Proper Use of Ibuprofen?

[tnumrych]

Ibuprofen affects the kidneys. Acetaminophen affects the liver.

Reference? Although I used the oft-dismissed Wikipedia to confirm this, both Ibuprofen's and Acetominophen's metabolic pathway is listed as hepatic.

[tertius]

Reference? Although I used the oft-dismissed Wikipedia to confirm this, both Ibuprofen's and Acetominophen's metabolic pathway is listed as hepatic.

Yup. It undergoes conjugation in the liver.

It can apparently cause kidney failure at extremely high doses, like above 200 mg/kg. Which is not what we're talking about.

[Gunnhild Bruno]

Which states that if you take COX-2 selective inhibitors you should be fine regarding reduced protein synthesis. Good luck convincing your doctor to prescribe you some Celebra, though.

Do you mean Celecoxib? Because I just ask my doctor for some, and he writes me a script. He also tends to toss samples of it my way whenever I visit his office. It's not hard to get in the U.S., where the brand name is "Celebrex".

[Carlos Daniel]

Do you mean Celecoxib? Because I just ask my doctor for some, and he writes me a script. He also tends to toss samples of it my way whenever I visit his office. It's not hard to get in the U.S., where the brand name is "Celebrex".

That's the one. Doctors might not be so liberal with it as it has been shown to increase the risk of certain cardiovascular diseases. I don't really care because I'm 22, but older people might.

About acetaminophen, in somewhat high doses it is metabolized into a substance that overloads the liver's antioxidant reserve which then proceeds to oxidize the liver itself. I read on reputable sources that it can cause kidney failure, IIRC with the same mechanism.
Ibuprofen and COX inhibitors in general reduce renal blood flow, which is in part controlled by prostaglandins, which is some cases can lead to renal hypoperfusion.

[jillingworth]

How does aspirin, particularly the "low-dose for heart-health", factor into this? Is it's anti-inflammatory process a problem for training?

[Jonathon Sullivan]

That's the one. Doctors might not be so liberal with it as it has been shown to increase the risk of certain cardiovascular diseases. I don't really care because I'm 22, but older people might.

About acetaminophen, in somewhat high doses it is metabolized into a substance that overloads the liver's antioxidant reserve which then proceeds to oxidize the liver itself. I read on reputable sources that it can cause kidney failure, IIRC with the same mechanism.
Ibuprofen and COX inhibitors in general reduce renal blood flow, which is in part controlled by prostaglandins, which is some cases can lead to renal hypoperfusion.

All correct. Acetaminophen toxicity is due to exhaustion of the normal glutathione-dependent pathway, and it then gets shunted to an alternate route that results in the accumulation of a toxic metabolite. Very nasty, but not to worry if you take the recommended doses.

Motrin nephrotoxicity is very real, but only when high doses are used chronically and/or in susceptible individuals. Again, no worries with moderate use. These are very, very safe and effective drugs.

[Gunnhild Bruno]

That's the one. Doctors might not be so liberal with it as it has been shown to increase the risk of certain cardiovascular diseases. I don't really care because I'm 22, but older people might.

From what I understand, the dangers from occasional use are unknown. Even the dangers from chronic use are undetermined and may not be any higher than dangers from traditional NSAIDs.

As someone whose stomach can get shredded by even one dose of Ibuprofen, Celebrex is actually the less risky option, since I don't use it chronically for something like arthritis, but to help with occasional inflammation and injury. Any doctor that rules out a drug categorically in all cases because of undetermined risk should not be a doctor.

[Mark Rippetoe]

How does aspirin, particularly the "low-dose for heart-health", factor into this? Is it's anti-inflammatory process a problem for training?

At that dose, I don't think aspirin really functions as an anti-inflammatory.

[Roy]

I've taken 5g per day for up to a couple of months at a time for sciatic pain. Certainly not a good idea, but I didn't have a problem with gastric ulcers. Some folks are more prone than others. I can't speak to whatever damage it may have done to my liver. Don't do this any more, but I thought I'd share the anecdote. I think it's a fairly common therapy to run a month of NSAIDs plus PT for non-surgical treatment of herniated discs.

I wanted to share another anecdote regarding somewhat longer term use of NSAIDs since I saw this mentioned about sciatic pain. I had a herniated l5-s1 with pretty bad sciatica, which I let go on more or less untreated for 5-6 months until I came out of denial. The MRI didn't look good, but the Dr's I was with advised a 14 day course of prednisone, followed by 800 MG of ibuprofen, 3 times a day. The ibuprofen use went on at that level for about 2 and a half months, and then tapered off over another month.

Liver tests before and after showed no problems. During that time period I was very careful about any other medication and alc. use, though. I'm very happy to not have gone the surgery route, and now am lifting more w/ squat and DL than before the initial injury.

I would suggest speaking with a medical professional before letting yourself get into a habit of relying on any NSAIDs for longer term usage, for a couple of reasons. First, there may be something more powerful like prednisone which can have a big effect, and sooner for you, which a Dr might think is appropriate for you. That course alone took my sciatic pain down to about 5%-10% during it's use, and then when it came off it didn't get higher than 50% from before treatment. Then ibuprofen was able to keep it at bay whereas it hadn't been able to before. But the other reason to have a Dr to consult with is that they can try a couple of different NSAIDs if one isn't as effective for you. I did actually try a couple different ones but plain old ibupro/motrin seemed to work best for me.