dangerous side effects in some people.

What are NSAIDs?

Non-steroidal anti-inflammatory drugs are often used to reduce stiffness, fever, and pain. They work by inhibiting the body’s production of chemicals that cause inflammation. Health professionals often recommend them for arthritis, back pain, cramps, muscle aches, and toothaches. “Over-the-counter medicines can help a lot, but people need to take them carefully,” says anesthesiologist Donna-Ann Thomas, MD, at Yale Medicine. “You have to remember that you are still taking medication. It is important to follow the directions on the label, especially if you have health problems or are taking other medications.” The Cleveland Clinic recommends taking NSAIDS for no more than three days for fever and no more than ten days for pain, unless otherwise directed by a doctor. However, it is important to watch for side effects if you use naproxen, aspirin, or ibuprofen at any time.

Who Should Avoid NSAIDs?

Remember, NSAIDs do not help the body heal; in fact, a 2024 medical review shows evidence that they may delay bone healing. So even though a person may feel better, their body may still be recovering. For example, a mild fever actually helps the healing process. Also, pain is the body’s way of asking for rest, and sometimes ignoring this request can lead to depression and worse symptoms. Additionally, NSAIDS can lead to the formation of stomach ulcers. So it is recommended to take them with food, or not at all. People who should avoid NSAIDs include those with:

• Bleeding problems
• Chronic acid reflux or GERD
• Bleeding in the intestines
• Heart failure
• A history of heart attack or stroke
• Kidney disease
• Liver disease
• Pregnancy
• Stomach ulcers
• Ulcerative colitis
• Type 2 diabetes
• Uncontrolled high blood pressure
• Future surgical procedures

Additionally, people should avoid aspirin if they have asthma that worsens after taking it. Children and adolescents with viral infections should not take aspirin because of the risk of Reye’s syndrome. Talk to your doctor before taking NSAIDs if you are 65+, take blood thinners, or drink alcohol daily.

Possible Side Effects

Even over-the-counter ibuprofen, aspirin, or naproxen can cause side effects if not used properly. Unless directed by your provider, do not take more NSAIDs or more than the recommended dose. The most common side effects include abdominal pain, gas, bloating, nausea, constipation, diarrhea, and vomiting. Others may include headaches, dizziness, light-headedness, and difficulty concentrating and balancing. Dr. Mark Porter, GP, pointed out that many people who take low-dose aspirin to reduce the risk of stroke, heart attack, and blood clots are aware of the risk of heavy bleeding. “However, very few people who take NSAIDs realize how dangerous they can be to others,” he wrote in The Times.“NSAIDs account for almost a third of all NHS hospital admissions caused by adverse drug reactions, accounting for almost one in five hospital beds. And it’s not just gastrointestinal bleeding; NSAIDs can cause heart attacks, strokes, and kidney damage.”

Dr. Porter explained that people who suffer from stomach problems such as heartburn or constipation may find their symptoms worsen with occasional NSAIDs. “…But if they are taken for a long time, they can do much worse. The same mechanism of action (prostaglandin inhibition) that helps many NSAIDs relieve aches and pains weakens the stomach’s natural defenses against its gastric juices, leading to irritation, ulcers, bleeding, and even perforation.”

According to Theodore R. Fields, MD, FACP, seek medical help immediately if you have:

• Black or bloody stools
• Cloudy or bloody urine
• Severe abdominal pain
• Blood in vomit
• Jaundice
• Poor eyesight
• Tinnitus
• Difficulty thinking or speaking
• Allergies such as rash, chest pain, fatigue, itchy skin, palpitations, unexplained rashes, shortness of breath, fluid retention, and flu-like symptoms.

NSAID Alternatives

NSAIDs are not the only way to treat pain. Acetaminophen (the active ingredient in Tylenol) doesn’t target inflammation, but it can still reduce colds and provide relief, according to a 2020 review. However, taking it the wrong way can cause liver damage, so talk to a healthcare professional if you have concerns about its interactions with medications or existing conditions. Another option is topical NSAIDs or lidocaine creams. It can relieve muscle and joint pain while reducing potential gastrointestinal side effects. A 2021 study found it particularly useful in osteoarthritis.

If you suffer from chronic pain and/or inflammation, talk to a medical professional about creating a pain management plan that may include lifestyle or dietary changes. Chronic conditions can negatively impact sleep, mental health, and overall quality of life. If you’re relying on over-the-counter medications to get through the day, that’s a clear sign to talk to your doctor about what’s causing the pain and how to manage it more effectively.

Read more: A person took 1,176 ibuprofen tablets in one month and experienced severe side effects