Consumer Reports on the COX-2s and NSAIDs

I was browsing the Consumer Reports Best Buy Drugs site to see what they had on the COX-2/NSAID controversy:

If you need medication for osteoarthritis or other chronic pain:

* Try acetaminopen (Tylenol, generic) as an initial choice for pain relief since it’s reasonably safe even for frequent, prolonged use if you don’t exceed the recommended doses. Overdoses can cause liver problems. Avoid acetaminophen if you drink alcohol heavily or have a liver disorder.

* If you need an NSAID for greater relief, opt for over-the-counter ibuprofen (Advil, generic), or prescription salsalate, which may be gentler on the stomach than some other traditional NSAIDs. If you’ve had gastrointestinal ulcers or bleeding, or experience any gastrointestinal reaction to ibuprofen, ask your doctor about taking it with a stomach-protecting drug, such as misoprostol (Cytotec) or omeprazole (Prilosec, Prilosec OTC). If you take a daily aspirin to protect your heart, let several hours elapse before taking any NSAID as it may undermine aspirin’s coronary benefits.

* Avoid celecoxib (Celebrex) and valdecoxib (Bextra) if you have elevated heart risk. Use them only after consultation with your physician. These drugs are not more effective than ibuprofen or salsalate, both of which have longer safety records.

* Use caution with naproxen until more is known about its safety for long-term, daily use.

* Don’t take any over-the-counter painkiller regularly for more than 10 days without consulting your physician, and never exceed recommended doses.

That is pretty sound advice, similar to what was written here a few days ago.

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