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Posts Tagged ‘Naproxen’

What A Relief: How to Get the Best Out of Pain Relief Options Over-The-Counter, Part 1. By Our July Student Pharmacist, Andrew Chow.

One of the most common health problems facing many people is pain, in particular, pain in the muscles and joints. Muscle pain, also called myalgia, is a diffuse and constant pain that is often accompanied by weakness and fatigue. You may also notice swelling, as well.

Everyone has experienced muscle pain sometime in his or her lifetime. Typically, muscle pain is the result of sprains, strains, or excessive use of certain muscle groups. Straining is injury to a muscle or tendon caused by overextension. Spraining is injury to a ligament caused by joint overextension. Muscle spasms, on the other hand, are an involuntary contraction of the muscle. Muscle cramps are prolonged muscle spasms that produce painful sensations.

Joint pain can be either acute or chronic. Chronic joint pain is also called arthritis.

You can treat the pain using over-the-counter products except for the following conditions:

–       If you feel your pain is more than a 7 out of 10 with “10” representing the most excruciating pain.

–       Your acute pain has lasted more than 10 days (except if you have been diagnosed with osteoarthritis).

–       Your pain still persists or even gets worse after 7 days of treatment.

–       Your pain is in the pelvic or abdominal area, excluding menstrual pain.

–       Your pain is accompanied by nausea, vomiting, fever, or other signs of a systemic infection.

–       You have a visually deformed joint, abnormal movement, weakness in any limb, or a suspected fracture.

If any of the above conditions occur, you need to see a doctor.

You can treat muscle and joint pain either locally or systemically. For systemic analgesics, the over-the-counter options are Tylenol® (acetaminophen), non-acetylated salicylates, salicylates (such as aspirin), and non-steroidal anti-inflammatory drugs (NSAIDs).

Today, we will focus on ibuprofen and naproxen. They are the two most common over-the-counter NSAIDs in the United States.

The major brand names for ibuprofen are Advil® and Motrin®.

The main brand name for naproxen sodium is Aleve®.

NSAIDs work by blocking the production of certain body chemicals that cause inflammation and thus relieve pain. As such, NSAIDs can be used for temporary pain relief, decreasing inflammation and also reducing fever.

For ibuprofen, the adult dose is 200 to 400 mg every 4 to 6 hours for pain relief. The maximum dose is 1200 mg in a 24-hour period. Ibuprofen can be used for infants over 6 months old. The children’s dose is weight-based. Typically, you can give 5 to 10 mg/kg every 6 to 8 hours but no more than 40 mg/kg per day.

The adult dose of naproxen, on the other hand, is 220 mg every 8 to 12 hours for pain relief. The maximum dose for naproxen is 660 mg every 24 hours. Naproxen can only be used for people aged 12 or over.

The common side effects of NSAIDs can be categorized based on the gastrointestinal (GI), kidney, and blood systems. Common GI adverse effects are nausea, vomiting, diarrhea, dyspepsia (upset stomach), and ulcers. NSAIDs can also cause sodium and fluid retention, resulting in increased blood pressure. NSAIDs also increase the risk of bleeding.

NSAIDs cannot be taken for the following reasons:

–       Aspirin allergy.

–       Before upcoming surgical procedures, including heart surgery.

–       Bleeding problems and stomach ulcers with a previous history of stomach ulcer bleeding.

–       Heart conditions, including active congestive heart failure. Read more about that HERE.

For a complete list of reasons not to take NSAIDS, go HERE.

Please remember: take NSAIDs for a maximum of 10 days with the dose as recommended above. Take the lowest dose for the shortest duration in order to get adequate pain relief. Contact your doctor if symptoms do not improve or get worse in 10 days.

Take NSAIDs with food, milk, or an antacid if stomach upset occurs.

For pregnancy, avoid NSAIDs in the third trimester and ask your obstetrician whether you should take them in the first or second trimester.

Next time, we will talk about acetaminophen, aspirin, and non-acetylated salicylates for muscle and joint pain relief.