Each week, OMRF Chief Medical Officer Dr. Judith James opens “Adam’s Journal” to answer a medical question from Adam Cohen, OMRF’s senior vice president & general counsel.
Adam’s Journal
A friend of mine is (surprise!) a runner, and as he’s aged, his knees have grown creakier and more painful. When I asked him if he took ibuprofen for the pain, he said he generally tried to avoid it, as he’d read that it carried a much higher risk of side effects in people 65 and over. Is this a real thing?
Dr. James Prescribes
There’s nothing magical about turning 65. You don’t go from no risk at 64 and 11 months to danger on your 65th birthday.
However, there’s a reason your friend and many others hear this number: We know the risks of adverse events for ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs) increase with age, especially at full doses and when used daily.
That said, many can take these medicines without major concern, particularly if they do so only on occasion. Still, this is not true for all.
Ibuprofen and other NSAIDs can cause a heightened risk for gastrointestinal bleeding and other GI complications. They can also bring an increased chance of kidney dysfunction, along with a rise in blood pressure and fluid retention.
Finally, these drugs may also increase a person’s probability of experiencing a heart attack or stroke, most notably in people who already have cardiovascular disease or are at high risk for these conditions due to other factors.
Fortunately, most of these risks can be managed through regular monitoring with your healthcare provider.
According to a review in the medical journal Pain Medicine, 90% of all NSAID prescriptions are for patients over the age of 65. That same review said up to 35% of patients over 65 take them daily, and 70% use them at least once a week.
As these statistics strongly suggest, NSAIDs can be and often are safe and effective treatments for pain. But using them is a balancing act, one that requires taking enough to control acute discomfort but not so much as to ratchet up the risk of serious side effects.
For those with higher risk factors, which include increasing age, it’s wise to explore other options. For your friend with knee pain, those could include topical NSAIDs, acetaminophen, quadricep-strengthening exercises, and even injections.
In the longer term, companies are developing new drugs for conditions like osteoarthritis. We hope that trials for promising disease-modifying medications for osteoarthritis will soon become available in Oklahoma.
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James, a physician-scientist, is executive vice president and chief medical officer of the Oklahoma Medical Research Foundation. Cohen is a marathoner and OMRF’s senior vice president and general counsel. Submit your health questions to contact@omrf.org.
