Ibuprofen- Friend or Foe?

Recently I was chatting with a new young friend who has a passion for running. It turns out he also played high school basketball and happened to ask me what I knew about ibuprofen. It seems it was common practice for his teammates to pop 800 mg before games and who knows how much after.

The practice of taking over-the-counter anti-inflammatories is not uncommon among high school athletes. One survey found 75 percent of high school football players used them to some extent.

Since it was approved by the FDA as an over-the-counter drug in 1984, ibuprofen has been thought of as a harmless yet effective way to relieve pain related to such maladies as arthritis, joint pain, toothache, headache, sports injury, fever, or general muscle pain due to overuse. In the military, ibuprofen has been standard issue for years in first- aid kits and used extensively by soldiers hoping to ward off the inevitable muscle soreness following a long march or hump, hence the nickname grunt candy.

Ibuprofen can be your friend and is considered safe and effective if taken for a few days at a time or as prescribed by your doctor. When using over-the-counter ibuprofen, take exactly as recommended on the container. The maximum dose for is no more than 1200 mg in one 24 hour period, taking one or two 200 mg tablets every 4-6 hours.

Professional athletes, once notorious for popping ibuprofen and other pain killers like candy, nowadays are wary since two of their own, Sean Elliot of the San Antonio Spurs and Alonzo Mourning of the Miami Heat, underwent kidney transplants. Mourning is convinced that his kidneys were damaged by years of taking non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen. Another athlete, former Seattle Seahawk football player Kenny Easley, thinks he lost a kidney because he once took up to 32 ibuprofen tablets a day for several months.

The National Kidney Foundation estimates that 10 percent of kidney failures are due to substantial overuse of NSAIDS. While doctors and the Kidney Foundation both maintain that there is no established link between the kidney condition afflicting Mourning and Elliot, called focal segmental sclerosis, and use of anti-inflammatory drugs, players around the league remain unconvinced.

Since it is sold as an over-the-counter drug without a prescription, ibuprofen is generally thought of as safe. However, when taken under extreme conditions that may promote dehydration, in excess, or for long periods of time, it can cause health problems.

NSAIDs work by inhibiting prostaglandin, a hormone that plays a role in sensing pain, controlling fever and inflammation. It also regulates blood flow to the kidneys. During exercise, it becomes vitally important that the kidneys receive adequate blood and oxygen in order to continue normal function. As dehydration levels rise, such as during exercise, ibuprofen becomes more concentrated, potentially reaching toxic levels.

Some general rules on taking ibuprofen are:

1. Do not take ibuprofen before, during, or shortly after lengthy endurance exercise, especially when there is potential for dehydration.

2. Take ibuprofen with a full glass of water or milk, ideally with meals to avoid stomach irritation.

3. Do not combine ibuprofen with alcohol.

4. Do not take in combination with other medicines, supplements, or herbal products without first consulting with your physician or pharmacist.

5. Avoid if you have a history of any reaction or allergy from another anti-inflammatory medication.

6. Discontinue use immediately if you notice any of the following symptoms: urine that is cloudy or bloody, pain or burning in the stomach, diarrhea or black tarry stools, severe nausea, indigestion or heartburn, vomiting blood.

7. Do not use if you are pregnant or breast-feeding.

8. Talk to your doctor first if you have high blood pressure, liver or kidney disease, heart failure, ulcers or other stomach problems.