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OTC Pain Meds & High Blood Pressure

Over-the-counter pain meds raise the risk of high blood pressure — for men as well as women. A recent study indicates that all painkillers are potential culprits, they include:

This is yet more proof that over-the-counter does not mean safe. Some other problems with OTC painkillers are increased heart attack risk, stomach bleeding and liver damage.

The American Heart Association advised yesterday that doctors be cautious in prescribing painkillers, particularly Celebrex, because of the risks. Today’s New York Times warns that few patients know the appropriate dose of acetaminophen or the havoc it can wreak on one’s liver.

No wonder I try so hard to tough it out.

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Tough Girl

Walking hunched up like a terrified rescue dog, I’m trying to ignore the pain reverberating in my head. It’s a day that I should be reading on the couch, but I have things to get done. They’re small, quiet activities, like packaging up some books I sold through Amazon and moving the basil plant I just bought outside. But this damn pain has me in its grip.

Finally I give in and make some tea. Caffeine might knock it down enough for me to put books in envelopes. The kettle on the stove, I’m struck with a brilliant idea — take some Advil. While no other painkiller or headache abortive does much for me, a small dose of an NSAID, like Advil or Aleve, often brings my headaches down a notch or two.

Yet I rarely take any meds. Whether this is a tough-girl complex or fear of rebound, I don’t know. It’s not like I need to prove to myself that I can handle the pain; that’s confirmed for me every single day. Nor do I have any history of rebound headaches.

I like to think that I save the drugs for when I’m on vacation or have plans with friends. Or when my head is so bad that all I can do is lie in bed and moan. Those aren’t the motivators either. I’m just conditioned to not take meds. Maybe it’s so I have something to be proud of.

Today I don’t have to pretend I’m tough. I take the Advil and drink the tea (and get bonus antioxidants!). I’m still waiting for relief. I may have gotten too far into the migraine for it to make a difference. It’s time to lose myself in a light, fluffy book.

I wrote this yesterday but wasn’t up to posting. After resting and reading for a couple hours, I did feel better. Probably just the course of the headache and not the painkillers or caffeine. In any case, I got the books ready to mail and the basil outside.

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Advil’s Curious Name

Have you ever noticed that if you replace the D in Advil with an N, the word is anvil? How much do you want to bet that drug company employees brainstormed product names while eating doughnuts at a conference table — and laughed hysterically when someone suggested Anvil?

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Tylenol & Ibuprofen Linked to Women’s High Blood Pressure

Women who take more than 400 milligrams of ibuprofen (or other NSAIDs) or 500 milligrams of acetaminophen per day have an increased risk of high blood pressure than those who do not take the meds, found a study that will be published in the September issue of the journal Hypertension.

Taking more than 400 milligrams of NSAIDs per day increased the risk of high blood pressure by 78% in women 51 to 77 years old and by 60% in women between the ages of 34 and 53. Daily use of more than 500 milligrams of acetaminophen raised the risk of high blood pressure by 93% in women in the older age group and by 99% in younger women.

This study clarified that it is the painkillers and not the headaches that women are trying to treat that cause high blood pressure.

Learn more by reading the WebMD article, Common Pain Drugs Up High Blood Pressure Risk, or the journal article abstract, Non-Narcotic Analgesic Dose and Risk of Incident Hypertension in US Women.

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Enough is Enough: Rebound Headaches

News anchors, journalists and medical websites have warned that “painkillers might be causing your pain!” too many times to count. OK, OK, rebound headaches are nasty; so are chronic daily headaches and migraines. I want to know how much is too much. Not vague amounts, but clear, precise doses.

In comes the conflicting advice. One doctor said to rotate Imitrex, Migranal and Advil every three days to avoid rebounds. Another said that it’s perfectly fine to take a triptan a couple days a week and an OTC painkiller another few days. Of course, no doctor knew just how much Advil I took because I was afraid to admit the amount to myself, much less say it out loud.

When dignity took a backseat to pain relief, I stopped the painkillers. Four years later, I can barely remember how much better I felt when I took occasional painkillers. I often forget that it’s even an option. But I do remember my headache specialist telling me that the goal of my treatment is to make me feel like I do when I take Advil*. Lately, the forbidden drug has started calling my name.

Because my headache specialist, who I think is terrific, relies on the International Headache Association’s standards, I’ll do the same. IHS’s bottom line is that rebounds are likely if you take painkillers or migraine abortants more than once or twice a week or more than 10 times a month. As you well know, nothing is one size fits all, but these are good guidelines.

Think you might be in rebound? Here are some frequently prescribed meds that can cause rebound headaches. You’ll be miserable if you stop them cold turkey, so get your doc’s advice first.

Triptans: Amerge, Axert, Frova, Imitrex, Maxalt, Relpax, Zomig

Ergots: Cafergot, D.H.E. 45, Migranal, Sansert

OTC Painkillers: Acetaminophen (Tylenol, Excedrin, Vanquish), Asprin (Bayer, Bufferin), Ibuprofen (Advil, Motrin), Naproxen Sodium (Aleve)

Prescription NSAIDs: Indomethacin (Indocin), Ketorolac Tromethamine (Toradol), Naproxen Sodium (Anaprox, Naprelan, Naprosyn), Piroxicam (Feldene)

Opioids: Fentanyl (Duragesic, Actiq), Hydrocodone (Vicodin, Lortab, Lorcet, Norco), Morphine (MSIR, MS Contin, Oramorph), Oxycodone (Roxicodone, OxyContin, OxyFast, OxyIR)

The scariest part about stopping the meds is that your headaches might not change or may even worsen.The underlying condition that prompted you to take them in the first place is probably still there. Even if you don’t get immediate relief, your headaches may be easier to treat in the long run with fewer drugs getting in the way. And your kidneys will thank you.

*Advil doesn’t get rid of my headaches, but it sometimes reduces the severity of the pain. For me, feeling “much better” is having pain that’s below threshold that would keep me in bed.