Anti Inflammatory Tablets

[Updownupdown]

Be careful about using non-steroidal anti-inflammatories (NSAIDs) such as Ibuprofen, Dicloflex, Diclofenac, Voltaren (/ol). They can cause acute renal failure in some people particularly in combination with dehydration. They can also cause epigastric/pancreatic pain. There have been deaths attributed to ibuprofen used by dehydrated runners in the Marathon des Sables and other ultras. One of my daughters ended up in hospital on a drip in February after such a reaction and it's not as rare a side effect as you might think.
now.

Finally some sense! Non steroidal anti inflammatory tablets (NSAIDs) such as Ibuprofen and diclofenac, are effective pain killers, as Tussockface says they can cause renal failure (I've seen a user end up on dialysis -forever -but it's rare) for the endurance athlete the combination of dehydration or low sodium (usually the result of overdrinking) and NSAIDs can be very serious.

Their effects on inflammation are debatable, they're probably bad for acute injury (they affect bleeding and chemicals called prostaglandins involved in the tissue damage). They are a good pain killer if that's your poison, otherwise, paracetamol is safer and in many studies only fractionally less effective than an NSAID. NSAIDs cause ulcers and gastritis, it's a prostaglandin effect, apparently you could inject them or use suppositories and still risk gastric effects, but you don't get much of the NSAID gels/creams into the bloodstream. Poor old paracetamol if they invented it again now, tarted it up and renamed it with a trendy moniker it would be a wonder drug!

There is increasingly good evidence showing cramp may have nothing to do with salt or hydration it's probably muscle fatigue related in race situations. Nor do humans have salt stores in their bodies as other threads have suggested.

Training effectively and hydrating carefully (note "carefully" overdrinking is out) may be a better solution than doping.

Sorry to rant but the quality of medical advice forumites are giving each other is shocking.

[Trog]

I am actually on my first ever course of AI’s (Diclofenic) as prescribed by my GP. I have an inflamed hip (not fully sure, Xray on Friday) and a bit of PF.

From Day 1 (last Sat) the pains have eased, although they tend to return as the next tablet is due.

The injury is obviously still there, and the pain is the body’s way of saying ‘slow down’. So I am not sure why people would want to run ‘normally’ whilst on the stuff.

As a truly addicted runner I can understand the need to run, and indeed after a fortnight off (even though I was swimming and cycling) I was suffering the classic signs of withdrawal symptoms and decided to partake in a slow easy 15 minute trot per day.

[Witton Park]

As someone with no medical training I have posted on here advising that I take Ibups and advising that I am careful ie. I don't take many, I use them in a long race - so perhaps 2 or 3 times a year - and hydrate as well.

I agree with all the cautionary notes.

I ran the PPP on ASaturday and started on paracetemol as a painkiller as I had a sore hip.
It worked a treat.

I have just found that Ibups and ibup gel help me cope with cramp. At least they seem to do.

[Updownupdown]

[QUOTE
I have just found that Ibups and ibup gel help me cope with cramp. At least they seem to do.[/QUOTE]

Well you're probably right I don't doubt that they will, it cannot be disputed they are pretty good pain killers and cramp is pretty painful. I was off on a major rant .

[NirvanaBliss]

Mmm since getting the Meltets i could say i am quite addicted to them.

And since the shin splints i have got into having ibrufen and paracetamols together, but reading this...Problem is the shin splints is seriously painful!

[Updownupdown]

Mmm since getting the Meltets i could say i am quite addicted to them.

And since the shin splints i have got into having ibrufen and paracetamols together, but reading this...Problem is the shin splints is seriously painful!

That is an entirely conventional approach to stepping up analgesia from one or another of those meds, (all the comments above aside). But if you need that much stuff to run don't you need your injury sorting out? .

[ZootHornRollo]

I think Updownupdown might be being a tad alarmist here about the terrible consequences of Ibupe and diclofenac. Saying they 'cause renal failure' and 'cause ulcers and gastritis' without massive qualifications is just misleading. Where's the empirical evidence to back all this up?

The vast majority of people who take these anti-inflamms have no side-effects whatsoever. Taken properly they pose virtually no problems to anyone. Most people aren't daft enough to take large amounts on empty stomachs and get dehydrated.

I wasn't aware that Ibupe can prevent cramp, but glad to hear it does.

[Updownupdown]

I think Updownupdown might be being a tad alarmist here about the terrible consequences of Ibupe and diclofenac. Saying they 'cause renal failure' and 'cause ulcers and gastritis' without massive qualifications is just misleading. Where's the empirical evidence to back all this up?

The vast majority of people who take these anti-inflamms have no side-effects whatsoever. Taken properly they pose virtually no problems to anyone. Most people aren't daft enough to take large amounts on empty stomachs and get dehydrated.

I wasn't aware that Ibupe can prevent cramp, but glad to hear it does.

I agree I'm somewhat alarmist, the risks are relatively low. Not sure I'd say it's actually misleading. There is good evidence, you are quite reasonably querying the incidence of harmful effects though.

For GI bleeding an NSAID user has about 4x the risk of a non user, however this is based on pooled studies it's dose and drug related, and if you're young and healthy its lower, if you're old and have bled previously it's masses higher, and that's still a low risk of course as a non users GI bleeding risk is only 1 per 1000 person years. Evidence since you ask: Association Between Nonsteroidal Anti-inflammatory Drugs and Upper Gastrointestinal Tract Bleeding/Perforation
An Overview of Epidemiologic Studies Published in the 1990s Sonia Hernández-Díaz, MD, MPH; Luis Alberto García Rodríguez, MD, MSc
Arch Intern Med. 2000;160:2093-2099.

Renal issues; probably easiest to look at here if you really want:http://www.cks.library.nhs.uk/nsaids...nsider#-330673

And being pedantic they do not prevent cramp, they would be expected to reduce the pain of cramp as they are painkillers.

Actually I wish I'd never mentioned it,

[Tussockface]

I think Updownupdown might be being a tad alarmist here about the terrible consequences of Ibupe and diclofenac. Saying they 'cause renal failure' and 'cause ulcers and gastritis' without massive qualifications is just misleading. Where's the empirical evidence to back all this up?
The vast majority of people who take these anti-inflamms have no side-effects whatsoever. Taken properly they pose virtually no problems to anyone. Most people aren't daft enough to take large amounts on empty stomachs and get dehydrated.

Zoot, I'll take some of the flak here as Updown was supporting my original post.
Perhaps it is alarmist, but then seeing your 18-year-old daughter on a drip with failed kidneys is pretty alarming.
It's true that use of NSAIDs is widespread and they can be fantastically effective without any apparent side effects. I once had back pain that left me on the floor thinking I was dying until one tab of Voltaren got me up and about in minutes. I'm sorry if anyone thought I was denigrating an entire class of incredibly useful drug.
But you suggest that bad reactions are a result of daftness, and that "taken properly they pose virtually no problems to anyone". Now, I realise that an anecdotal case is scant evidence, but my younger daughter certainly did nothing daft. She took a prescribed amount of Diclofenac and undertook an ordinary school day (she's doing her A2s). She was healthy and fit with no other medical condition and yet within 24 hours she was in hospital with acute renal failure. This completely baffled the specialists until they discovered that she'd had Diclofenac, and then they more or less said 'Of course, that explains it', as if it wasn't an irregular occurrence.
This set me off googling the key terms and possible links between NSAIDs and kidney problems began to emerge. Subsequently, a surprising number of friends and friends-of-friends have related similar tales.
So I'm not scaremongering, or saying that NSAIDs are terrible and inevitably damaging or dangerous. I'm just saying that it's wise to be aware that there can be problems and that you don't have to act in a daft way to be susceptible to them.

[ZootHornRollo]

Tussockface, I genuinely didn't mean to be dismissive of what happened to your daughter, or to imply that she was daft.

I didn't go back to re-read all the previous posts in this thread properly when I came back to it, and had forgotten your experience with your daughter - I just remembered a general point being made (by Upanddown I thought!) about dehydrated ultra-athletes, and I was responding to that.

Even so, daft was the wrong word. I just meant that most people aren't taking them in such circumstances.

Didn't read thread properly, chose my words very badly and it came out totally wrong. Please accept my apologies.

Ade