Pain Relievers and Running

For years we have been warning customers to be cautious about ibuprofen as a running suppliment in regard to potential digestive issues and injured tissue recovery. Below is a good article and study findings to support caution and perhaps avoidance during and immediatly after endurance activities.


Article  from  online  U.S.  Pharmacist,  May  8,  2013  

Painkiller  Use  Before  German  Marathon  Resulted  in  More  Adverse  Effects

Erlangen,  Germany␣Serious  runners  might  bring  in  prescriptions  for  analgesics  or  purchase  OTC   products  to  try  to  prevent  pain  from  interfering  with  their  performance.  

 A  new  report  published  by  the  British  Medical  Journal,  however,  suggests  why  pharmacists  and  other   health  care  professionals  should  caution  about  painkiller  use  before  marathons  and  other  challenging   endurance  sports.


"The use of analgesics before participating in endurance sports may cause many potentially serious, unwanted [adverse effects] that increase with increasing analgesic dose," according to German researchers.  Analgesic use before endurance sports appears to pose an unrecognized medical problem as  yet.  If  verifiable  in  other  endurance  sports,  it  requires  the  attention  of  physicians  and  regulatory authorities."


To  find  out  what  impact  common  analgesics  could  have  on  runners,  the  authors  sent  surveys  to  all  7,048   competitors  in  the  2010  Bonn  Marathon/Half-­‐Marathon  about  their  use  of  medication  and  any   symptoms  they  had  during  and/or  after  the  race.       


Surveys  were  returned  by  56%  of  the  participants,  and  most  of  those  (87%)  said  they  had  run  marathons   before.       


While  1%  said  they  never  use  painkillers,  one  in  five  who  reported  taking  painkillers  before  the  race  also   said  they  used  painkillers  during  training  to  control  or  avoid  pain.  In  fact,  10%  of  the  respondents  said   they  were  in  pain  even  before  the  race  began.       


More  than  half  of  the  drugs  used  (54%)  were  bought  OTC  without  a  prescription,  and  included   diclofenac,  asprin,  and  ibuprofen.       


While  use  of  painkillers  appeared  to  make  little  difference  in  the  numbers  of  runners  forced  to  withdraw   during  the  race  because  of  pain  and  other  health  symptoms,  withdrawal  from  competition  because  of   gastrointestinal  problems  was  significantly  more  common  among  those  taking  painkillers.  Withdrawal  as   a  result  of  muscle  cramps,  while  rare,  also  was  significantly  more  common  in  those  who  had  taken  these   drugs.    


Overall,  the  risk  of  experiencing  health  symptoms  was  13%  greater  among  runners  who  had  ingested   painkillers  than  those  who  had  not.  Symptoms  included  stomach  cramps,  cardiovascular  problems,   gastrointestinal  bleeds,  blood  in  the  urine,  and  joint  and  muscle  pain.       


Of  the  runners  who  took  painkillers,  nine  reported  they  had  ended  up  in  the  hospital:  three,  who  had taken  ibuprofen,  for  temporary  kidney  failure;  four,  who  had  taken  aspirin,  for  bleeding  ulcers;  and  two,   who  had  taken  aspirin,  for  heart  attacks;  and  one,  who  took  aspirin,  for  mild  foot  pain.        None  of  the  runners  who  competed  without  painkillers  was  admitted  to  the  hospital,  survey  results   found.    


  Furthermore,  the  rate  of  symptoms  rose  along  with  increasing  drug  dosages,  according  to  the  report   authors,  which  was  especially  problematic  because  the  runners  often  reported  taking  more  than  the   recommended  amounts.  One  in  10  of  those  using  diclofenac  took  more  than  100  mg;  43%  of  those  who   took  ibuprofen,  the  second  most  popular  choice,  took  doses  of  800  mg  or  more␣twice  the   recommended  dose,  according  to  the  researchers.       


The  authors  noted  that  painkillers  block  cyclooxygenases,  which  regulate  the  production  of   prostaglandins,  and  that  prostaglandins  protect  tissues  when  the  body  is  under  extreme  stress,  such  as   during  endurance  sports.


"Taken together, our data indicate  that  the  widespread  use  of  cyclooxygenase  inhibitors  in  connection   with  endurance  sports  is  potentially  damaging.  Further  investigations  are  warranted  to  examine   whether  the  use  of  analgesics  before  and  during  sports  activities  should  be  avoided  altogether," authors  conclude.