A Look at the Safety Profile of Over‐the‐Counter Naproxen Sodium: A Meta‐analysis

Bansal, Vidhu; Dex, Terry; Proskin, Howard M.; Garreffa, Stephen

doi:10.1177/00912700122009935

Cited by 27 publications

(14 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…7, 10, 11, 27, 28 Our data show that among participants who report pain, only 11% take opioids, which was significantly less than using non-opioids, such as NSAIDs. In addition, recent clinical trials have shown effectiveness in using opioids for pain among older adults with musculoskeletal conditions.…”

Section: Discussionmentioning

confidence: 69%

Pain Treatment of Underserved Older African Americans

Yazdanshenas

Bazargan

Smith

et al. 2016

J American Geriatrics Society

View full text Add to dashboard Cite

Older adult African Americans who experience pain are especially at high-risk for under assessment and treatment. This study examined the patterns and correlates of pain medication use that include the following: severity of pain, medical conditions, and access to care. Four hundred African American older adults aged 65 years and older were recruited from 16 churches located in South Los Angeles. Structured face-to-face interviews and visual inspection of each participant’s medications were conducted. More than 39% of participants were 75 years and older and 65% were female. Forty-seven percent used at least one type of pain medication. The frequency of pain medication use by pharmaceutical class was as follows: non-opioid (33%), opioid (12%), adjuvant (9%), and other drug (8%). Furthermore, 77% of non-opioids were Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and were used among 25%, 28%, 26%, and 28% of participants with hypertension, stroke, kidney disease, and gastrointestinal problems, respectively. Among participants who used NSAIDs, 98%, 69%, and 65% experienced Potentially Inappropriate Medication (PIM) use, drug duplication, and drug-drug interactions, correspondingly. This study suggests a severe mismanagement of pain among underserved African American older adults, particularly among individuals with co-morbidity, multiple providers, and limited access to health care. The use of pain medication was associated with drug-drug interactions, drug duplication, and PIM use. Our data shows that a large number of participants with severe pain are either not taking pain medication or experience PIM use. One out of four participants was taking NSAID pain relievers, which can cause serious side effects among aged African Americans with multiple chronic conditions.

show abstract

Section: Discussionmentioning

confidence: 69%

Pain Treatment of Underserved Older African Americans

Yazdanshenas

Bazargan

Smith

et al. 2016

J American Geriatrics Society

View full text Add to dashboard Cite

show abstract

“…Currently, two fixed-dose combinations of an NSAID and a PPI are in development; naproxen/esomeprazole from AstraZeneca [5] and ibuprofen/famotidine from Horizon Therapeutics [6]. While both ibuprofen and naproxen are available in higher, prescription-strength doses as well as lower, OTC doses, the occurrence of adverse GI side effects in patients taking OTC doses of naproxen (up to 660 mg/day) has been shown to be comparable to, and in some cases lower than, the incidence of GI side effects in patients taking placebo [7]. Additionally, while COX-2-specific inhibitors have been linked to an increased risk of CV events [8], naproxen has been shown not to be associated with an increased risk of acute MI [9,10].…”

Section: Discussionmentioning

confidence: 99%

A patient with osteoarthritis and cardiovascular disease presenting with bilateral hip pain: a case report

Yanow

Pappagallo

2009

Cases J

View full text Add to dashboard Cite

IntroductionThe pharmacological management of osteoarthritis normally begins with the administration of acetaminophen or a nonselective nonsteroidal anti-inflammatory drug. However, acetaminophen may not be efficacious in all patients, and nonsteroidal anti-inflammatory drugs may be associated with gastrointestinal and cardiovascular adverse effects.Case presentationA 79-year-old Caucasian man with bilateral hip pain was diagnosed with osteoarthritis of the hip. His past medical history included three prior myocardial infarctions, the most recent one occurring 2 years ago. He is taking aspirin 81 mg once daily. Despite no history of ulcer disease or bleeding, he has been reluctant to take nonsteroidal anti-inflammatory drugs, and because of his cardiac history there is a contraindication to cyclooxygenase-2-specific inhibitors. He was started on naproxen 220 mg twice daily, with the proton pump inhibitor omeprazole 20 mg once daily. Upon follow-up at 4 weeks, his hip pain had decreased from a rating of 7 (on a ten-point scale) to 5 on his left side and from 5 to 2 on his right side. The patient began a course of physical therapy in conjunction with a regimen of naproxen 440 mg in the morning and 220 mg at night, plus the omeprazole and acetaminophen 650 mg twice daily. He reported no gastrointestinal effects.ConclusionThe addition of a proton pump inhibitor to nonsteroidal anti-inflammatory drug therapy can reduce the risk of peptic ulcer bleeding by ≥80%, making the incidence of gastropathy the same as with cyclooxygenase-2-specific inhibitors. The fact that naproxen is not associated with an increased risk of acute myocardial infarction made it an appropriate choice for this patient.

show abstract

“…NSAIDs relieve short‐term low back pain as well [44,45]. In the general adult population, over‐the‐counter dosing of selected NSAIDs has a good safety profile [46], although older adults are at higher risk for adverse NSAID effects. Particular caution must be exercised when considering NSAID therapy for individuals with low creatinine clearance, gastropathy, cardiovascular disease, or intravascularly depleted states such as congestive heart failure.…”

Section: Pharmacotherapymentioning

confidence: 99%

Pharmacological Management of Persistent Pain in Older Persons

2009

Pain Med

742

View full text Add to dashboard Cite

A Look at the Safety Profile of Over‐the‐Counter Naproxen Sodium: A Meta‐analysis

Cited by 27 publications

References 12 publications

Pain Treatment of Underserved Older African Americans

Pain Treatment of Underserved Older African Americans

A patient with osteoarthritis and cardiovascular disease presenting with bilateral hip pain: a case report

Pharmacological Management of Persistent Pain in Older Persons

Contact Info

Product

Resources

About