Anti-inflammatory analgesics: Use with caution!

Aspirin and ibuprofen are staples of many household medicine cabinets. Since they are inexpensive and available over-the-counter, people often take them without a second thought. And yet many – especially the elderly – should get better informed before taking them on a regular basis.

The American Geriatrics Society recently expressed strong reservations concerning the use of anti-inflammatory medication like aspirin and ibuprofen for treating chronic, persistent pain in adults aged 75 and older. According to this learned society, anti-inflammatories should rarely be used in those over the age of 75, and only in select individuals. The chronic use of anti-inflammatories in the elderly can lead to more adverse effects than in younger individuals because as we age, our bodies no longer absorb and metabolize medication the same way, which also changes the way our bodies respond to the medication. For example, persons over the age of 65 are at higher risk of suffering from ulcers and gastrointestinal bleeding, from heart attacks and strokes, and from hypertension or kidney problems caused by taking anti-inflammatory medication on a regular basis.

Chronic pain is very common among the elderly, affecting 25 to 50 percent of those living at home and up to 85 percent of those living in nursing homes. This chronic pain, which is caused by degenerative spine conditions, arthritis or cancer, can greatly decrease a person’s quality of life.

Among elderly individuals requiring long-term treatment, acetaminophen is usually a first-line option for treating chronic pain, except in rare individuals in whom this drug is contraindicated. If acetaminophen does not provide adequate relief, the physician can then look at other options based on the type of pain involved. These alternatives include narcotic analgesics or certain anticonvulsants or antidepressants that have pain-relieving properties. Physiotherapy, exercise and other interventions may also help treat pain.

If you have any questions about over-the-counter medication, speak to your pharmacist!