Step-by-step recommendations for pain medicines
Not long ago, choosing a pain reliever meant finding one that eased your pain without being too hard on the stomach.
Now, research suggests that some commonly used pain medications — not just the now-banned Vioxx — can raise the risk of having a heart attack or stroke.
New step-by-step recommendations from the American Heart Association (AHA) can help you choose a pain reliever that's good for both the heart and stomach, reports the June 2007 issue of the Harvard Heart Letter.
• The AHA suggests starting with aspirin or acetaminophen (Tylenol) to quell muscle or joint pain. Aspirin is good for the heart, and acetaminophen doesn’t affect blood clotting.
• If they don't work, the next step for most people would be a nonsteroidal anti-inflammatory drug (NSAID). Try naproxen (Aleve) first, then ibuprofen (Advil).
• Next is diclofenac, but more caution is needed with this drug (which is available only by prescription).
• Celebrex, the only drug in the class known as COX-2 inhibitors that remains on the market, should be the last resort for managing pain. In addition to the side effect of increasing the risk of clots in the bloodstream, COX-2 inhibitors can also reduce blood flow through the kidneys and raise blood pressure.
• For short-term pain in some people, a narcotic pain reliever such as tramadol (Ultram), codeine, or fentanyl (Actiq, Duragesic) may be an option.
______