Consumers in the dark about OTC NSAIDs

While they are easily available in pharmacies, supermarkets and convenience stores, many Australians don’t understand the risks, researchers argue

In a study conducted across a number of NSW pharmacies, University of Wollongong researchers investigated consumer knowledge about commonly purchased OTC ibuprofen products, specifically Nurofen and Nurofen Plus.

Of 262 respondents who were surveyed, most of whom were older than 50 years with adequate health literacy, almost a third could not correctly identify the safe maximum daily dose of ibuprofen.

The same amount was unaware of some contraindications such as having asthma, kidney disease or high blood pressure.

And fewer than half recognised potential side effects from the drugs, such as kidney disease and ringing in the ears.

Over a fifth of the study sample (21.8%) incorrectly believed that no side effects were associated with taking these OTC products.

Lead author Associate Professor Judy Mullan from the University of Wollongong’s School of Medicine says lack of knowledge of the side effects is particularly concerning.

“Many consumers believed that because these products are readily available over-the-counter in pharmacies and several retail outlets that they don’t have any side effects,” says Associate Professor Mullan.

“Our concern is that people take them without being mindful of the fact that they can cause kidney failure and gastrointestinal harm if not taken appropriately.

“This, coupled with the lack of knowledge about recommended maximum dosages and potential contraindications, is a major public health issue and a real cause for concern.”

Her concerns come at a time when other studies have shown a link between NSAIDs and increased risk of cardiac arrest and heart failure.

One Danish study found use of any NSAID was associated with a 31% increased risk of cardiac arrest. Diclofenac and ibuprofen were associated with a 50% and 31% increased risk, respectively.

“The findings are a stark reminder that NSAIDs are not harmless,” says author Professor Gunnar H. Gislason, professor of cardiology at Copenhagen University Hospital Gentofte, Denmark, who called for the drugs to be pharmacy only.

However ASMI Regulatory and Legal Director Steve Scarff says the study should not cause any alarm to those who follow the instructions on the labels.

Associate Professor Mullan says public awareness needs to be improved through more information sources, a possible redesign for packaging, and increasing the role of all healthcare practitioners in educating consumers about the potential harms associated with NSAIDs.

“A combination of strategies to improve the knowledge gap would help to reinforce public awareness of the possible adverse effects associated with taking these products inappropriately,” she says.

Her team’s findings were published in the Australian and New Zealand Journal of Public Health.

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1 Comment

  1. Ron Batagol

    I can’t believe that the pharmacy media routinely publishes comments on clinical risk versus benefit issues from non-health professional practitioner groups, when
    It goes without saying that they will offer the predictable comments like “NSAIDs shouldn’t cause any alarm to those follow follow the instructions on the labels”.
    That viewpoint simply ignores the main point of publicising this Study -namely that it highlights the fact that public awareness of the potential adverse effects of NSAIDs needs to be improved, including health practitioners reinforcing public awareness of the possible potential side-effects, including
    G-I, renal and cardiovascular complications in at-risk patients. And guess what? The instructions on the labels do advise on renal risks for dehydrated/fluid-depleted infants or children but say nothing about the same renal risks for otherwise healthy but fluid-depleted adults using NSAIDs even short-term.
    For community safety, NSAIDs need to be pharmacy-only, where a trained health professional can give appropriate patient counselling!

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