Ibuprofen, aspirin, cortisone ... all you need to know before taking anti-inflammatories
Ibuprofen® and ketoprofen® are the two most popular anti-inflammatories. However, an alert launched in July 2019 by the Agence du médicament confirms that they promote serious infectious complications and are, contrary to our habits, to be avoided in case of common infection (cough, nasopharyngitis, dental abscess, angina, infection pulmonary, otitis, cutaneous lesion ...). They are nevertheless proud of their services and there is no danger for short-term prescriptions. The point with Professor Gisèle Pickering, Clinical Pharmacologist (University Hospital of Clermont-Ferrand).
There are 4 classes of anti-inflammatories, each with specific indications. They act mainly on prostaglandins, substances responsible for inflammation. They help fight against pain and fever.
Nonsteroidal anti-inflammatory drugs (NSAIDs) called nonselective
The most famous : Ibuprofen (Advil®), Ketoprofen, Naproxen, Diclofenac (Voltarene®)
Main indications: body aches, fever, painful periods, headaches (migraines, tension headaches), sprains, tendinitis, sprains, lumbago, rheumatic and articular pain ....
They are in the form of tablets, capsules, suppositories, eye drops, gels, creams or plasters.
Dosage: not more than 3 days in case of fever and 5 days in case of pain, with a minimum delay of four to six hours between each 400 mg dose for ibuprofen (1200 mg / day max).
Caution: They should not be used in case of a history of stomach or duodenal ulcer, chronic diseases of the intestines, severe liver disease and in pregnant women from the 6th month of pregnancy (exceptionally before), and with great caution after 65 years. They can interact with many drugs (anticoagulants, diuretics ...). They should not be taken in case of severe renal and cardiac insufficiency.
Nonsteroidal anti-inflammatory drugs (NSAIDs) or coxibs
The most famous : Celebrex® (celecoxib) and Arcoxia® (etoricoxib)
Main indications: Osteoarthritis, rheumatoid arthritis and ankylosing spondylitis.
Dosage: The usual dose is 200 mg daily (400 mg maximum).
Caution: Precautions are the same as for non-selective NSAIDs.
"Steroidal" anti-inflammatory drugs
The main ones: cortisone and all corticosteroids.
Main indications: Inflammatory pain (joint, etc.), ENT diseases, chronic bronchitis.
Dosage: 0.35 to 1.2 mg / kg / day.
Attention: It is necessary to consult at the slightest symptom (fever, pain). The stop is progressive. Some side effects occur mainly during prolonged treatments (insufficiency of the adrenal glands, excess of cholesterol), others from the beginning (insomnia, increase of the appetite)
Main indications: Its anti-inflammatory action (muscular and articular pains) manifests itself in high doses. It is today mainly used for its anticoagulant effect.
Dosage: In the case of pain and fever, the maximum dosage in adult self-medication is 1 g of aspirin every 8 hours (3 g per day maximum).
It is used at low doses (between 75 and 300 mg per day) for its blood-thinning effect in case of increased risk of cardiovascular events or after stenting (to keep the artery open).
Caution: The precautions for use are identical to those of NSAIDs.
Anti-inflammatories: pay attention to mixtures!
One NSAID with another NSAID or cortisone or aspirin is not associated with the same dose: significant risk of bleeding. In addition, it is either oral or ointment, but not both!
What to do in case of chronic illness?
Nonsteroidal anti-inflammatory drugs should not be confused with potent anti-inflammatory drugs such as anti-TNF, monoclonal antibodies (suffix -mumab). In injections or infusions, they calm the immune system to counteract generalized inflammation. These biotherapies have revolutionized the management of chronic inflammatory bowel disease, rheumatoid arthritis, psoriasis, etc. And research is moving forward to guide the immune system to fight inflammation itself.
Read also :
⋙ Paracetamol, statins, antitussives ... what you need to know about controversial drugs
⋙ Drugs: what is the "nocebo" effect?
⋙ Atarax: all about this medication for anxiety disorders