Pain Relief Medications: Are They Good for You?

Other Problems

Several recent studies found that problems with NSAIDs are not just stomach related.

In a University of Massachusetts Medical School study of 4,099 people over age 70, investigators found warning signs of kidney failure among those who used NSAIDs regularly. Signs include swelling of the ankles, lower legs and feet, and unusual weight gain.

Researchers at the Emory University Swallowing Center report that elderly people who use NSAIDs risk getting significant complications of gastroesophageal reflux disease (GERD)—typically caused by chronic exposure to stomach acid in the esophagus.

NSAIDs can also cause other problems:

• Dizziness, drowsiness, confusion, ringing of the ears, and anxiety can occur, all of which usually disappear once the drugs are stopped.
• Because NSAIDs interfere with blood clotting, some people who take high doses of NSAIDs bruise easily. If you take blood thinners (eg, aspirin, coumarin, warfarin), consult with your doctor before starting NSAIDs.
• Allergic reactions to NSAIDs are not uncommon. Signs of a drug allergy include rapid heartbeat, rapid breathing, wheezing, fainting, hives or rash, and puffiness around the eyes.

Why Seniors Are at Increased Risk

"Many things that happen with aging tend to make drugs linger in the body longer," explains John T. Boyer, MD, director of the Arizona Center on Aging and section head of Geriatrics at University Medical Center in Tucson.

The following changes are a primary reason why drug doses for seniors are typically lower than those recommended for younger people:

• The liver is the body's central processing plant for drugs. As we age, the "plant" decreases in size, which means blood flow declines and processing slows: between ages 25 and 65, blood flow through the liver decreases 40% to 45%.
• The amount of body fat increases while the amount of lean body mass and total body water decrease. These changes result in a higher concentration of drugs in the body fluids and hinder drug elimination.
• The kidneys help eliminate drugs from the body, but their work is slowed by declining kidney function, which may be at only 40% by the sixth decade. If you have kidney problems, use of NSAIDs should be avoided or monitored closely by your physician.