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Ibuprofen every day: Is It Bad to Take Ibuprofen Every Day?


Is It Bad to Take Ibuprofen Every Day?

Roll out of bed with a gnawing pain in your lower back, develop a throbbing headache, or start feeling excruciating period cramps, and your first course of action might be to pop an ibuprofen in hopes of easing the discomfort. If those aggravating symptoms just won’t quit, you might gulp down another dose later that day — and, if you’re still in pain, continue to take the pain-relieving medication for days on end without batting an eye. After all, a drug that’s sold over-the-counter can’t be that harmful to your health with long-term use, right?

Seriously, is it bad to take ibuprofen every day?

Spoiler: It’s not a good idea to take ibuprofen every day. Taking ibuprofen daily, with doses spaced out six to eight hours, for more than five to seven days is not recommended or viewed as safe by medical professionals, says Janet Morgan, M.D., an internist at the Cleveland Clinic. In this case, taking more than 600 milligrams total each day is not recommended, either, says Dr. Morgan. “[Ibuprofen] can cause ulcers in your stomach if taken every day, long-term, and it can damage your kidneys and even liver if taken long-term,” she explains.

The non-steroidal anti-inflammatory drug, which helps decrease the pain-inducing inflammatory process throughout the entire body, is known to irritate and “eat away at” the inside lining of your stomach, particularly when taken without food, says Dr. Morgan. Over time, this irritation can lead to an ulcer — an open sore that can cause burning stomach pain, heartburn, and an intolerance to fatty foods, according to the Mayo Clinic. “Imagine if I took my fingernails, stuck them inside your stomach, and slowly scratched off layers of your stomach,” says Dr. Morgan. “That’s kind of what it does — it can get [through] the layers and layers and layers until you’ve actually developed an ulcer.” (Wait, should you avoid ibuprofen while sick with COVID?)

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Similarly, long-term use of ibuprofen can damage tissue in the liver and the kidneys, as the drug decreases blood flow to the waste-removing organs, says Dr. Morgan. The risk of kidney damage is greater for folks who already have decreased kidney function or kidney disease. But even individuals without any pre-existing conditions are at risk of developing chronic interstitial nephritis — a disorder in which the spaces between the small tubes inside the kidney become inflamed, which may lead to acute kidney failure — with long-term or heavy ibuprofen use, according to the National Kidney Foundation.

But internal damage isn’t the only side effect you have to worry about. Taking ibuprofen daily can also cause unpleasant symptoms such as heartburn, nausea, and vomiting, says Dr. Morgan. “That’s more if you don’t take it with food, but it can certainly occur in people that just have sensitive stomachs in general,” she adds. And if you’re already using prescription medications for high blood pressure or diabetes, simultaneously taking ibuprofen every day can be “dangerous,” says Dr. Morgan; NSAIDs such as ibuprofen may increase blood pressure and make medications designed to lower high blood pressure levels less effective, and in individuals taking a sulfonylureas medication to manage Type 2 diabetes, ibuprofen may cause hypoglycemia (aka low blood sugar). (Related: Can Ibuprofen Really Reduce Your Period Flow?)

Is It Bad to Take Ibuprofen Every Day?

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What can you do for your pain instead?

TL;DR: Taking ibuprofen daily comes with plenty of health risks, which is why Dr. Morgan recommends opting for a topical pain reliever to ease your symptoms, such as an anti-inflammatory gel or lidocaine patch. “Topicals are not absorbed as much into your bloodstream and into your system [as oral medications], so working locally at the area where you’re having your pain tends to be a safer option,” she explains. If you’re suffering from an unbearable headache and a gel isn’t in the cards, Dr. Morgan suggests home remedies such as going for a walk and practicing deep breathing to help create some relief. And for throbbing period cramps, consider applying a heating pad or hot water bottle to your lower abdomen, taking a hot bath, or rolling out your yoga mat and flowing through a few stretches to alleviate some of the pain.

If your symptoms are still lasting after five days of treatment — whether it’s multiple doses of ibuprofen a day, a topical agent, a casual stroll, or a heating pad — it’s time to book an appointment with your doctor, says Dr. Morgan. “If you’re just getting this random headache, for instance, and it’s been more than three to five days, definitely check with a provider to make sure there [isn’t] something underlying that you could be missing,” she explains. The same goes for menstrual cramping that worsens over time and doesn’t stop after your period ends, as you may have a serious health condition such as endometriosis or fibroids, according to the American College of Obstetricians and Gynecologists. “Even if it’s just a joint ache, if it’s going on and on, there could be something going on that you need to x-ray or get checked with a provider.”

Making the Decision on NSAIDs

Experts agree that, for most people, there’s no harm in taking nonsteroidal anti-inflammatory pain relievers, called NSAIDs, for the occasional headache, fever, or muscle ache. Indeed, on any given day more than 30 million Americans use NSAIDs to soothe headaches, sprains, arthritis symptoms, and other daily discomforts, according to the American Gastroenterological Association.

But these useful pain relievers also raise the risk of ulcers and heart problems in some people. Should you take an NSAID every day if you have arthritis or chronic pain?

To help you understand the pros and cons, WebMD turned to four experts for advice:

  • Byron Cryer, MD, a gastroenterologist, spokesman for the American Gastroenterological Association, and an associate professor of medicine at the University of Texas Southwestern Medical Center in Dallas.
  • Nieca Goldberg, MD, a cardiologist, spokeswoman for the American Heart Association, and chief of Women’s Cardiac Care at Lennox Hill Hospital in New York.
  • John Klippel, MD, a rheumatologist and president & CEO of the Arthritis Foundation in Atlanta.
  • Scott Zashin, MD, a rheumatologist and clinical assistant professor at the University of Texas Southwestern Medical Center in Dallas.

Here is the information they gave to help you understand your choices, whether you share in the decision-making process or rely on your doctor’s recommendation. If you already know this basic information, you can jump directly to your NSAID decision worksheet and begin assessing the pros and cons as they apply to you.

Key Points in Making the NSAID Decision

Consider the following when making your decision:

  • NSAIDs (nonsteroidal anti-inflammatory drugs) are a common class of over-the-counter and prescription painkiller. Examples include aspirin, Advil, Aleve, Motrin, and prescription drugs like Celebrex.
  • You should never take any over-the-counter medicine regularly without discussing it with your doctor. Most over-the-counter painkillers should not be used for more than 10 days.
  • Like any medicine, over-the-counter and prescription NSAIDs have side effects. The FDA has recently required that all over-the-counter and prescription NSAIDs — except aspirin — include warnings about possible risks of gastrointestinal and cardiovascular side effects and allergic reactions.
  • The risks of NSAIDs have been highlighted in the media recently. But it’s important to understand that, for many people, NSAIDs are a safe and effective treatment. The key is to work with your doctor. Together, you can weigh the benefits and risks and decide on the best treatment in your case.
  • NSAIDs are not alike. They can have very different pros and cons. Talk to your doctor about the NSAID that might work best for you.
  • NSAIDs can appear in unlikely places. For instance, many over-the-counter medicines for colds and the flu contain doses of these pain relievers. Make sure you know the ingredients of any medicine you use.
  • There are alternatives to NSAIDs. Many people who can’t take NSAIDs benefit from Tylenol (acetaminophen.) Other options for people with severe chronic pain are prescription narcotics, like OxyContin, Percocet, and Vicodin. Some find that physical therapy, weight loss (if overweight), biofeedback, yoga, meditation, and acupuncture can also reduce their pain.
  • In some people, complete pain relief isn’t possible. But in such cases, you can focus on reducing your pain so that it doesn’t interfere with your life.

What Are NSAIDs?

NSAIDs — nonsteroidal anti-inflammatory drugs — are a common treatment for ailments, such as joint pain, related to inflammation. They relieve pain, reduce swelling, and lower fevers.

Examples of over-the-counter NSAIDs are:

There are also prescription strength NSAIDS. Some examples are Daypro, Indocin, Lodine, Naprosyn, Relafen, and Voltaren.

Cox-2 inhibitors are a newer form of prescription NSAID. Celebrex is the only one of these drugs still on the market. Two others — Bextra and Vioxx — are no longer sold because of concerns about their side effects.

How Do NSAIDs Work?

When you injure yourself, the damaged tissue releases certain chemicals. These chemicals cause the tissue to swell, and they amplify the feeling of pain. NSAIDs work by blocking the effects of these chemicals. As a result, you get less swelling and less pain.

What Are the Side Effects of NSAIDs?

The side effects — and benefits — of different NSAIDs vary. Here’s a rundown of some of the more important risks.

  • Heart attacks and strokes. Experts believe that all NSAIDs — except aspirin — have the potential to increase the risk of heart attacks and strokes. Celebrex may be the most likely to cause these effects. However, aspirin can lower the risks of heart attacks and strokes because it reduces the risk of blood clots.
  • High blood pressure. All NSAIDs have the potential to raise high blood pressure. However, because aspirin has such good effects on the cardiovascular system, you doctor may ask that you take it especially if you are at risk for heart attack or stroke.
  • Heartburn, ulcers, and gastrointestinal (GI) bleeding. Most NSAIDs increase the risk of GI problems. Celebrex is the NSAID least likely to cause problems because it was designed to avoid GI side effects.
  • Kidney damage. NSAIDS can be damaging to the kidneys in some people.
  • Allergic reactions. NSAIDs can cause allergic reactions, resulting in wheezing, hives, facial swelling, and shock. Dangerous side effects may be more common in people with asthma, especially if they also have sinus problems or nasal polyps — tissue growths on the inside of the nasal cavity.

Other Warnings

  • Many NSAIDs are not safe for pregnant women, especially in the last three months.
  • Children and teenagers should not take aspirin because it’s associated with the serious disease Reye’s syndrome.
  • Most over-the-counter and prescription pain relievers do not mix with alcohol. If you take an NSAID, including aspirin, just one drink a week can increase your risk of gastrointestinal bleeding. People who have three or more drinks a night should not use NSAIDs.

Your Decision on NSAIDs

Your choices are:

  • To take NSAIDs on a regular basis
  • Not to take NSAIDs on a regular basis

When deciding whether to use NSAIDs on a regular basis, you have to weigh both your personal feelings and the medical facts.

Reasons to Take NSAIDs Regularly Reasons Not to Take NSAIDs Regularly
  • NSAIDs help control your chronic pain.
  • NSAIDs have never given you any side effects.
  • You have never had an allergic reaction to an NSAID.
  • You have no kidney or liver problems.
  • You are not pregnant.
  • You are 60 or younger.

Are there other reasons you might want to use NSAIDs regularly?

  • NSAIDs don’t really seem to help with your pain.
  • You have had significant side effects from NSAIDs in the past.
  • You have had an allergic reaction to an NSAID in the past, such as hives, swelling, or wheezing.
  • You have kidney or liver disease.
  • You are pregnant.
  • You are over 60, which puts you at higher risk of developing an ulcer.

Are there other reasons you might not want to use NSAIDs regularly?

Making Your Decision on NSAIDs

Use this worksheet to help you make your decision. After finishing it, you should have a better idea of how you feel about using NSAIDs on a regular basis. Discuss the worksheet with your doctor.

For each question, circle the answer that best applies to you.

I am in chronic pain that restricts my life and activities. Yes No Unsure
NSAIDs help me control my pain. Yes No Unsure
I only get relief if I take NSAIDs in high doses. Yes No Unsure
I have high blood pressure. Yes No Unsure
I have had a heart attack, stroke, or heart surgery. Yes No Unsure
I have angina. Yes No Unsure
My doctor has told me that I am at a higher risk of heart attack or stroke. Yes No Unsure
I have kidney or liver disease. Yes No Unsure
I have a history of ulcers or gastrointestinal bleeding. Yes No Unsure
I am over 60 and am at higher risk of developing an ulcer. Yes No Unsure
I have asthma. Yes No Unsure
I have asthma as well as nasal polyps or sinus problems. Yes No Unsure
I have had an allergic reaction to an NSAID in the past. Yes No Unsure
I have to take steroids, like prednisone, for a medical condition. Yes No Unsure
I take anticoagulants or “blood thinners.” Yes No Unsure
I have more than one alcoholic drink a night. Yes No Unsure

What Is Your Overall Impression About NSAIDs?

Your answers in the above worksheet may give you a general idea of where you stand on this issue. You may find that you have one overriding reason to use or not to use NSAIDs on a regular basis.

Check the box below that represents your overall impression about your decision.

Leaning toward using NSAIDs regularly Leaning toward not using NSAIDs regularly

If you are leaning toward using an NSAID, which type and why?

One Arthritis Drug Won’t Hurt You More Than The Others

A new study comparing three popular arthritis drugs shows they’re all about equally safe — and equally dangerous for the heart.

It’s good news for people who have to take pills every day for chronic pain, but the drugs are not completely safe. Ibuprofen, naproxen and the prescription drug celecoxib all can cause heart problems, especially when taken long term in high doses.

IbuprofenNBC News

The findings only apply to people taking high doses over time – they do not apply to people who take ibuprofen or naproxen for fevers, headache or the occasional aches and pains. But even occasional use should be limited, experts say.

“My advice to the public is to take the lowest dose you can for the shortest period you can,” said Dr. Steve Nissen, the heart expert at the Cleveland Clinic who ran the study.

The study was started because of a scandal going back to 2004, when the new arthritis drug Vioxx was pulled from the market when it was shown to cause heart attacks and other heart deaths.

It was a shocker because Vioxx, approved in 1999, was designed to be a more refined version of the drugs in the same class as aspirin and ibuprofen, which both can cause dangerous stomach bleeding.

Since then there has been a bit of suspicion surrounding other so-called COX-2 inhibitors, including celecoxib, sold generically and under the brand name Celebrex.

“We gave everybody a drug to protect the stomach and it happened anyway.”

The Food and Drug Administration now mandates a black-box warning on all COX-2 inhibitors and nonsteroidal anti-inflammatory drugs, or NSAIDs, which include aspirin, ibuprofen, naproxen and other over-the-counter pain relievers.

Nissen’s team did a long-term, head-to-head comparison of celecoxib, ibuprofen and naproxen in 24,000 volunteers with rheumatoid arthritis or osteoarthritis for almost three years.

As expected, naproxen and ibuprofen caused some gastric bleeding and celecoxib caused less, Nissen’s team reported in the New England Journal of Medicine and at a meeting of the American Heart Association.

“We gave everybody a drug to protect the stomach and it happened anyway,” Nissen told NBC News. All the patients got a stomach drug called esomeprazole or Nexium.

And all three drugs caused small numbers of heart events such as heart attacks or strokes– 2.3 percent of those assigned to take celecoxib, 2.5 percent of those assigned to take naproxen and 2.7 percent of those given ibuprofen.

The team saw other expected side-effects. “The effect of Celebrex on blood pressure was zero,” Nissen said. “Ibuprofen caused a clear increase in hospitalizations for high blood pressure. Naproxen had intermediate effects.

“We are not saying that if you take an occasional 200 mg of ibuprofen that you are going to die.”

“We’ve known these drugs have heightened risks, and we’ve known ibuprofen is less safe than naproxen,” noted Dr. Alan Taylor, chief of cardiology at Georgetown University, who was not involved in the study. “If your doctor prescribes celecoxib, it’s probably pretty safe.”

The study did not necessarily reflect what happens in real life. Most of the patients – more than two-thirds – dropped out before the end of the trial and more than a quarter did not show up for follow-up visits.

And the patients got extremely high doses of ibuprofen – 600 mg three times a day. The usual dose is 200 mg, or one tablet. The people given naproxen got 375 mg twice and day and those given celecoxib got low doses of 100 mg twice a day.

“We are not saying that if you take an occasional 200 mg of ibuprofen that you are going to die,” Nissen said.

It’s not completely clear why the drugs affect heart attack and stroke rates.

COX-2 inhibitors may increase the risk of heart attacks by raising blood pressure and making the blood more likely to clot, researchers say. COX, or cyclooxygenase, is an enzyme that comes in two forms — COX-1 and COX-2. Aspirin and other NSAIDS affect both COX-1 and COX-2. The COX-2 inhibitors were meant to be safer by targeting only COX-2.

Nissen believes people who take high doses of ibuprofen, naproxen and other NSAIDs may be bleeding just a little.

“You are losing blood and you gradually trickle down to where you get to an anemic level. And anemia is not good for the heart,” he said.

“One of the most important messages is if you are going to take these drugs, you should take the lowest dose that’s effective for the least possible period of time.”

And people take too much, he added. “The term the FDA uses is dose creep. One of the most important messages is if you are going to take these drugs, you should take the lowest dose that’s effective for the least possible period of time.

It’s a huge market. Millions of Americans take NSAIDs and COX-2 inhibitors, spending $1 trillion in 2015 for naproxen, ibuprofen and celecoxib.

That’s a big drop from 2014 when it was a $2.8 trillion market. Celecoxib sales also were $2.5 trillion, almost all of them for the brand-name drug Celebrex. Now most sales are for the much cheaper generic form.

Maggie Fox is a senior writer for NBC News and TODAY, covering health policy, science, medical treatments and disease.

Taking ibuprofen regularly for one week ‘increases heart attack risk’ | The Independent

Taking ibuprofen could quickly increase the risk of heart attack – a “worrying” potential side-effect that appears to occur from the first week of regular use, according to a new study.

While the overall risk of heart attack remains low, they are most likely to occur within the first month of taking a high dose of ibuprofen or other common painkillers, an international team of researchers has claimed.

Ibuprofen, available in supermarkets and corner shops, is a type of non-steroidal anti-inflammatory drug (NSAID).

“Taking any dose of NSAIDs for one week, one month, or more than a month was associated with an increased risk of myocardial infarction [heart attack],” wrote the researchers, led by Michèle Bally of the University of Montreal Hospital Research Centre in Canada.

“Prescribers should consider weighing the risks and benefits of NSAIDs before instituting treatment, particularly for higher doses.”

The study, published in the British Medical Journal, analysed data from almost 450,000 people, 61,460 of whom had suffered a heart attack.

Researchers examined the effect over time of taking three common anti-inflammatory painkillers – ibuprofen, diclofenac and naproxen – and two others, called celecoxib and rofecoxib.

The increased risk of suffering a heart attack was between 24 per cent and 58 per cent overall when taking the drugs, compared with not using them.

In context, these jumps are small, as the average likelihood of heart attack among those taking NSAIDs is around one per cent a year, with patients who already have heart disease or related conditions such as diabetes at greater risk.

But Dr Bally told The Independent even small increases in heart attack risk are important from a public health viewpoint because the use of these medicines is so widespread.

“If an individual’s risk of heart attack is one per cent and it increases to 1.25 per cent, they don’t care,” she said. “But at a population level, it’s important, and if people want to contribute to public health, they might wish to make more informed choices.”

Boy helps save man having a heart attack in Virginia

Using the drugs for longer than one month did not increase risk more than with shorter use, found the researchers, from Canada, Germany and Finland.

They studied people who took both a low dose of the drugs or a high dose, defined by the researchers as over 1200mg, or three maximum-strength tablets, of ibuprofen each day. For diclofenac, this was over 100mg and for naproxen, over 750g.

“This large-scale study worryingly highlights just how quickly you become at risk of having a heart attack after starting NSAIDs,” said Dr Mike Knapton, associate medical director of the British Heart Foundation.

Dr Knapton said it was already known that these drugs increase the risk of having a heart attack, adding: “Whether you are being prescribed painkillers like ibuprofen, or buying them over the counter, people must be made aware of the risk and alternative medication should be considered where appropriate.”

Naproxen is available over the counter for period pain and on prescription for conditions such as arthritis and back pain. Diclofenac was available over the counter in the UK until 2015, but is now only available on prescription.

In 2013, researchers said one year’s high-dose treatment with ibuprofen and diclofenac, used by hundreds of thousands of arthritis sufferers in the UK, leads to three avoidable heart attacks and one fatal heart attack for every 1,000 users.

A spokesperson for the National Institute of Health and Care Excellence said all prescribing guidance was regularly reviewed and would take into consideration all evidence that comes to light between reviews.

Sales of over-the-counter painkillers amounted to almost £600 million in the UK in 2015.

“This study builds on research highlighting the risks involved in using NSAIDs, such as ibuprofen, to treat pain – and it’s important that as new research is published, it is taken on board to inform the clinical guidelines that support our work,” said Professor Helen Stokes-Lampard, Chair of the Royal College of GPs.

“This study should also raise awareness amongst patients who self-medicate with NSAIDs that are available over the counter, to treat their pain.

“Actually, the use of NSAIDs in general practice to treat patients with chronic pain is reducing and some of the drugs in this study are no longer routinely prescribed in the UK, such as coxibs, as we know that long term use can lead to serious side effects for some patients.

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When you feel particularly exhausted, it can definitely feel like you are also lacking in brain capacity. Now, a new study has suggested this could be because chronic sleep deprivation can actually cause the brain to eat itself


Health news in pictures

Exercise classes offering 45 minute naps launch

David Lloyd Gyms have launched a new health and fitness class which is essentially a bunch of people taking a nap for 45 minutes. The fitness group was spurred to launch the ‘napercise’ class after research revealed 86 per cent of parents said they were fatigued. The class is therefore predominantly aimed at parents but you actually do not have to have children to take part


Health news in pictures

‘Fundamental right to health’ to be axed after Brexit, lawyers warn

Tobacco and alcohol companies could win more easily in court cases such as the recent battle over plain cigarette packaging if the EU Charter of Fundamental Rights is abandoned, a barrister and public health professor have said


Health news in pictures

‘Thousands dying’ due to fear over non-existent statin side-effects

A major new study into the side effects of the cholesterol-lowering medicine suggests common symptoms such as muscle pain and weakness are not caused by the drugs themselves


Health news in pictures

Babies born to fathers aged under 25 have higher risk of autism

New research has found that babies born to fathers under the age of 25 or over 51 are at higher risk of developing autism and other social disorders. The study, conducted by the Seaver Autism Center for Research and Treatment at Mount Sinai, found that these children are actually more advanced than their peers as infants, but then fall behind by the time they hit their teenage years


Health news in pictures

Cycling to work ‘could halve risk of cancer and heart disease’

Commuters who swap their car or bus pass for a bike could cut their risk of developing heart disease and cancer by almost half, new research suggests – but campaigners have warned there is still an “urgent need” to improve road conditions for cyclists. Cycling to work is linked to a lower risk of developing cancer by 45 per cent and cardiovascular disease by 46 per cent, according to a study of a quarter of a million people. Walking to work also brought health benefits, the University of Glasgow researchers found, but not to the same degree as cycling.


Professor Jane Mitchell, Head of Cardiothoracic Pharmacology at Imperial College London, said: “This is an observational study so it cannot say whether these painkillers actually cause heart attacks, but it does give more information about an association we knew about from previous studies.

“We do not know what the potential underlying mechanism could be, but other research has suggested it might involve these drugs blocking a hormone in the body called prostacyclin which protects our blood vessels, protects the kidney and thins the blood.

“But we need more research to know whether this is indeed the case – finding the mechanisms is vital so that we can devise tests that can identify those people at greatest risk of heart attacks so that the majority patients can take their medication with relative confidence.”

FAQ: Heart Disease | Patient Education

Q: There are mixed messages about whether or not eggs are okay to eat if a person is on a watchful cardio diet. Is it okay to eat eggs, and if so, how many per week?

A: Eggs are an excellent source of protein and are available in a cholesterol-free form (Egg Beater Pour Spout and similar products at Safeway). These cholesterol-free eggs can be eaten without any limitations. However, for regular or “real” eggs, some limitations may be desirable.

If you have elevated LDL cholesterol (the “bad” cholesterol) and other risk factors for heart attack or stroke, such as high blood pressure, diabetes, or family history of heart attack or stroke, you should probably limit eggs to no more that two per week. However, if you are on a statin such as simvastatin (Zocor), atorvastatin (Lipitor) or rosuvastatin (Crestor), and your LDL is now low, you can safely eat eggs more often, perhaps daily.

I suggest doing a “before and after” test: Check your LDL cholesterol on your best-effort diet low in eggs, then eat as many eggs as you desire and recheck your LDL cholesterol. For many of my patients, the statin completely overpowers the effects of the eggs (or cheese for that matter).

As an item of full disclosure, I have an egg-cheese omelet most Sundays and a slice of extra-sharp cheddar cheese as part of my regular, daily breakfast, which also includes a bowl of strawberries, bananas, raisins and almonds or walnuts.

Q: According to recent articles, it seems that salt is not the “no-no” it once was. Is it true that, unless you have high blood pressure, the intake of salt is not bad for you?

A: A very good question, and there is definitely some truth to the statement that salt is not bad for everyone. In fact there are some conditions, such as Addison’s disease, cortisone deficiency and chronic low blood pressure, where salt is part of the therapy. And there are many people who tolerate salt well and have no need to restrict it. Unfortunately, many of us — including yours truly — have a problem with large quantities of salt.

When I was in my 40s, I developed high blood pressure (160/100 mmHg). I saw an internist who put me on medication that brought my blood pressure right down. In those days it was fashionable to conduct a urine test on all newly diagnosed hypertensives. My test revealed a very high sodium content. The internist told me to stop adding salt at the table and to cut down on salty foods, which I did. Over the next year, during which I also lost 20 pounds, my blood pressure came down and I was able to get off the antihypertensive medication. That was 20 years ago, and my blood pressure has remained 120/80 mmHg or less ever since.

Other conditions where salt can be dangerous include congestive heart failure, edema (fluid retention) and kidney disease. As in most things, moderation is probably the wisest course.

Q: I am a 65-year-old woman taking medication prescribed by my internist for high blood pressure and high cholesterol. Would it be advisable to get a heart screening test, evaluation and treatment recommendation from a cardiologist? Should a heart screening be part of a routine physical, and if so, how frequently and what tests should be given?”

A: This question is actually several good questions, all of which are difficult to answer.

First, does everyone with high blood pressure and high cholesterol need to see a cardiologist? My answer is no — if he or she has a good internist. The problem is that many internists are very busy and may not be expert in the latest treatment of these conditions.

If your blood pressure has come down to 120 mmHg systolic (the top number) or less, you and your internist are doing a great job. If your LDL cholesterol has come down to 70 mg percent or less, you and your internist are to be congratulated, and a cardiologist is not likely to add anything. Asking your internist for a one-time consultation with a cardiologist might not be a bad idea if you have doubts about the thoroughness of his or her cardiologic evaluation.

Regarding heart screening, there are many different types of heart screening tests. Everyone should have complete blood screening tests — including full cholesterol profile, high-sensitivity C-reactive protein, kidney and diabetes testing — and an EKG (electrocardiogram).

I do not recommend routine treadmill or nuclear stress tests, echocardiograms or CT scans on everyone; I order them based on issues in each individual case.

The echocardiogram is particularly helpful if there is a heart murmur, shortness of breath, fluid retention, or signs of heart failure. The treadmill and nuclear stress tests are helpful if there is chest pain or pressure, or an abnormal EKG. The CT scans expose you to a lot of radiation — more than 100 times that of a standard chest X-ray —, and I reserve those for cases where I am really concerned about a particular question, such as pulmonary embolism or aortic aneurysm.

Finally, regarding the routine heart screening calcium score CT, I rarely order this test and don’t find it useful. There are too many false positives — i.e., the test indicates the presence of serious disease, but further, more specific testing shows that none is present.

Is it safe to take ibuprofen every day? – MVOrganizing

Is it safe to take ibuprofen every day?

It’s safe to take ibuprofen regularly for many years if your doctor prescribes it, and as long as you do not take more than the recommended dosage. If you need to take ibuprofen by mouth for a long time and you’re at risk of getting a stomach ulcer, your doctor may prescribe a medicine to help protect your stomach.

Can taking alot of ibuprofen everyday hurt you?

Ibuprofen Can Increase Bleeding Risk “Daily long-term use of ibuprofen may increase the risk of uncontrolled bleeding.” Remember it’s a good idea to talk with your doctor about all medications you take regularly.

What can I take instead of ibuprofen?

If you’re concerned about the level of pain medicine you’re taking, here are a few things you might try instead.

  • Acetaminophen or aspirin.
  • Omega-3 fatty acids.
  • Turmeric.
  • Acupuncture.
  • Exercise and mindful movement.
  • Meditation.
  • More sleep (or coffee, in a pinch)

Is it OK if I don’t eat eggs?

2. Eating eggs increases your risk of early death, according to a new study. By eliminating eggs from your diet, you increase your chances of living longer. Those who consumed less than one egg a week had no increased risk.” To make sure you live a long and healthy life, eliminate eggs from your diet now, at any age.

Are eggs better for you than meat?

Meanwhile, along with prawns, eggs are the only food high in cholesterol that are low in saturated fat. “While the cholesterol in eggs is much higher than in meat and other animal products, saturated fat increases blood cholesterol.

How often can you eat eggs a week?

So, enjoy eggs in your weekly diet, but like everything in life, moderation is key. If you are in general good health, seven eggs per week should be fine.

Why is bread bad for you?

The highly processed flour and additives in white, packaged bread can make it unhealthful. Consuming too much white bread can contribute to obesity, heart disease, and diabetes. However, buying bread with the word “whole” as the first ingredient still does not guarantee a healthful product.

Is it good to eat bread with milk?

While milk gives us enough protein and calcium to kick-start our day, bread helps fill our tummy with all its fibre and carbs content. Use the same pairing of bread and milk to make some interesting yet easy breakfast recipes to turn your morning meals better and worth waking up to.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) | CS Mott Children’s Hospital

Topic Overview

Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce fever and inflammation and relieve pain. Examples of NSAIDs include aspirin, ibuprofen, and naproxen.

Be sure to follow the nonprescription medicine precautions.

Ibuprofen (such as Motrin or Advil)

  • Adults: The initial dose is 400 mg. Follow-up doses are 200 mg to 400 mg every 4 hours as needed, up to a maximum of 4 doses in a 24-hour period.
  • Children: Your child’s over-the-counter medicine will have a “Drug Facts” label. On the label, you’ll find directions for your child’s age or weight, the dose to give, and how often to give the dose. For children younger than 6 months of age, follow what your doctor has told you about the amount to give.

    • Be extra careful with liquid medicines. Infants usually need a different dose than older children do. And some liquid forms are stronger (more concentrated) than others. Always read the label so that you give the right dose.
    • When you give medicine, use the tool that comes with the medicine, such as a dropper or a dosing cup. Don’t use a spoon instead of the tool. Spoons can be different sizes. If the medicine doesn’t come with a tool to give doses, ask your pharmacist for one.

Naproxen (such as Aleve)

  • Adults: Initial dose is 440 mg. Follow-up doses are 220 mg every 8 to 12 hours as needed. Drink a full glass of water with each dose. Do not take more than 440 mg in any 8-hour to 12-hour period or 660 mg in a 24-hour period.
  • Adults older than 65: Do not take more than 220 mg every 12 hours unless your doctor tells you to.
  • Children: Do not give naproxen to children younger than 12 unless your doctor tells you to. Your doctor may prescribe naproxen for your child.

Side effects

The most common side effects of NSAIDs are stomach upset, heartburn, and nausea. If the medicine upsets your stomach, you can try taking it with food. But if that doesn’t help, talk with your doctor to make sure it’s not a more serious problem.

  • NSAIDs can cause a severe allergic reaction. Symptoms may include hives, swelling of the face, wheezing, and shock. If you have any of these symptoms, call 911 or other emergency services immediately.
  • For safety, read the label carefully and do not take more than prescribed. Taking a larger dose or taking the medicine longer than recommended can increase your risk of dangerous side effects.
  • Do not use a nonprescription NSAID for longer than 10 days without talking to your doctor.

Reasons to stop taking NSAIDs

NSAIDs may delay healing. If you develop any of the following signs of infection, stop taking the medication:

  • An increase in pain
  • Skin that is hot to the touch around the injury or wound
  • Redness or red streaks extending from the injury or wound
  • Pus that continues to form in the wound
  • Fever with no other cause
  • Swollen glands above the injury or wound

NSAID risks

  • NSAIDs have the potential to increase your risk of heart attack, stroke, skin reactions, and serious stomach and intestinal bleeding. These risks are greater if you take NSAIDs at higher doses or for longer periods than recommended.
  • Aspirin, unlike other NSAIDs, can help certain people lower their risk of a heart attack or stroke. But taking aspirin isn’t right for everyone, because it can cause serious bleeding. Talk to your doctor before you start taking aspirin every day.

Talk to your doctor about whether NSAIDs are right for you. People who are older than 65 or who have existing heart, stomach, kidney, liver, or intestinal disease are at higher risk for problems. For other people, the benefits may outweigh the risks.

Do not take NSAIDs if you have ever had an allergic reaction to any type of pain medicine.

If you are pregnant, trying to become pregnant, or breastfeeding, don’t use NSAIDs unless your doctor says it’s okay. They can cause problems with the baby or the delivery.

Talk to your doctor before taking NSAIDs if you have:

  • Ulcers or a history of stomach or intestinal bleeding.
  • Stomach pain, upset stomach, or heartburn that lasts or comes back.
  • Anemia.
  • Bleeding problems.
  • A habit of drinking more than 3 alcoholic drinks a day. This increases your risk of stomach bleeding.
  • High blood pressure.
  • Kidney, liver, or heart disease.
  • Any serious health condition.

Talk to your doctor before using NSAIDs if you take:

  • Blood thinners (anticoagulants).
  • Lithium.
  • Diuretics (water pills).
  • Medicine for arthritis or diabetes.
  • Aspirin to protect your heart.
  • Any other drugs.

Do not give aspirin to anyone younger than 20 because of the risk of Reye syndrome, a rare but serious disease.


Current as of:
August 4, 2020

Author: Healthwise Staff
Medical Review:
William H. Blahd Jr. MD, FACEP – Emergency Medicine
E. Gregory Thompson MD – Internal Medicine
Adam Husney MD – Family Medicine
Martin J. Gabica MD – Family Medicine
Kathleen Romito MD – Family Medicine
David Messenger MD

Current as of: August 4, 2020

Healthwise Staff

Medical Review:William H. Blahd Jr. MD, FACEP – Emergency Medicine & E. Gregory Thompson MD – Internal Medicine & Adam Husney MD – Family Medicine & Martin J. Gabica MD – Family Medicine & Kathleen Romito MD – Family Medicine & David Messenger MD

90,000 Treatment of a migraine attack with combined pain relievers

What are combined pain relievers

Combined pain relievers (analgesics) – drugs that contain two or more active substances in a tablet or capsule.

Combined pain relievers such as butalbital (barbiturate) -containing drugs based on aspirin or acetaminophen with added caffeine were once prescribed to relieve migraine attacks.However, they are now recommended much less frequently due to the risk of developing an abusal headache.

Other combination preparations based on ergotamine with added caffeine, which are the progenitors of triptans, are still used today [5].

OTC combination analgesics containing aspirin, acetaminophen, and caffeine may be used at the onset of a migraine attack when pain is still mild. [3].

How combined pain relievers work

In some preparations, a combination of active substances is aimed at relieving pain and treating associated symptoms (nausea, vomiting).Others contain two pain relievers that reinforce each other’s effects. The third include substances that relax muscles [2].
One of the most effective combinations for relieving a migraine attack is a combination of a non-steroidal anti-inflammatory drug (ibuprofen, naproxen) and a specific anti-migraine drug of the triptan group [1].

Thus, combined analgesics can be used to relieve migraine attacks and are effective. However, it is very important to remember that an excess of these drugs can cause migraine attacks to become more frequent and more severe [4].If you are taking combination analgesics more than 4-5 times a month, see your doctor for more effective and safer drugs.


  1. A.V. Amelin “NSAIDs and triptans for migraines: separately or together?” // RMJ. – 2011.- www.rmj.ru/articles_7651.htm
  2. Ekusheva E.V., Filatova E.G., Golubev V.L. “Zaldiar in the treatment of migraine attacks.” // RMJ. – 2011.
  3. Steiner TD, Pemelera K., Jensen R., et al. European principles of managing patients with the most common forms of headache in general practice. // M .: “OGGI. Advertising production “, 2010 – 56p.
  4. Bigal M.E., Lipton R.B. Migraine chronification. // Curr Neurol Neurosci Rep. – 2011. – v.11. – p. 139-148
  5. Rothrock J.F. Compound medications for acute migraine treatment. // Headache. – 2008. – v.48. – p. 1283

Photo by Anna Shvets from Pexels

111 reviews, instructions for use

Gabit Nurumbetov, chemist: plaster “

How clinical trials are conducted

The first part is the bioequivalence test.A group of random people is recruited, say 20 people. Some of them will receive a placebo, others will be given a real drug. Then every two hours they will take 5 ml of blood from a vein. The blood is purified and the concentration of our medicine in it is measured, and then the two groups are compared. It is necessary to determine whether there is a certain concentration in the blood, which is called therapeutic. Our goal is to achieve a therapeutic concentration in the blood after we have glued the product to the skin. Accordingly, those wearing a placebo should have absolutely nothing.As a result of the first part of the study, we need to prove that we can deliver the right amount of the substance.

In the second part of the study, safety is verified. It may be that you want to make tablets from an already known substance. It was approved and has been on the market for 20-50 years, but the patent belonged to another manufacturer. Let’s say the patent has expired, and you want to make exactly the same pills, but much cheaper. Then you don’t need to do the second part of the clinical trial.It is intended only for new substances that were not previously available on the market. Approximately 200 people take part in this stage. But it depends on the requirements of the regulator, he may oblige you to hire 1000 people.

Check here which dose is the maximum and which is the minimum. How does this medicine work for people? Will someone die (God forbid) or will there be some kind of reaction. Also check the dependency. As the saying goes, “everything is poison, everything is medicine.” All research is carried out in large clinics and is supervised by doctors.This is important because there can be different consequences when a medical emergency is needed. For example, from 20 milligrams, a person may begin to vomit or anaphylactic shock may occur.

After determining the permissible limits, the third part of the test begins. The largest group of people, for example, 20,000 people, is recruited for her, and a double randomized placebo study is carried out. That is, neither patients nor doctors know what a placebo is and what a medicine is. This is necessary in order to exclude any variations.Doctors are simply supplied with packages, and patient monitoring begins. Usually this research goes under some kind of disease and the effectiveness of the medicine is checked. Patients take these pills (and placebos and medications) for 6 months to 2 years, depending on the disease.

At the end, the data are consolidated. The clinic provides a report to the manufacturer with bare data: who the drug helped, and who did not. And the manufacturer, knowing who took the placebo and who the active substance, makes a conclusion.Let’s say in the group of those who were cured by the drug, 75% of people took the active substance. That is, the medicine really helps with this disease. Conversely, the main group of those who did not benefit from it took a placebo. But it so happens that in the group of cured up to 40% of patients took placebo.

If you start with a completely new substance, then it takes 10-12 years to go through all these stages. The manufacturer of the medicinal product collects all the data and gives it to the regulator. In Europe it is the European Medicines Agency (EMA), in America it is the FDA.There, experts read reports, verify the data and give their opinion: whether to allow them to be released on the market or not.

How are things going with the testing of plasters

Since our company itself develops plasters, we also need to carry out these studies. We are considered a pharmaceutical company, and are responsible for the data that the EMA or FDA provide, and they will already give us permission to sell in the US or European markets.

Our medicine is not new, it is already on the market, but no one has ever produced it in a patch before.We are now awaiting the results of the first phase. This part of the tests is allowed in principle to everyone, because this is a small study. Then, when we receive this data, we will consult again with the regulator. Since the safety of the drug has already been proven, we want to go straight to the third stage, skipping the second. They can either agree or refuse, demanding to do the second phase.

How to move from academic to commercial science

It was a challenge for me, because we were building a company from scratch, there was nothing: no laboratory, no methods, and we had to take into account money – everything depends on them.Previously, if I needed 50 ml of methanol, I could take 2.5 liters and use as much as I wanted, simply because my supervisor would pay for it. Now, there is a budget for every experiment purchase.

The bottom line is that money should produce data that will make more money. Each experiment must be counted: whether it is needed or not, it gives data or not. Nobody has done any experiments for fun, and this is the first difference. The second is that the academy is a fairly relaxed environment.As my mentor says, “we ourselves invented this industry for ourselves and we cook in it, and the rest of the world does not care what we do there”. Because there are practically no publications in the public domain. Fortunately, there is a sci-hub that can hack any publisher. In fact, the public does not read this data. This voluminous array of information and knowledge just hangs somewhere. Due to the fact that the society is closed, everyone is quite relaxed, especially in terms of deadlines. When you are in the Western system, you have defended your dissertation, you are a PhD and that’s it, there is nothing further to defend and you can calmly, without rushing to do research, get paid and think high.Here, in the company, there is no such thing, because you spend money every day and you cannot just walk around and think about something high. We need to solve the problem here and now. That was the switch for me. At first it was difficult, but then I got used to it, and at some point I caught myself thinking that I could not return to the academy, and if I did, it would be just to relax.

90,000 What they are treating us with: Nurofen. Does the popular pain drug treat

Three sisters and just blondes

A little about how ibuprofen works.NSAIDs block the work of three cyclooxygenase enzymes. It should be noted that the third cyclooxygenase is a type of the first, synthesized from the same gene, and its presence in human tissues has not yet been proven. They look like three sisters. The eldest, cyclooxygenase-1 (COX-1), is constantly present in the body and does important physiological things, the middle one, COX-2, tries to help her, but always does everything wrong, and the youngest, COX-3, knows even less.

Let’s say these sisters work in a hairdresser.They work real miracles there: they receive nondescript molecules of fatty arachidonic acid, which are ubiquitous in the body, and after the attachment of only two oxygen atoms, the beautiful prostaglandin h3 leaves. Since it is obtained not without the help of peroxide, its name is easy to remember by the consonance “just blond” (in fact, the name keeps the memory that this substance was first isolated from the secretion of the prostate gland, in English prostatic gland). It can already be converted into many other prostaglandins.

Prostaglandins are not real hormones, but almost as powerful: they are subject to many reactions, from the production of mucus in the digestive tract, which protects the delicate mucous membrane from, for example, gastric hydrochloric acid, to sensitivity to pain. That is, they do not themselves cause pain, but rather increase the sensitivity to some of the chemical signals that we perceive as pain. The derivatives of our “just blond” have an effect on both blood coagulability and the width of the bronchi, therefore, when its work is suppressed, symptoms of asthma or problems with the cardiovascular system may occur.

Sister COX-1 works with these clients all the time, and after visiting the “hairdresser” they become “good” and go to protect the gastrointestinal tract. COX-2 comes to help when she is “called” by special signals informing that the body is sick or growing. But while the middle sister works pretty much the same way and gets the same primary “just blonde” out of the box, it might seem like he is unhappy with the quality of the service. Its derivatives “go over to the evil side” and begin to rage: increase the body’s sensitivity to pain, cause inflammation and fever.The same story with COX-3, only in this case it does without inflammation.

Biochemistry of Chekhov and Tolstoy

Here demiurges-pharmacists interfere in the fate of the sisters, sending them their narrowed – drug molecules. Married, they hope, TsOG-2 will calm down, abandon an unsuccessful career and cease to be destructive. NSAIDs come into cells and “take” COX-2 “as a wife”. “No more blondes!” – proclaims the jealous spouse. Everything would be fine, only the sisters are incredibly similar, and most drugs cannot distinguish them, at the same time prohibiting COX-1 from binding with arachidonic acid.Aspirin, for example, is even 170 times more likely to marry COX-1 than COX-2, and make her wear an acetyl tag so that arachidonic acid is afraid to approach her. It is impossible to persuade him to let his older sister go to work further: the reaction is irreversible.

How to take pills so that they help, not harm

The effectiveness of pain relievers is increased when taken according to a specific regimen.

Pain – tablet pain

The headache is debilitating.Pain relieving pills available in pharmacies with active ingredients such as diclofenac, ibuprofen or triptans come to the rescue.

Be careful, just taking a pill every time you have a headache is not the best solution. Improper treatment or overdose can lead to a vicious circle: pain – pill – pain.

Take a break

That many of his patients make the mistake of taking pain pills too often, says Oliver Emrich, a German general practitioner . According to him, if the medication is taken continuously, the opposite effect can ultimately be achieved and the symptoms worsened.

Pain can take on a life of its own from taking the pills. This increases the suffering as the attacks last longer and become more intense. It is necessary to follow a certain method of taking pills, – explained Oliver Emrich.

The same method

To avoid the side effect in the treatment of headaches, the specialist recommends adhering to the proven “10-20 rule”.This means that you need to take painkillers no more than ten days a month, after which you need to take a break for 20 days.

At the same time, the expert notes that the same diclofenac, paracetamol, ASA and ibuprofen are anti-inflammatory drugs and simply do not work for the most common types of headaches.

More often than not, headache can be caused by overstrain of muscle spasms. Therefore, targeted muscle training and regular endurance sports are the best prevention.

Rules for taking painkillers, which you need to find out about before you get sick

It often happens that painful sensations not only spoil our mood, but also interfere with work and have fun with friends. However, pain is not a whim of our body that can be brushed aside, but a defense mechanism, which must be responded to correctly.

Bright Side found out when you shouldn’t grab painkillers right away and how to take these pills correctly.

Pain is an important signal from the body

Do not take pills right away trying to get rid of pain. Unpleasant sensations are an important signal from the body that something is wrong in it. Thus, he warns us and asks for help.

Pain can be caused by spasms or more serious problems. First of all, it is important to understand what exactly caused the discomfort.

How to understand what causes the pain?

One of the easiest ways to find out is to take an antispasmodic such as papaverine or drotaverine.Its action is based on the fact that it relaxes the contracted muscle, blood flow is restored and the organ or the entire system begins to function normally again. If the result is not felt, then it is better to go to the doctor.

Another type of pain reliever, analgesic, of course, will relieve pain, but will not eliminate its true causes. It will only temporarily eliminate unpleasant sensations, and the problem that our body signals about will remain.

Stomach pain should never be ignored.There are a lot of important organs and systems of our body, in which just some kind of malfunction could occur. If you do not consult a specialist in time, the problem will not be solved by itself, but will worsen, which may lead to the need for surgical intervention.

Take pain relievers on time

Usually, the effect of the tablets begins 20-30 minutes after they enter the body. If you feel the first symptoms of discomfort, then you should not postpone taking medications.Better to take the pill beforehand.

Alcohol and medications are incompatible

It is absolutely forbidden to drink alcohol with medications or simply consume it while taking medications. Alcoholic beverages can not only enhance or, conversely, greatly weaken the effect of the drug, but also change the body’s response to it in a completely unpredictable way.

Do not take pills on an empty stomach

First, before taking the medicine, unless otherwise indicated in the instructions, it is advisable to eat.Well, or at least drink a glass of kefir. This is necessary to keep the stomach safe. Secondly, it is better to take painkillers with a glass of warm water or a cup of tea, so that they get inside at least partially diluted.

Do not exceed the permissible dose

This applies to both taking drugs at a time and per day. Sometimes the pain is so unbearable that you want to eat all the pills at once, so that only it goes away as soon as possible. However, this will only lead to side effects and an even greater deterioration in well-being.Therefore, do not take more than 1-2 tablets at a time.

In the instructions for all drugs, it is also written after what interval of time and how many times a day you can take certain drugs. No need to experiment on yourself and exceed the norm. If the medication does not work or the pain persists, it is best to see a doctor.

Do not mix different analgesics

Do not mix different groups of analgesics, taking them at the same time. Drugs that should not be taken in combination with each other include the following.

  • Derivatives from pyrazolone: ​​analgin, butadione.
  • Salicylic: aspirin, acelysin.
  • Derived from organic acids: ibuprofen, voltaren.
  • Aniline: paracetamol.
  • Oxicam: tenoxicam, piroxicam.

Mixing the drugs will not improve their speed of action or the final result, but the side effects will not be long in coming. For example, nausea, dizziness, weakness, muscle cramps, and even trouble breathing may appear.

Do not abuse drugs

If you often take certain painkillers, the body at some point can get used to them and the drugs will lose their effect. In addition, our body is quite capable of stopping mild pain on its own. If you take pain relievers even with the slightest discomfort, the body will no longer cope with unpleasant sensations on its own. And he will always wait for help from the outside.

Be sure to see a doctor

Self-medication is not always effective, and sometimes it becomes dangerous.In case of severe or recurring pain, as well as for the choice of pain medication, it is still better to consult a doctor.

Listen to your body and be healthy!

90,000 A new addiction: why analgesics are dangerous

Maria, television producer, 37 years old, in the mid-1990s became interested in “Advil” – the same ibuprofen, only American. “I brought it from the States in barrels. I liked the feeling that appeared ten minutes after taking it, as if I had slept, lost weight and learned her homework at the same time, – recalls Masha, who reached 20 tablets a day.- I was finishing school then, moonlighting as a simultaneous translation at negotiations and ate “Advil” almost once an hour. When people saw that I was taking pills, in their eyes there was not disgust for the drug addict, but on the contrary, almost respect. Like, the girl works day and night, does not spare herself. And even then, it was just as cool to walk with foreign pills, as, for example, with a color player or in Velcro sneakers. True, the stomach fell off, because the doses had to be increased in order to experience this feeling of mild arousal again.But when you are 20, it is more important that your head does not hurt and your mood is good, and you can eat nails at least. ” At the age of 30, Maria was admitted to the hospital with a diagnosis of perforated stomach ulcer. On this, her romance with codeine, fortunately, ended. The first-aid kit contains only adhesive plasters and “No-shpa”. When asked why adult women are so easily addicted to analgesics, Maria shrugs: “I think it’s out of laziness. You don’t want to be treated seriously or play sports, but taking pills to relieve symptoms is an express solution.Why go on a diet, if you can lie on the couch, eat everything, and then drink a laxative and seize on drugs for weight loss? Why go to the gym when you can soothe back pain with a pill and no problem? At least six hours while the codeine is active. ”

And then what? Either increase the dose or quit. But that’s easy to say. Dr. Maxim Ryashentsev from the Medsi clinic, who has observed many people addicted to codeine, notes that codeine withdrawal develops more slowly than from morphine.