Pain medicines: What to do if you have heart problems or kidney disease

pain medicine advil NSAID Aleve Celebrex kidney heart

When people have pain, they often take pain medicines called NSAIDs (non-steroidal anti-inflammatory drugs). These include:

  • Advil and Motrin (generic and store-brand ibuprofen). Ibuprofen is also in other over-the-counter drugs, such as cold medicines.
  • Aleve (generic and store-brand naproxen).
  • Celebrex (generic celecoxib).

NSAIDs help ease pain and inflammation. But if you have high blood pressure, heart failure, or kidney disease, you should not take an NSAID. And you should not take any drugs that have ibuprofen or another NSAID in them. Here’s why:

NSAIDs are bad for your blood pressure.

NSAIDs can cause high blood pressure. And if you have high blood pressure, they can make it worse. This increases your chances of having a heart attack or a stroke.

NSAIDs can also keep some blood pressure drugs from working right. NSAIDs can interfere with:

  • Diuretics, or water pills, such as apo-Hydro (generic hydrochlorthiazide). Diuretics remove excess water from the blood vessels.
  • ACE inhibitors, such as Altace and Coversyl (generic ramipril and perindopril). ACE inhibitors are drugs that relax the blood vessels.
  • ARBs such as Cozaar (generic losartan). ARBs are another group of drugs that relax the blood vessels.

NSAIDs are bad for your heart and kidneys.

Long-term use of NSAIDs can make your body hold onto fluid. This can worsen the symptoms of heart failure, such as shortness of breath, swollen ankles, and a rapid or irregular heartbeat. NSAIDs can also keep the kidneys from working well. This makes taking NSAIDs risky for people who already have kidney disease.

Which painkillers can you use if you have heart or kidney disease?

There is no simple answer. The best painkiller to use depends on your health problems. It also depends on any other drugs you take. Be sure to tell your doctor about any prescription drugs, over-the-counter drugs, or herbal medicines you take.

Over-the-counter Tylenol (generic acetaminophen) is often the best choice for people with high blood pressure, heart failure, or kidney problems.

  • However, high doses of Tylenol can damage the liver, so take the lowest dose you can to get enough pain relief.
  • Never take more than 4,000 milligrams (mg) a day. That’s equal to twelve 325 mg pills.

Managing pain without taking drugs:

Non-drug treatments, such as yoga or massage, can often reduce or even replace the need for drugs. Here are some things you can try, depending on your kind of pain:

Back pain. Stay physically active. Walking is a good choice. Acupuncture, massage, physical therapy, and yoga can help reduce pain, too. And care from a chiropractor may help.

Headaches. Cut back on alcohol and avoid foods that trigger your headaches. This may help relieve pain. Exercise can help reduce stress that causes headaches. So can meditation, deep breathing, and other forms of relaxation therapy.

Osteoarthritis. Do low-impact exercise, such as walking, biking, and yoga. This can help ease pain and stiffness. Avoid high-impact activities, such as running or tennis. They can make your symptoms worse.

Fibromyalgia. Get regular exercise to help reduce pain and give you more energy. Tai chi— a form of exercise involving slow, gentle movements combined with deep breathing—is a good choice. Meditation can help with pain. So can a type of counseling called cognitive behavioral therapy.