Ibuprofen-the pain killer sold over-the-counter as Advil, Nuprin and Motrin-could be harmful to your health, some physicians warn. Side effects of the popular drug can include kidney failure and ulcers, they say, but ibuprofen packages carry no such specific warnings.
“It should not be over-the-counter medication,” said Dr. Shashi Kant, who argues that the dangers of ibuprofen are heightened because it is sold without prescription and many patients take too much. “People do not believe these things to be medicine. That’s what makes them so dangerous.”
Kant, a kidney specialist at the University of Cincinnati Medical Center, cites two recent cases as evidence of the dangers of ibuprofen:
– One patient had been taking eight to 10 tablets a day for two days for fever and body aches associated with the flu. He had no previous kidney ailments but urinalysis and blood tests showed he had developed a kidney infection. Kant attributed the infection and a rash to the ibuprofen.
– Another patient with high blood pressure had been taking over-the-counter ibuprofen for pain in his foot. He developed blood in his urine and needed emergency treatment.
Ibuprofen works partly by decreasing blood flow. But constricting blood flow to the kidneys, which depend on a high rate of blood to work properly, can be risky, Kant said.
Kant said he sees 15 to 20 patients a month with some underlying kidney problem that has worsened because of taking ibuprofen.
A study published in 1990 supports Kant’s concerns. It found that patients suffering from kidney disease so mild they don’t know they have it run a serious risk of kidney failure from using ibuprofen.
The three-year study, conducted by researchers at Johns Hopkins University, found that the change caused by ibuprofen poses little risk if the drug is used for a short period. But for those whose blood flow to the kidneys is already reduced by kidney, heart or liver damage, the flu, or aging, ibuprofen could trigger acute kidney failure.
Researchers said over-the-counter use of ibuprofen was of special concern because, without monitoring, people may not know their kidneys are failing.
A 1991 study done by Vanderbilt University researchers found that ibuprofen doubles the risk of ulcers.
Ibuprofen, available without a prescription since 1985, has captured nearly 30 percent of the $2.5 billion non-prescription pain-reliever market. In 1985 it had only a 5 percent share.
Physicians routinely prescribe ibuprofen for arthritis, menstrual cramps and joint inflammation. The label suggests taking one or two tablets every four to six hours, but physicians often prescribe twice that much.
Dr. Charles Margolis, a family physician, said some patients, especially those suffering from arthritis, take 12 to 15 tablets a day indefinitely. He said he usually knows their medical histories.
Margolis said the drug should be better labeled. “It should be on there in bold print that it causes ulcers and could cause significant kidney damage,” he said.
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Ibuprofen manufacturers say the current warnings are adequate. The label for best-seller Advil says to consult a doctor before taking if under a doctor’s care “for any serious condition.”
That covers anyone who has high blood pressure or kidney problems, said Karen Richards, spokeswoman for Whitehall Laboratories, maker of Advil. She said the U.S. Food and Drug Administration recommended general terms rather than a list of possible side effects.
Dr. Sandy Furey, medical director for Whitehall Laboratories, said ibuprofen is safe. Furey cited studies, including one published in the Journal of the American Medical Association in 1984, that found the risk to kidneys from ibuprofen was low.