February 2, 2015
Alliance for Rational Use of NSAIDs reacts to JAPhA literature review
EUGENE, OR — A recent literature review published in the Journal of the American Pharmacists Association (JAPhA) reported on the impact of nonsteroidal anti-inflammatory drugs (NSAIDs) on the kidneys in high-risk patients and highlighted the pharmacists’ role in ensuring safe and appropriate use of these pain relievers. The Alliance for Rational use of NSAIDs commends this educational work and advocates for a broader discussion on safe and appropriate use of NSAIDs in the community pharmacy.
“By calling for a greater role for the community pharmacist, this report represents a significant step towards raising public awareness of the appropriate use of NSAIDs,” said Byron Cryer, MD and chairperson of the Alliance. “However, while the article evaluated renal risks associated with NSAID use, it is important to note that patients with history of cardiovascular and/or gastrointestinal issues are also at risk for complications caused by NSAIDs.”
The review noted that while NSAIDs are widely available, they are not necessarily harmless for those at risk. In an analysis of 12,065 participants with documented kidney disease in the cross-sectional National Health and Nutrition Examination Survey, 5% reported using nonprescription NSAIDs regularly, and 66.1% of those patients had used these agents for one year or longer. Use of NSAIDs can result in blood flow impairment to the kidneys, which can lead to acute kidney injury (AKI) — especially in high-risk patients.
The study concluded that the community pharmacist can play a pivotal role in in NSAID avoidance education at the point of prescription dispensing or nonprescription purchase. This could prevent potential episodes of AKI.
The Alliance agrees that the pharmacist plays a critical role to ensure patient safety and appropriate medication use, not only for patients at high-risk for renal complications but all NSAID users.
“It’s a complex problem because many — if not, most — people don’t know what an NSAID is,” said Cryer, M.D., who is an associate dean at The University of Texas Southwestern Medical Center. “You also have many NSAID products — available both over-the-counter and by prescription — that are identified by either brand or generic names, and many consumers aren’t aware that they are members of the same class of drugs and may be identical substances.”
Multiple data sources demonstrate that many individuals take higher than the recommended dose of an NSAID and/or take them for a significant period of times. Many individuals also take multiple NSAIDs in combination, typically inadvertently.
“The safest and most appropriate way to take an NSAID is at the lowest dose for the shortest duration for a desired therapeutic effect,” said Cryer. “And of course, it is always important to read medication labels and know what you are taking.”
ABOUT: The Alliance for Rational Use of NSAIDs is a public health coalition dedicated to the safe and appropriated use of nonsteroidal anti-inflammatory drugs (NSAIDs).