Sunday, August 15, 2010

Why Racing and NSAIDs Don’t Mix

By: Pharmie

I met a great guy named Mike at WIBA last month. He is preparing or his first IM at WI this fall. We talked about the course, training, nutrition, and equipment. He was asking all sorts of questions, and one of them concerned me. "So one of my friends told me I should just take a bunch of ibuprofen before the race," he started. "What do you think?"

As a pharmacist, I immediately let out an emphatic "NO," and then I felt the need to explain.

Ibuprofen and all Nonsteroidal Anti-inflammatory Drugs (NSAIDs) certainly have their place in injury treatment given their ability to alleviate pain and reduce inflammation. However, extreme caution should be exercised when using them in long, strenuous training or in racing.

There are many types of NSAIDs. Ibuprofen (marketed under the names Advil and Motrin, among others) and naproxen (Aleve) are two of the most common types. They all work in the same basic way to reduce pain and inflammation. Aside from the fact that they can be irritating to an already stressed GI tract, the concern is the potential damage they can cause in the kidneys.

One of the effects that NSAIDs have in the body is that they cause blood vessels leading to the kidneys to clamp down, reducing blood flow to them. In intense training or racing or any other condition that can cause dehydration and thus decreased blood volume, less blood will be circulating. The combination of dehydration and NSAIDs may result in significantly decreased blood flow to the kidneys and could lead to temporary or irreversible damage.

A safer bet during and immediately after intense activity is acetaminophen (Tylenol). Although it will alleviate pain, it has very little anti-inflammatory eff ct. It also will not affect kidney blood flow. Never exceed a total daily dose of 4 grams of acetaminophen.

Since urine color and frequency of urination aren't necessarily good indicators of hydration, make sure your weight has normalized before resuming NSAID use.