Definitely, all of us would like to believe that a human being was made to live in peace and harmony with the surrounding world, to enjoy the living, to be happy, to love and to be loved, and finally, to give life to the new happy, healthy, and wise generations. For some reason something went wrong in this world, and these days we often have to struggle for the living under the sun, for the future, for happiness, and even for our health.

Even the brave-hearts cannot fight for it all successfully, if their bodies are weakened by the continuous pain. They definitely have to sooth or lessen it if there are no means to eliminate it from their bodies once and forever.

That is the reason why pain-killers are among the most important and most often sold drugs, which are always in great demand. Nonetheless, questions and difficulties arise even in this aspect. Patients are worried about the safety profiles and long-term use consequences of the newest, as well as older generations of pain-relievers.

Selective and non-selective nonsteroidal anti-inflammatory drugs (NSAIDs) seem to be the most promising options for eliminating pain associated with multiple health disorders as arthritis,osteoarthritis, rheumatoid arthritis, and other conditions, as well as for fighting different types of pain. In many cases sufferers have to take these drugs for very long periods of time, or even life-long. Can they be sure the pills are not going to harm some other systems of their bodies?

Unfortunately, the answer is “no” for the time being. Any of the non-selective NSAID (ibuprofen (Nurofen), naproxen (Naprosyn), diclofenac (Voltarol) and others) is associated with gastrointestinal adverse reactions, some of which can be dangerous and even life-threatening, for example, stomach ulceration and gastrointestinal bleeding.

The matter is that non-selective NSAIDs relieve pain inhibiting the production of hormone prostaglandin and the activity of COX-1 and COX-2 enzymes, all of which are involved in regulation of inflammatory mediation and sensitizing of nervous cells to pain. However, COX-1 enzymes also have stomach-protecting function, inhibiting of which results in stomach irritation and the development of the above described side effects.

On the other hand, COX-2 inhibitors, a newer class of pain relievers, block the action of COX-2 enzyme only, not affecting the stomach-guarding COX-1 enzyme. As a result, the rates of gastrointestinal adverse reactions are much lower with these medications. Here belong Celebrex (celecoxib) and Arcoxia (etoricoxib). 

Nevertheless, selective NSAIDs do have flaws as well. The recent research reports about the increased risks of experiencing such dangerous side effects as heart attacks and strokes. For this reason such drugs as Vioxx and Bextra were removed from the market after a number of deaths from cardiovascular events, which had been linked to their use. Celebrex these days contains the so-called “black box warning” on its label to inform the users about the possibility of experiencing these dangerous side effects.

Researching the drugs goes on even if they are already approved by the official institutions and can be legally bought and used in many countries. Some of such studies reported about the slightly increased risk of thrombotic events (heart attack and stroke) even with the older non-selective NSAIDs described above.

For example, scientists suggest that diclofenac has practically the same risks of experiencing heart attacks or strokes as coxibs. Naproxen, on the other hand, seems to be safer in this aspect than selective NSAIDs. Ibuprofen is believed to pose minor danger to the cardiovascular system of a human body.

The available data shows that these risks are dose-related. That means that high doses of any of these drugs may potentially have the unwanted effects on patient’s health. In addition, scientists suggest that the duration of the treatment may also influence the development and occurrence of side effects.

It should be noted that no matter what drug is chosen for pain relief, either selective or non-selective NSAID, it is believed (due to research and studies done) to be effective in relieving the symptoms of many health disorders and in eliminating pain of different types. The most important thing is to remember that the lowest effective dose should always be taken, as well as the treatment period must not be prolonged without the doctor’s recommendations. This will help a patient reduce the risk of experiencing adverse reactions.

To sum it up it should be said that no drug is perfect, the side effects and long-term use need further research, and the scientists still have to work hard to improve the existing medications or to develop the newer and safer ones.