Seniors need to know the safest pain reliever to take
Older adults are often dealing with aches and pains caused by chronic health conditions, physical therapy, or recovery from surgery. Many use over the counter painkillers to manage daily pain.
There are many different pain relievers available at the drugstore and some can be very dangerous for older adults. Dr. Leslie Kernisan, a San Francisco Bay Area geriatrician, was recently asked to recommend the safest over the counter painkillers for seniors.
In her full article, Dr. Kernisan explains which over the counter painkillers are safest, why they’re safer, and which pain medications need to be used with caution. We’ve summarized the key points from her article here.
5 tips from Dr. Kernisan on safe over the counter painkillers for seniors
1. Geriatricians consider acetaminophen the safest over the counter painkiller
For most seniors, the safest over the counter painkiller is acetaminophen (like Tylenol). However, older adults must NOT take more than 3000 mg of acetaminophen in one day.
In high doses, acetaminophen can cause serious or fatal liver damage. Seniors with a history of alcohol abuse or chronic liver disease need a lower daily limit – speak with their doctor to find out what a safe daily amount would be.
Be careful because acetaminophen is included in many over the counter and prescription medications. For example, Nyquil, Theraflu, Percocet, and Norco all contain acetaminophen. If your older adult takes any other medications containing acetaminophen, it’s essential to include those amounts in their total daily limit.
Other than making sure to take the correct dose, acetaminophen has few side-effects and rarely harms seniors.
2. Avoid NSAIDs like ibuprofen and naproxen
The most common over the counter alternatives to acetaminophen are ibuprofen and naproxen (like Advil or Aleve). These are drugs called non-steroidal anti-inflammatory drugs (NSAIDs).
Older adults should be very careful with NSAIDs. Their side effects are especially likely to cause harm as people get older.
Serious and fatal side effects from NSAIDs include:
- Risk of bleeding in the stomach, small bowel, or colon. Seniors taking daily aspirin or a blood-thinner are at especially high risk.
- Problems with the stomach lining, causing stomach pain or peptic ulcer disease.
- Decreased kidney function – a big problem for seniors who already have a chronic decline in kidney function.
- Interference with high blood pressure medications.
- Fluid retention and increased risk of heart failure.
Experts estimate that NSAIDs cause 41,000 hospitalizations and 3,300 deaths among older adults every year. The American Geriatrics Society includes NSAIDs on the Beers list – medications that seniors should avoid or use with caution.
Be aware that many doctors may still recommend or prescribe NSAIDs to older adults. It’s usually because they are anti-inflammatory and can relieve pain from arthritis, gout, and other conditions. Prescription NSAIDs are stronger and can cause an even higher risk of serious problems. These doctors may be less familiar with the Beers list or the increased risk to older bodies.
If your older adult’s doctor prescribes an NSAID, don’t be afraid to question their decision. As your senior’s health advocate, ask about alternatives and share your serious concerns about the risks.
3. Aspirin should also be avoided
Aspirin used to be the standard household over the counter painkiller. Today, most doctors use it to reduce heart attacks and stroke and no longer use it for pain relief.
Like all drugs, aspirin has risks and benefits. It’s similar to NSAIDs and increases the risk of internal bleeding. That’s why it’s not recommended anymore as a pain reliever for seniors.
4. Painkiller safety tips
The safest over the counter painkiller for most seniors is acetaminophen, limited to 3000 mg per day (or less for those with liver issues).
The #1 thing to do is make sure your older adult’s doctor is aware of their chronic pain. That way they can figure out what’s causing it and develop a pain management plan. There are also many safer, non-drug options available for pain relief. Make sure to ask about them because busy doctors may not volunteer the information.
Note: Avoid any over the counter medications marked “PM.” That means it’s also supposed to make people sleepy. That ingredient is typically an anticholinergic drug and is bad for the brain. It can make dementia worse or increase dementia risk.
5. What to do if more pain relief is needed
If acetaminophen isn’t enough to relieve your older adult’s chronic pain, speak with the doctor to discuss alternatives. Make sure to understand the risks vs. benefits and explore non-drug options.
By DailyCaring Editorial Team
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