I watched a program this morning and a doctor talked about taking Ibuprofen in excess as being a possible symptom of kidney damage. Any thru-hikers heard of anyone having to deal with such?.. I know that vitamin I is highly recommended on the trail…thanks…
Chairman
A symptom or a cause? Check with your doc before you leave as to what is “excessive”. I took 1 in the AM and 1 at night for 4.5 months, with no apparent after effects (so far). Has this been determined by clinical trials, or is it one opinion based on anecdotal evidence?
Mango
I have very bad ankles. (Many surgeries on each) I take 2 to 3 800mg each day and have for years. I have asked if I am doing any damage by prolonged use of the drug. I am always told the same thing…as long as your stomach can handle it, it will not damage your kidneys.
Bill
I took one a day for one year with an asperin thrown in now and then. I quit after passing and going into severe shock. Turns out that I lost 4 pints of blood with a bleeding ulcer caused by the aspering exasperated by the IB. Now I take Tylenol for everything whether it works or not.
Foot Notes
I have pretty bad arthritis and bad knees as well. I am on a Naproxin script, which is actually just a way for the insurance to pay for my Aleve. I take 1 in the AM and 1 in the PM. If the pain is so bad that the Naproxin is not working I have been told I can add in some Tylenol as they will not contraindicate each other. – My husband has slightly deformed arthritic hands and is prescribed IB-800’s every 6 hours. – The thing about excessive is taking it every couple of hours or taking 1000 mg or more at a time.
Hammock Hanger
You should never, ever combine NSAIDs. Taking ibuprofen and aspirin at the same time is flirting with disaster, as Foot Notes can attest.
Aspirin can cause GI ulcers all by itself, but all NSAIDs, even the newer ones, have that potential because they work by the same pathways (COX1 and COX2 inhibition). When you combine them you can get into serious trouble. If you have to change NSAIDs, you should ideally give your body a couple week “wash out” period.
Excessive use of any NSAIDS can CAUSE kidney damage, too.
Common NSAIDS include: aspirin, ibuprofen, naproxen, ketoprofen, Celebrex, Vioxx, meloxicam (Mobic), Bextra, and many more
Unless there is a very pressing medical reason and your doctor has carefully weighed the risks, another combination to avoid at all costs is an NSAID with any oral steroid medication (prednisone, prednisolone, dexamethasone, etc.). Frankly, you should even be careful with some topical steroids and NSAIDS, since some of the potent steroids can be absorbed systemically. This combination also carries a very high risk of GI ulceration. So, if you’re on prednisone for poison ivy, for example, avoid any NSAIDs during that time, and if you can avoid it, give your body a few extra days to flush the steroids out before starting any NSAIDs again.
As for Tylenol, please keep in mind that the margin of safety with this drug is quite narrow, so you should be very careful with it, too. If you take Tylenol, be very careful that there is no additional acetominophen in any other meds you are taking (cold meds, Rx pain meds, etc.). Acetominophen will destroy your liver PDQ if you go over the rec. dosage, and is a common cause of acute liver failure.
Don’t be afraid to take pain meds when you need them, but you should never mix them unless you know exactly what you are doing and have consulted a doctor first.
Chipper
Tylenol and an NSAID are safe to combine, as long as the dose for each is safe.
One final NSAID warning to all hikers: Avoid using higher doses of NSAIDs when you are at all dehydrated. When you are dehydrated, your kidneys are much more vulnerable to damage.
Chipper
Wow, great info. This is what Trail Forums is all about. One last question though. I’ve heard that Tylenol and alcohol are a really bad mix. does this go for all of the other drugs including Ibuprofen.Thanks.
Jalan
I’ll have to chime in on this one, since I have far too much experience with the full range of NSAIDS, being a rheumatoid arthritic for the last 28 years. I’ve been on them all, including Ibuprofen (Motrin) when it was THE treatment of choice. Hammock Hanger is right about excessive doses, once you get past 1000mg at a time, you’ve gone too far (I think I topped out at about 1600mg four times a day, but that was back in the dark ages of. You also shouldn’t really be on 800mg for more than a couple of years. For most people the drug either loses effectiveness or starts causing damage by that time (ulcers, kidney damage, etc.) Chipper’s warnings are well made, and he says much of what I would have in that regard. One caveat, if you take one of the COX-2 inhibitors (Celebrex, the now defunct Vioxx, Mobic [my current daily NSAID]) then you can often avoid the ulcers and other stomach problems since these drugs don’t affect the COX-1 that is involved in digestion as well as inflammation.
To answer Chairman’s original question, I’d say that as long as you’re using Ibuprofen on an irregular basis and take care that you don’t take it in a way that will exacerbate it’s side effects (like dehydrated, on an empty stomach, etc.) you’ll be just fine and suffer no damage from the drug.
A last personal side-note to Hammock Hanger; I’ve been there with the pain and failing treatment. There are other options, no matter what form your arthritis takes. I took the step of going on immuno-suppressants a couple of years ago(the “big guns” for rheumatoid), and it made all the difference. I was headed for a wheelchair in five to ten years, but now I’m back on the trail (though not without pain, you may be sure, but it’s manageable.) Don’t be afraid to take what looks like a radical step.
Strategic
I’ve seen plenty of patients in the ER with kidney related damage from NSAIDS, but worse is a Tylenol overdose. It kills your liver and its an ugly death, though fairly quick (in terms of a week or so from the overdose) less than one bottle of Tylenol will damage your liver (if taken at once)
I did half a thru last year and never took one single ibuprofen or Tylenol. there was no need, you are sore and achy for a while and it goes away, the pain wont’ kill you but the drugs could.
HeartFire
It is best if each person goes and see there individual doctor before the hike and speaks directly to them. They have your medical history and can better instruct you on what is right for you.
I too worked in the ER for a couple of years. It is very easy to OD on Tylenol. Never take more then the recommended dose. I know people who buy over the counter IB which is 200 mg and then take 4 to get the equivalent of a prescription 800. You should never do this with Tylenol.
Some folks also mentioned dehydration and alcohol. Both are a bad combination if you are taking a lot of meds.
Allows use the small dose you can and use a lot of food common sense.
Hammock Hanger
Mobic is actually a mixed inhibitor of both COX1 and COX2. All NSAIDS, regardless of whether COX2 selective or mixed COX1/COX2, carry a real risk for GI ulceration. COX2 selective meds carry a relatively lower risk to the GI tract, but they carry higher cardiovascular risks.
It’s absolutely true that Tylenol and alcohol really are another mixture to avoid. Both depend on your liver for metabolism, and together, they can overwhelm your body’s detoxification ability, leading to liver injury.
-Jenn
Chipper