NSAIDs: Know The Side Effects Of Your Medication

'I've never been in this much pain.'

That's what I told my doctor when she examined my knee and suggested I take a powerful and potentially addictive opioid drug called Oxycodone (also known as OxyContin or OxyNorm in its sustained-release form).

Apparently I may have torn a knee ligament (we're still waiting for the results from my MRI). My concern is that if we mask the pain with a very potent drug I'll use the leg in ways it shouldn't be used while the knee is healing. I'm afraid that we'd interfere with the healing process and possibly inflict permanent damage.

I also told my doctor I have no interest in taking drugs unless it's absolutely necessary. Naturally, she wrote a prescription for Oxycodone. And I'll admit I picked it up from the chemist so that if the need did become absolutely necessary, it would be there.

My doctor also wrote a prescription for an anti-inflammatory - an 800 mg dose of ibuprofen - to be taken three times each day. About this she was adamant. She put it this way: 'The anti-inflammatory is non-negotiable.'

Non-negotiable! As if she had a way to hide it in my food like I do for my dog. But when the pain became so intense that my partner was literally begging me to take it, I did try the ibuprofen. And it worked.

And here begins a simple tale of effects - and more importantly side effects - that everyone should be aware of.

Serious side effects

Having filled the prescription for Oxycodone I figured I might as well read the attached information sheet. And as I suspected, I found some entertainment there.

One of the first warnings I came across read: 'Tell your doctor and pharmacist if you are allergic to Oxycodone.' Incredible. And just HOW am I supposed to know if I'm allergic to this drug? Is there a number I can call? Or maybe there's a web site where I can check to see if my name is on a list.

No. There's only one way to find out. But I wasn't willing to bite the bullet (or swallow the pill) just to see if I was allergic.

Here's another statement from the info sheet that delivered some dry comedy: 'Many people who use this drug don't have serious side effects.' MANY people! Now that's reassuring. Not 'most' or the 'majority' - MANY people. So if a million people take the drug, and 50,000 don't experience serious side effects...well, 50,000 people would qualify as 'many.' You could fill a football stadium with that many people.

But what did I expect, right? After all, this is a highly addictive drug with side effects that include hallucinations, difficulty breathing, yellowing of the skin or eyes, dizziness and vomiting. The real surprises awaited in the ibuprofen.

High dose can be dangerous

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that's available over-the-counter in lower doses. As I've noted in many e-alerts, side effects range from liver and kidney impairment to an increased risk of congestive heart failure. But how seriously should we regard these 'possible' side effects? Very seriously.

According to a commentary published in the journal Clinical Cornerstone, well over 100,000 hospitalisations per year are attributed to gastrointestinal events associated with long-term NSAID use. About 15 percent of those patients die as a result of their adverse reactions. That's more than 16,000 deaths every year.

The standard over-the-counter dose of ibuprofen is 200 mg. The prescription dose my doctor gave me was FOUR TIMES that amount. So I decided to take only one dose per day - not the three-per-day my doctor prescribed.

As I mentioned above, the ibuprofen gave me relief. And I don't mind admitting I was grateful for that.

But then I felt dizzy. And then I felt extremely tired. And then I realised my mistake. I took the medication first and read the information sheet second. And sure enough, my side effects were listed there. I had simply never known that drowsiness could be a side effect on an NSAID. As I kept reading I found other unsettling side effects, such as unexplained wheezing, nausea, trouble hearing, and swelling of the face (lovely). And the most disturbing: 'Stomach pain and stomach ulcer with or without bleeding.'

After reading that list of horrors I wondered if another side effect was worrying yourself sick!

Take care

The aspect of this experience that I found most daunting was the fact that ibuprofen and other NSAIDs are so commonly used every day, but the side effects of these higher doses are comparable to the side effects of 'serious' prescription drugs. Looking back, this makes perfect sense. But I'm sure that many people get tripped up like this, believing they know what to expect from a drug just because they're comfortable using a lower dose.

I also believe that I was more susceptible to the effects of the drug simply because I rarely take any prescription or over-the-counter drugs at all. That's something that I probably have in common with many HSI members.

The lesson here is simple but needs to be stated clearly: If your doctor prescribes something much more powerful than you're used to taking, be aware of the unique side effects that may come along with a prescription dose. Oh, and read the instructions, warnings and list of side effects before you're too drowsy to understand what they mean.