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Q: I take a lot of ibuprofen (Advil) or naproxen sodium (Aleve) for aches and pains. Is it safe?

A:  Like all drugs, ibuprofen and naproxen sodium (non-steroidal anti-inflammatory drugs, or NSAIDs) have benefits and risks.

NSAIDs are effective at decreasing inflammation and pain caused by acute injuries. Inflammation is a necessary component of the healing process–you want to manage it but not erase it completely. NSAIDs do not restore muscle function, repair chronic tendon injuries or assist in the healing of bones.

Side effects of NSAID use include nausea, abdominal pain and gastrointestinal bleeding, complications with kidney function and increased blood pressure. There is also an increased risk of cardiovascular-related events. NSAIDS are therefore best used for short periods, not for long-term chronic pain.

Because of the risks associated with NSAIDs, you should use the lowest effective dose for the shortest duration possible and always with food.

When experiencing pain after a workout or race, use PRICE (protection, rest, ice, compression, elevation) as much as possible in order to minimize the use of NSAIDs.

And for those of you who pop a couple of ibuprofen or naproxen before or during a race: don’t. Some of the side effects listed above can be exacerbated under race conditions. Think about the stress that race-induced dehydration puts on your kidneys. Add NSAIDs to the mix, and you could be endangering your health. Wait several hours after longer races and workouts (especially in hot conditions) before taking any NSAIDs and make sure you are well hydrated.

Dosing tips:

Ibuprofen (200 mg) – over-the-counter Advil, 1-2 tablets (200-400 mg) every 4-6 hours with maximum of 1200 mg/day.

Any higher dosing is prescription strength and you should consult with your physician.

Naproxen sodium (220 mg) – over-the-counter Aleve, 1 tablet every 8-12 hours. Initial dose may take 2 tablets within the first hour. Do not exceed 2 tablets in any 8-12 hour period. No more than 3 tablets in 24 hours.

Any higher dosing is prescription strength and you should consult with your physician.

(Thanks to Dr. Heather Cichanowski, MD for the information above.)

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