FYI: Short-Term Use of High-Dose Ibuprofen Linked to GI Bleeding

[arlo 0]

in a nutshell, taking 800mg (4 pills) ibuprofen 3X day may increase your chance of GI bleeding. the amount recommended on the bottle is 400mg (2 pills) 3X day.

long story:


Review
HAMILTON, Ontario, Nov. 1 - Taking high doses of Advil or Motrin (ibuprofen) even for a few days can significantly increase the risk of gastrointestinal bleeding, researchers reported today.


After three days of treatment with 800 mg of ibuprofen three times a day, healthy men had evidence of significant blood loss compared with men randomized to placebo (P<0.001).


The volume of fecal blood loss was 3.64 mL greater in the ibuprofen group, Richard Hunt, M.D., of McMaster University here and colleagues reported in the November issue of Clinical Gastroenterology and Hepatology.


Dr. Hunt said the finding is somewhat surprising because ibuprofen is generally considered the safest of the non-steroidal anti-inflammatory drugs (NSAIDs) in terms of bleeding risk.


The authors conducted a post-hoc analysis of two small, single- center, randomized studies, with 68 participants. They defined fecal blood loss as significant when it was more than 2 mL daily. Fecal blood loss was measured by radioactive analysis of chromium-51 labeled red cells in stools during baseline and throughout the study for four weeks of treatment. At baseline fecal blood loss averaged 0.36 mL for all participants.


During the study, volunteers randomized to ibuprofen had an average fecal blood loss of more than 2 mL, with a daily mean loss of 2.55 mL versus 0.7 mL in the placebo arm (P<0.001).


Twenty-six of 31 participants randomized to ibuprofen had between one and seven episodes of microbleeding with fecal blood loss of more than 3 mL. Nine men in the ibuprofen arm had a maximum fecal blood loss of more than 10 mL and in two men the fecal blood loss volume reached 73 mL and 66 mL respectively.


Dr. Hunt noted that the study dose was significantly higher than the approved over-the-counter dose of ibuprofen, which is 1,200 mg daily. But he said that people who regularly use ibuprofen often use it to treat chronic pain, such as arthritis pain. Such patients "often increase the recommended dose of their painkillers."


The authors concluded that "the potential for a serious GI complication should still be considered when ibuprofen is recommended for self-medication."


In an editorial that accompanied the paper, Denis M. McCarthy, M.D., Ph.D, of the University of New Mexico pointed out that although the authors didn't investigate the development of anemia, "it is reasonable to assume that blood loss that continues at this rate in long term NSAID users could lead to significant anemia at least in some patients."


Primary source: Clinical Gastroenterology and Hepatology
Source reference:
Bowen, B "Time Course and Pattern of Blood Loss with Ibuprofen Treatment in Healthy Subjects" ClinGastroHep 2005;3:1-5.

[kelel01 1]

Arlo, what do you do exactly? I love your posts, as they're all very interesting and useful, but I'm noticing a theme here.

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[arlo 0]

i'm a freak by nature but i really love medical stuff. if isee something interesting i try to post it.

if you can figure out something good for me to do when i grow up, please, feel free. i bought a lotto ticket hoping that would help with my decision making process.

[skycat 0]

Very interesting considering when I hurt my back my Doctor told me to take 1000mgs of Ibuprofen 2-3x a day for pain and inflamation.

Fly it like you stole it!

[Hooknswoop 19]

The Army issues the stuff like candy, it's their cure-all.

Derek

[riddler 0]

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The Army issues the stuff like candy, it's their cure-all.

Yeah, the Army saw that headline and thought they should give Ibu to any General Infantryman that was bleeding Sometimes I think that infantry and vets are one big medical test group for those guys

Trapped on the surface of a sphere. XKCD

[Girlfalldown 0]

Well that's just fucking great. I'm taking 800mg of Ibuprofin 3 x a day and have been for months.

--------------

(Do not, I repeat DO NOT, take my posts seriously.)

[GQ_jumper 4]

Majority of the time though soldiers are taking that stuff on an empty stomach, and that's when its really bad for you.

History does not long entrust the care of freedom to the weak or the timid.
--Dwight D. Eisenhower

[Jeff.Donohue 0]

The risk is significantly worse if you consume alcohol regularly while taking high doses of ibuprofin.

[Deuce 1]

Arlo, forgive for not really reading it, but on the same note, Tylenol is the biggest liver-killer out there.

Folks who are addicted to Vicoden suffer liver damage due to the Tylenol, not the morphine. My sister suffered complete liver failure due to Vicoden addiction.

Frighteningly, heroin addiction is far less damaging.

Argh.

[Jeff.Donohue 0]

Deuce,

You're right that Tylenol can do great damage to the liver. However, Tylenol is the brand name of acetaminophen. It is not ibuprofin. They're different chemicals, basically.

People confuse them a lot, but they are very different, both in their chemistry and in their pharmocological properties (how they are absorbed in the system, what they do while in the system, and how they are excreted out of the system).

The problem with acetaminophen is that it causes liver damage for patents who have impaired livers (whether as a result of high ALT leves from drinking booze, or from Hepititis C, or other forms of liver disease). The problem with ibuprofin is that it blows holes in the gastro system of just the people who probably can't take acetaminophen.

Edit:

In re-reading your post, you probably knew that already. I'm going to leave the post up there, though, because it might help someone who doesn't know...

[arlo 0]

yeah, take it all with a grain of salt. this article just came out today. i am a HUGE fan of ibuprofen and will huck down 4 if i break a nail so i'm with ya there.

i've always steered WAY clear of tylenol/acetaminophen due to it's liver destruction properties. that's what makes vicodins, percodans, lortabs, etc so bad (high levels of acetaminophen). so i hated reading this as much as you guys do. but because i know how much i take them, i figured it was enough for me to take into consideration and wanted to share it with others.

deuce, no worries, dude. you're spot on about the vics etc. also, someone mentioned alcohol and ibuprofen. i know that acetaminophen(tylenol) and alcohol is the cardinal sin NO NO combination because it can shut a liver down with no warning. i'm somewhat versed in livers and have a vested interest there.
so anyway, not meaning to stir the pot but at least raise a level of awareness if you trust the source of info.

edited to add:
deuce, i'm sorry about your sis. was she able to get a transplant?

also edited to delete a joke that was bad timing.

[ChasingBlueSky 0]

Quote

in a nutshell, taking 800mg (4 pills) ibuprofen 3X day may increase your chance of GI bleeding. the amount recommended on the bottle is 400mg (2 pills) 3X day.

Went out with a girl in college that did this....detroyed part of her stomach - ate away at tissue and caused bleeding. Required surgery to fix and had digestion issues afterwards. Yet another one of the reason I prefer to manage pain without pills if at all possible.

_________________________________________
you can burn the land and boil the sea, but you can't take the sky from me....
I WILL fly again.....

[Lindsey 0]

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Well that's just fucking great. I'm taking 800mg of Ibuprofin 3 x a day and have been for months.

You can always guaic your stool to see if there's any occult bleeding . Just take a gloved finger....oh nevermind....

linz

--
A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

[Lindsey 0]

We've known for a long time that Ibuprofen can cause GI bleeding. It's not much of a surprise. A lot of people who take NSAIDs also take PPIs and/or Carafate to help with these sometimes-unfortunate side effects.

linz

--
A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

[LouDiamond 1]

I just love these types of articles. it has been known for ever and a day that Motrin (ibu) can cause this among other side effects, just like every medication out there. As it has been stated, the military gives motrin out for everything. I can attest for that fact as I have been taking motrin in the 800mg and higher range for most of my military career which is 16 + years. While I don't doubt that it does cause some fecal blood loss as the article states, I do believe that unless you are invalid, taking motrin in 800mg or higher doses as prescribed by a Dr. will not have an effect on the average person that will put them at any more risk than any other current OTC medication out there. If the miniscule loss of blood that is stated in the article is a major concern to anyone I would venture to say they are probably laying in a bed somewhere under a Dr's care and not the average joe on the street.

"It's just skydiving..additional drama is not required"
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[mnealtx 0]

Also, if you are taking low dose aspirin for the heart health aspect of it, acetominophen can block the effects...

Mike
I love you, Shannon and Jim.
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