Are some painkillers safer for your heart than others?
By health.harvard.edu
People with aching joints from arthritis—which affects nearly one in four adults—often rely on drugs known as NSAIDs to ease the pain of this often-debilitating condition. These popular medications also relieve headaches, cool fevers, and dampen inflammation. But with the exception of aspirin, most NSAIDs pose a risk to the cardiovascular system, notes Harvard professor Dr. Elliott Antman, a cardiologist at Brigham and Women's Hospital.
"Taking NSAIDs routinely over a long time period can raise the risk of blood clots, increase blood pressure, and accelerate cardiovascular disease," says Dr. Antman. While the danger is greatest in people with heart disease, it's also present in people without any signs of the disease.
Researchers have scrutinized the safety of NSAIDs for more than a decade (see "A brief history of NSAIDs"). The most recent study was a 10-year-long investigation of more than 24,000 people with arthritis, who were assigned to take ibuprofen, naproxen, or celecoxib. The results, published in The New England Journal of Medicine on Nov. 13, 2016, suggest that people who took celecoxib were no more likely than those taking ibuprofen or naproxen to have a fatal or nonfatal heart attack or stroke. Also, people in the celecoxib group were less likely to have serious gastrointestinal bleeding compared with those in the other two groups. They were also less likely than those in the ibuprofen group to have kidney problems or to be hospitalized for high blood pressure.
Limitations and uncertainty
But limitations of the study created some uncertainty about the findings, according to Dr. Antman. For one thing, 69% of the participants had stopped taking their assigned drug by the end of the study, and researchers lost track of another 27%. Another concern was the dose of celecoxib, which was limited to the FDA-approved amount for treating people with osteoarthritis, who made up most of the trial participants. Their average daily dose was 209 milligrams (mg) per day—an amount unlikely to fully ease joint pain, some arthritis experts say. However, doctors were allowed to increase the prescription-strength doses of ibuprofen and naproxen to achieve better pain control (the average daily doses were 852 mg and 2,045 mg, respectively).
The low celecoxib dose likely explains why that drug appeared to cause fewer harmful effects. And the resulting inadequate pain relief may be why more people in the celecoxib group dropped out of the trial than those in the other groups, says Dr. Antman.
The lowest dose for the shortest time
So it's still not entirely clear whether any of these three NSAIDs is safer for your heart than the others. If you're at risk for heart disease (or already have it), an NSAID for a headache or other occasional aches and pains is likely relatively safe. But if you need one several times a week, or every day, work closely with your doctor to choose the best drug for your needs—and make sure you're taking the lowest possible dose for the shortest possible time, advises Dr. Antman. He occasionally sees patients who've had a heart attack who take NSAIDs routinely, but more out of habit than necessity. "They might say, 'Oh, I started taking it after I twisted my back playing tennis about a year ago. I don't want to have that pain again, so I just kept taking it.'" That's a bad idea, he cautions.
Source: http://www.health.harvard.edu/heart-health/are-some-painkillers-safer-for-your-heart-than-others
Wednesday, May 6, 2026
Medrol: Brand Name Medication Guide For Corticosteroids
Medrol is the brand name for methylprednisolone, a medication used in the management of conditions associated with corticosteroids. Brand name medications are pharmaceutical products marketed under a proprietary name by the company that originally developed them. Understanding the relationship between brand name and generic formulations, as well as the conditions for which the medication is approved, helps patients make informed choices about their treatment. The spectrum of allergic disease is broad. Seasonal allergic rhinitis, often called hay fever, flares in response to outdoor allergens such as tree pollen in spring and ragweed in fall. Perennial allergies occur year-round and are typically triggered by indoor allergens like dust mites and pet dander. Chronic urticaria manifests as persistent hives and can last months or years without a clearly identifiable cause. All of these conditions share a common inflammatory pathway driven by the immune system's release of chemical mediators. The brand name Medrol has built a clinical track record through use in a wide range of patients and healthcare settings. Brand versions and their generic equivalents contain the same active ingredient at the same strength, but may differ in inactive ingredients such as fillers, binders, and coatings. In most cases, generic formulations are therapeutically equivalent and offer cost savings, though some patients prefer to stay on a specific formulation for consistency. When prescribed Medrol, patients should follow the guidance of their prescribing physician regarding dose, frequency, and duration of therapy. The medication should be stored as directed on the label, typically at room temperature away from heat and moisture. Any unused medication should not be disposed of by flushing down the drain unless the label specifically says to do so, as this can harm the environment. Comprehensive details on Medrol and other medications used for corticosteroids are available through corticosteroids. This resource provides evidence-based summaries to help patients and healthcare providers stay informed about treatment options in this therapeutic area.
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