Boston—Exceeding maximum recommended doses of nonsteroidal anti-inflammatory drugs (NSAIDs) is quite common, according to a new study.

The problem, points out a study in Pharmacoepidemiology and Drug Safety, is that NSAIDs have the potential of serious side effects, including gastrointestinal bleeding and cardiovascular issues, but are OTC and therefore, are often used without medical oversight.

Boston University School of Medicine–led researchers determined that 15% of adult ibuprofen users exceed the maximum recommended dose of that drug or other NSAIDs in a 1-week period. Exceeding the daily limit often occurred because the user either took too much of a single NSAID at one time, took two different NSAIDs at the same time, or didn’t to wait long enough before taking another dose.

“It is important to understand how many users exceed the maximum, how they do it and what characteristics are associated with over-use. This knowledge can help guide consumer interventions to promote safer use,” explained lead author David Kaufman, ScD, director of Boston University’s Slone Epidemiology Center and professor of epidemiology at Boston University School of Public Health. 

For the study, 1,300 adults who reported taking an ibuprofen medication in the preceding month completed a daily diary of their NSAID use for 1 week and continued to take ibuprofen during that time. Researchers then calculated the ingested daily dosages and compared them with the recommended daily maximum dose. Information on demographics, medical history, physical and mental health status, attitudes regarding label reading and dosing behavior, and knowledge of product label instructions was gathered in exit surveys.

Results indicate that most diary users (90%) took OTC ibuprofen during the week, while 37% also took nonibuprofen NSAIDs without recognizing all products as the same drug class.

Exceeding the daily dose (EDL) occurred among 11% of users for ibuprofen, 4% of users for other NSAIDs, and on 9.1% of NSAID usage days. Especially common was exceeding the one-time-daily dosage of pills with labels calling for that.

Characteristics more common in overusers of NSAIDs were a combination of medical factors such as chronic pain and poor physical state, attitudes conducive to ignoring the label recommendations, and poor knowledge of those recommendations. 

“The prevalence of EDL among NSAID users is nontrivial, and it is associated with potentially modifiable factors,” the study authors conclude. “Educating consumers about NSAIDs and their dosing directions could reduce excess dosing.”

« Click here to return to Weekly News Update.