Doctors warn patients that taking more than their prescribed dose of nonsteroidal anti-inflammatory drugs (NSAIDs) can increase their risk of gastrointestinal upset and ulcers. A new study shows that taking multiple NSAIDs – either intentionally or inadvertently – can adversely affect your overall health.

Published in Arthritis Care & Research, the study involved 138 patients from a large regional managed care organization who, according to a pharmacy database and medical records, filled at least one NSAID prescription between February and August 2002. Participants were questioned about NSAID use – both prescription and over-the-counter (OTC); in addition, they answered a survey that evaluates physical and mental health status.

The results showed that 26 percent of participants were dual users, meaning that they reported taking at least two NSAIDs (multiple prescriptions, OTC, or both) during the previous month. Using multiple NSAIDs was found to be associated with worse scores on the physical health component of the survey.

The authors point out that little is known about patients who take multiple NSAIDs, whether multiple prescriptions or OTC NSAIDs. They also note that because OTC use is difficult to track, few studies have evaluated it. In addition, OTC medication is often not discussed during doctor visits, even though taking high doses of NSAIDs raises safety concerns.

The study authors note that future research should focus on establishing factors, such as uncontrolled pain, that cause dual NSAID use and evaluate the best methods of identifying patients taking two or more NSAIDs, who may be at a higher risk of adverse side effects due to the drugs. They conclude: “Adequate pain management may have the potential to reduce dual use, improve patient symptoms, including physical functioning, and reduce patient safety problems.”