Nsaids Interactions With Supplements

Nonsteroidal anti-inflammatory drugs, or NSAIDs, are pain medications that may be available over-the-counter or with a prescription. Over-the-counter NSAIDs include aspirin, ibuprofen and naproxen. Common prescription NSAIDs include ketorolac, etodolac, piroxicam, celecoxib, indomethacin and higher doses of naproxen. The over-the-counter medications are used for mild to moderate aches and pain, inflammation and fever, while the prescription medications are used for moderate to severe aches and pain, acute gout and severe inflammation.

Actions

The NSAIDs decrease the activity of the enzyme cylooxygenase, which blocks the formation of prostaglandins. Prostaglandins promote inflammation and dilate blood vessels, which increases blood flow; this results in pain. "By stopping the usual actions of prostaglandins, NSAIDs help reduce pain and inflammation," the University of Maryland Medical Center reports. NSAIDs are effective, but you should use caution when combining them with supplements.

Herbal Supplements

NSAIDs may interact with many herbal supplements. NSAIDs can prolong bleeding time, so herbal products that affect coagulation can increase the risk of hemorrhage. According to the "Drug Information Handbook," cat's claw, dong guai, evening primrose, feverfew, garlic, ginger, ginkgo biloba, green tea, ginseng and red clover may thin the blood and should be avoided while on NSAID therapy. Other herbal supplements with this action include alfalfa, anise, sweet clover, reishi, licorice, horse chestnut and white willow. If you are taking aspirin, limit your intake of curry powder, paprika and licorice because it may lead to drug accumulation and toxicity.

Vitamins and Minerals

Vitamin E may increase the risk of bleeding; individuals on NSAIDs should avoid the use of vitamin E. NSAIDs can decrease your vitamin C level by causing it to be released in the urine. High doses of vitamin C may also increase the level of the NSAID in your body, leading to severe side effects and toxicity. Iron supplements can cause stomach upset, and combining them with NSAIDs can increase the risk of stomach bleeding. Taking NSAIDs and potassium supplements can increase the risk of developing kidney failure. Individuals with poor kidney function should avoid this combination.

Prevention

Prevent interactions and adverse reactions with vitamins and herbal supplements by informing your physician of all the supplements and medications you take before you start therapy with an NSAID. If the addition of vitamins is necessary, your physician can adjust the dose of the NSAID accordingly. Read all medication labels, and do not take more than the recommended dose. If you have any questions or concerns, always ask your physician or pharmacist to clarify.