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Hi folks
The last couple of races I've done have included warnings in the pre-race briefing about using Brufen before and during the run.
A quick look online seems to indicate possibility of liver damage?? Does anyone know much about this? I know personally that I've taken brufen on a regular basis to help with pain during longer runs.
Cheers
The last couple of races I've done have included warnings in the pre-race briefing about using Brufen before and during the run.
A quick look online seems to indicate possibility of liver damage?? Does anyone know much about this? I know personally that I've taken brufen on a regular basis to help with pain during longer runs.
Cheers
In reply to drunken monkey:
Not sure that taking a painkiller during exercise is a good idea. Way back we used to take Ibuprofen on endurance events 40+ mile walks, the effect was impressive as it gave you second wind. This practice was common in the military to get through endurance tests.
You suffered the next day the remedy was more pills. Not good idea really.
I can see taking muscle relaxants and painkillers can assist in recovery and injury but pain is there for a reason, masking it is not wise.
Better question would be should you be running (that distance) if you need to take drugs in order to do so, sorry.
Not sure that taking a painkiller during exercise is a good idea. Way back we used to take Ibuprofen on endurance events 40+ mile walks, the effect was impressive as it gave you second wind. This practice was common in the military to get through endurance tests.
You suffered the next day the remedy was more pills. Not good idea really.
I can see taking muscle relaxants and painkillers can assist in recovery and injury but pain is there for a reason, masking it is not wise.
Better question would be should you be running (that distance) if you need to take drugs in order to do so, sorry.
Post edited at 11:06
7
In reply to drunken monkey:
Ibuprofen has a pretty good safety profile with respect to liver toxicity. There a just a handful of reports of severe liver injury related to it and mild liver injury is pretty uncommon. Here is good overview
https://livertox.nlm.nih.gov/Ibuprofen.htm
Not specific to running but useful.
I wouldn't be too concerned about the liver. Kidney problems (particularly due to alterations in kidney blood flow, especially when coupled with dehydration), heart problems (especially in those with preexisting cardiac disease) and GI tract ulceration are the main worries.
Ibuprofen has a pretty good safety profile with respect to liver toxicity. There a just a handful of reports of severe liver injury related to it and mild liver injury is pretty uncommon. Here is good overview
https://livertox.nlm.nih.gov/Ibuprofen.htm
Not specific to running but useful.
I wouldn't be too concerned about the liver. Kidney problems (particularly due to alterations in kidney blood flow, especially when coupled with dehydration), heart problems (especially in those with preexisting cardiac disease) and GI tract ulceration are the main worries.
2
In reply to drunken monkey:
I'd say that the problem is likely to be that masking out pain during excercise allows you to do yourself further injury. Use it as a treatment after injury but not as a means of doing further injury.
> Hi folks
> The last couple of races I've done have included warnings in the pre-race briefing about using Brufen before and during the run.
> A quick look online seems to indicate possibility of liver damage?? Does anyone know much about this? I know personally that I've taken brufen on a regular basis to help with pain during longer runs.
I'd say that the problem is likely to be that masking out pain during excercise allows you to do yourself further injury. Use it as a treatment after injury but not as a means of doing further injury.
4
In reply to drunken monkey:
I've used it in extremis and on 'special occasions' but if you're needing it routinely for long runs then you need to change something.
As I recall it can leave you with a very unhappy stomach.
I've used it in extremis and on 'special occasions' but if you're needing it routinely for long runs then you need to change something.
As I recall it can leave you with a very unhappy stomach.
3
In reply to drunken monkey:
Marcus Scotney, who is a Montane sponsored ultra runner, had a serious issue with ibuprofen a couple of years ago.
A quick Google gives this article by Ian Corliss:
https://www.google.co.uk/amp/s/iancorless.org/2014/12/22/nsaids-and-sport/a...
Marcus Scotney, who is a Montane sponsored ultra runner, had a serious issue with ibuprofen a couple of years ago.
A quick Google gives this article by Ian Corliss:
https://www.google.co.uk/amp/s/iancorless.org/2014/12/22/nsaids-and-sport/a...
1
In reply to drunken monkey:
I have on at least 2 possibly 3 occasions (during investigations) been advised by health professionals that there are long-term health risks if it is taken prior to or during strenuous exercise. At least once by GP and secondly while answering questions after A & E admission
I have on at least 2 possibly 3 occasions (during investigations) been advised by health professionals that there are long-term health risks if it is taken prior to or during strenuous exercise. At least once by GP and secondly while answering questions after A & E admission
1
In reply to drunken monkey:
Thanks for all the replies folks - Appreciate it. I've been trying to get back into Ultra running this year, and it's only recently that I've noticed these warnings about Brufen.
I wouldn't say I'm popping them like sweets, but I have on occasion, used them on runs in excess of 30 miles, just to help.
One of the race briefings I've seen for a race coming up, actually mentions that the race directors [May] disqualify anyone seen taking ibuprofen before or during the race.
it just made me wonder what the specific risk with this drug is, as its so widely taken.
thanks again for all the replies
Thanks for all the replies folks - Appreciate it. I've been trying to get back into Ultra running this year, and it's only recently that I've noticed these warnings about Brufen.
I wouldn't say I'm popping them like sweets, but I have on occasion, used them on runs in excess of 30 miles, just to help.
One of the race briefings I've seen for a race coming up, actually mentions that the race directors [May] disqualify anyone seen taking ibuprofen before or during the race.
it just made me wonder what the specific risk with this drug is, as its so widely taken.
thanks again for all the replies
1
In reply to timjones:
This isn't why some events are cautioning against it though. It seems to be the risk kidney damage they are worried about. I've struggled to find anything definitive on this.
> I'd say that the problem is likely to be that masking out pain during excercise allows you to do yourself further injury. Use it as a treatment after injury but not as a means of doing further injury.
This isn't why some events are cautioning against it though. It seems to be the risk kidney damage they are worried about. I've struggled to find anything definitive on this.
1
In reply to drunken monkey:
This is the medical advice from Chris Ellis who is the doctor for the west highland way race. He's pretty knowledgeable when it comes to long distance running.
https://westhighlandwayrace.org/race-information/medical-advice/
He only mentions brufen once and says best avoided but he would be the man to ask!
This is the medical advice from Chris Ellis who is the doctor for the west highland way race. He's pretty knowledgeable when it comes to long distance running.
https://westhighlandwayrace.org/race-information/medical-advice/
He only mentions brufen once and says best avoided but he would be the man to ask!
Post edited at 15:57
2
In reply to DaveHK:
Hi Dave, yes that definitely seems to be the case - kidney damage is specifically mentioned.
Hi Dave, yes that definitely seems to be the case - kidney damage is specifically mentioned.
In reply to DaveHK:
All drugs of that class (non steroidal anti-inflammatory drugs) including ibuprofen, diclofenac, naproxen are toxic to the kidneys. They affect the chemical signals that maintain blood flow to the kidneys. Normally these aren't critical so they don't cause problems most of the time. But in those with kidney blood vessel disease (which is often not known about) or in setting of dehydration/physiological stress these signals are much more important so NSAIDs become toxic. They can also damage the kidney tissues directly. This is why they may be more risky in distance running than treating an injury/fever when resting etc..
I don't know the evidence in sports directly, but NSAID kidney injury is common and can be severe.
All drugs of that class (non steroidal anti-inflammatory drugs) including ibuprofen, diclofenac, naproxen are toxic to the kidneys. They affect the chemical signals that maintain blood flow to the kidneys. Normally these aren't critical so they don't cause problems most of the time. But in those with kidney blood vessel disease (which is often not known about) or in setting of dehydration/physiological stress these signals are much more important so NSAIDs become toxic. They can also damage the kidney tissues directly. This is why they may be more risky in distance running than treating an injury/fever when resting etc..
I don't know the evidence in sports directly, but NSAID kidney injury is common and can be severe.
4
In reply to Badgers:
Thanks for that! That's really useful info. I'm pretty constantly on slow-release ibuprofen for my Ankylosing spondylitis so am often doing high-intensity aerobic exercise whilst having ibuprofen trickling through the system. Might be worth a chat with my GP.
Thanks for that! That's really useful info. I'm pretty constantly on slow-release ibuprofen for my Ankylosing spondylitis so am often doing high-intensity aerobic exercise whilst having ibuprofen trickling through the system. Might be worth a chat with my GP.
In reply to drunken monkey:
As someone mentioned earlier, there are 2 main risks with non-steroidal anti-inflammatories such as ibuprofen. The first is acute kidney injury and the second is gastrointestinal irritation (including gastritis, erosions and ulcers).
Both of those problems can be very serious and both are significantly more likely if taken around the time of strenuous exercise.
As someone mentioned earlier, there are 2 main risks with non-steroidal anti-inflammatories such as ibuprofen. The first is acute kidney injury and the second is gastrointestinal irritation (including gastritis, erosions and ulcers).
Both of those problems can be very serious and both are significantly more likely if taken around the time of strenuous exercise.
2
In reply to Rich7:
There's a 3rd risk of increased cardiovascular risk: increased risk of heart attacks. This is highest with diclofenac, lower with ibuprofen, and appears to be less of an issue with naproxen. The increased risk is even with short courses. Those with pre-existing CVD disease or risks should be especially cautious.
With NSAIDS and running my understanding was the main concern was acute renal failure (kidneys failing) when combined with dehydration and extreme exertion.
There's a 3rd risk of increased cardiovascular risk: increased risk of heart attacks. This is highest with diclofenac, lower with ibuprofen, and appears to be less of an issue with naproxen. The increased risk is even with short courses. Those with pre-existing CVD disease or risks should be especially cautious.
With NSAIDS and running my understanding was the main concern was acute renal failure (kidneys failing) when combined with dehydration and extreme exertion.
In reply to DaveHK:
In lay terms, brufen type drugs can exacerbate fluid retention and worsen hyponatraemia(because of their effects at the kidneys). So it's usually during the very warm races that they really ought to be avoided when folks are at risk of over hydrating and are sweating profusely. People don't usually die of dehydration in races(they just do less well and drop out) but they have died due to overhydration and hyponatraemia.
Saying all that, i've taken brufen to get through an hour or two of "transient" knee pain in races and it works really well.
In lay terms, brufen type drugs can exacerbate fluid retention and worsen hyponatraemia(because of their effects at the kidneys). So it's usually during the very warm races that they really ought to be avoided when folks are at risk of over hydrating and are sweating profusely. People don't usually die of dehydration in races(they just do less well and drop out) but they have died due to overhydration and hyponatraemia.
Saying all that, i've taken brufen to get through an hour or two of "transient" knee pain in races and it works really well.
Post edited at 13:37
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In reply to graeme gatherer:
Interesting timing for me this thread... I ran an ultra on Saturday night and because I felt a knee niggle in the first few miles I had an ibu. Think I had three more over 13 hours. I've occasionally had ITB issues in the past so it was somewhat prophylactic as I didnt want to drop out. It does seem to give you a boost in a long run.
I asked my wife about this (she's a hospital pharmacist) - she didnt seem overly concerned and she is pretty cautious normally. She mentioned the kidney issues and possible masking of pain. I was well hydrated throughout, peeing quite regularly till the end, and ibu doesn't cause me gastric problems in gneeral use. Regarding the masking issue, I think you have to know your body and trust your instincts about pain and whether to push on.
So in short I don't worry about it. You have to put these risks in the context of being very fit vs being a couch potato/smoker/all the illnesses associated with inactivity.
Interesting timing for me this thread... I ran an ultra on Saturday night and because I felt a knee niggle in the first few miles I had an ibu. Think I had three more over 13 hours. I've occasionally had ITB issues in the past so it was somewhat prophylactic as I didnt want to drop out. It does seem to give you a boost in a long run.
I asked my wife about this (she's a hospital pharmacist) - she didnt seem overly concerned and she is pretty cautious normally. She mentioned the kidney issues and possible masking of pain. I was well hydrated throughout, peeing quite regularly till the end, and ibu doesn't cause me gastric problems in gneeral use. Regarding the masking issue, I think you have to know your body and trust your instincts about pain and whether to push on.
So in short I don't worry about it. You have to put these risks in the context of being very fit vs being a couch potato/smoker/all the illnesses associated with inactivity.
1
2
In reply to drunken monkey:
I meant to add, several times people have mentioned 'strenuous exercise'. I wouldn't class ultras as strenuous exercise. As evidenced by the fact you can eat and drink regularly during one.
I wouldn't dream of using ibu before or during a fast half marathon say, as a) I wouldnt bother racing it if I had any kind of injury and b) I would expect it to cause gastric irriation (and I wouldn't be eating or drinking much either).
Also it does amuse me that races would try to ban it - wouldnt exactly be hard to be 'unobserved' on an ultra course!
I meant to add, several times people have mentioned 'strenuous exercise'. I wouldn't class ultras as strenuous exercise. As evidenced by the fact you can eat and drink regularly during one.
I wouldn't dream of using ibu before or during a fast half marathon say, as a) I wouldnt bother racing it if I had any kind of injury and b) I would expect it to cause gastric irriation (and I wouldn't be eating or drinking much either).
Also it does amuse me that races would try to ban it - wouldnt exactly be hard to be 'unobserved' on an ultra course!
In reply to drunken monkey:
This sounds like just the sort of thing Pervitin was developed for. See if your race organisers will allow that instead
This sounds like just the sort of thing Pervitin was developed for. See if your race organisers will allow that instead
In reply to drunken monkey:
May be of interest
http://blog.parkrun.com/uk/2016/11/01/anti-inflammatory-medicines-research/
May be of interest
http://blog.parkrun.com/uk/2016/11/01/anti-inflammatory-medicines-research/
Post edited at 17:07
In reply to drunken monkey:
It seems like there's some very knowledgeable people on this thread, so I'm hoping to get an answer about another anti inflammatory drug.
Woke up this morning in immense back pain and have been stuck in bed all day. It's a bank holiday in France today and couldn't find a doctor and didn't fancy calling an ambulance. Just found a box of Prednisolone which was prescribed for me earlier this year for a double disc hernia and which was very effective at the time.
Is it dodgy to take these without seeing a doctor first? I'd just love a bit of pain relief until I can get to a doctor and the only other thing I have is ibuprofen which has been totally ineffective so far.
It seems like there's some very knowledgeable people on this thread, so I'm hoping to get an answer about another anti inflammatory drug.
Woke up this morning in immense back pain and have been stuck in bed all day. It's a bank holiday in France today and couldn't find a doctor and didn't fancy calling an ambulance. Just found a box of Prednisolone which was prescribed for me earlier this year for a double disc hernia and which was very effective at the time.
Is it dodgy to take these without seeing a doctor first? I'd just love a bit of pain relief until I can get to a doctor and the only other thing I have is ibuprofen which has been totally ineffective so far.
In reply to drunken monkey:
There is not drug in the world without some side effects and risks and individual advice from a doctor who understands sport medicine is important. The new UIAA paper on drug use and misuse in the mountains gives some specific advice: http://online.liebertpub.com/doi/pdfplus/10.1089/ham.2016.0080 .
Ibuprofen is a Non steroidal anti inflammatory drug (NSAID) and all have similar side effects but some more than others. All can erode the lining of the stomach leading to an ulcer especially if taken on an empty stomach. Most can have adverse effects on the Kidney which, if combined with dehydration can occasionally result in serious kidney damage.
Be very careful.
David Hillebrandt
There is not drug in the world without some side effects and risks and individual advice from a doctor who understands sport medicine is important. The new UIAA paper on drug use and misuse in the mountains gives some specific advice: http://online.liebertpub.com/doi/pdfplus/10.1089/ham.2016.0080 .
Ibuprofen is a Non steroidal anti inflammatory drug (NSAID) and all have similar side effects but some more than others. All can erode the lining of the stomach leading to an ulcer especially if taken on an empty stomach. Most can have adverse effects on the Kidney which, if combined with dehydration can occasionally result in serious kidney damage.
Be very careful.
David Hillebrandt
3
In reply to The New NickB:
That was very much n of 1 though.
It was possibly due to that but he also had got lost and ran hard. Plenty of people get rhabdo from just hard work. I wasn't convinced it could be attributed to that with any certainty.
That was very much n of 1 though.
It was possibly due to that but he also had got lost and ran hard. Plenty of people get rhabdo from just hard work. I wasn't convinced it could be attributed to that with any certainty.
1
In reply to Phil Payne:
I am not a doctor, but I would say - please please do not take prednisolone when you have taken ibuprofen and see a doctor before taking prescription medications! Steroids are not pain killers!
I am not a doctor, but I would say - please please do not take prednisolone when you have taken ibuprofen and see a doctor before taking prescription medications! Steroids are not pain killers!
1
In reply to Roadrunner5:
True, although I known people warn of the risks of ibuprofen for years. The issue with the Scotney incident is that it will put the potential issue with ibuprofen in the front of RO's minds.
> That was very much n of 1 though.
> It was possibly due to that but he also had got lost and ran hard. Plenty of people get rhabdo from just hard work. I wasn't convinced it could be attributed to that with any certainty.
True, although I known people warn of the risks of ibuprofen for years. The issue with the Scotney incident is that it will put the potential issue with ibuprofen in the front of RO's minds.
In reply to SouthernSteve:
Steve,
I am a doctor and I would totally agree with you.
David Hillebrandt
Steve,
I am a doctor and I would totally agree with you.
David Hillebrandt
In reply to drunken monkey:
The research suggests that ultra marathons etc. leave you at a pretty high risk of AKI as it is...
The research suggests that ultra marathons etc. leave you at a pretty high risk of AKI as it is...
In reply to David Hillebrandt:
Don't worry, I held out and went to see the doc this morning. I'm sure they over prescribe here in France because I walked out of the pharmacy with a bag of stuff to take. Lumirelax (Muscle relaxant), tramadol, solupred and something else to protect the stomach aparently.
Seems a bit much for a sore back.
Don't worry, I held out and went to see the doc this morning. I'm sure they over prescribe here in France because I walked out of the pharmacy with a bag of stuff to take. Lumirelax (Muscle relaxant), tramadol, solupred and something else to protect the stomach aparently.
Seems a bit much for a sore back.
In reply to drunken monkey:
As said above really. I wouldn't take it routinely on runs but on the very odd special occasion (the sort of run you'd only enter once or twice in your lifetime) I think its probably ok just to see you to the finish. If I ever do this I always take a long rest period after the race - sometime only very light running for several weeks to make sure I recover fully. If you are in that much pain regularly then there is probably an underlying issue that needs fixing.
As said above really. I wouldn't take it routinely on runs but on the very odd special occasion (the sort of run you'd only enter once or twice in your lifetime) I think its probably ok just to see you to the finish. If I ever do this I always take a long rest period after the race - sometime only very light running for several weeks to make sure I recover fully. If you are in that much pain regularly then there is probably an underlying issue that needs fixing.
In reply to Kid Spatula:
What research please? I am sceptical that there is any significant research base related to ultra marathons. Its a relatively new sport for a start.
And do people really think that dehydration is a significant risk in ultras? I haven't done many but in the UK at least I think it is easy to take on fluids (aid stations every 10 miles or so or less); and generally everyone carries water.
I would have thought dehydration seems more likely in standard road marathons in warm conditions and for relatively slower runners.
Unless by ultras you mean the genuinly more extreme/self-supported/multi-day events.
Not trying to be arsey, genuinely interested!
What research please? I am sceptical that there is any significant research base related to ultra marathons. Its a relatively new sport for a start.
And do people really think that dehydration is a significant risk in ultras? I haven't done many but in the UK at least I think it is easy to take on fluids (aid stations every 10 miles or so or less); and generally everyone carries water.
I would have thought dehydration seems more likely in standard road marathons in warm conditions and for relatively slower runners.
Unless by ultras you mean the genuinly more extreme/self-supported/multi-day events.
Not trying to be arsey, genuinely interested!
In reply to drunken monkey:
Howdy folks.
I remembered this thread when a GP was telling me about something they'd been told at a recent conference. I don't have any medical training but the gist of it was (I think) that there is a risk associated with ibuprofen taken during muscle injuries where the person also has a strep throat infection, which can lead to flesh-eating bacteria. This is apparently the kind of thing they were talking about:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4775098/
The basic idea I got was: don't take ibuprofen if you have a pulled muscle and a sore throat; take something else. Sorry if that sounds simplistic but that's how I understand it. I am going to find out more myself, if only because the workings in the body sounded fascinating, but for now I will add it to my list of reasons for avoiding NSAIDs during physical activity etc.
Jon
Howdy folks.
I remembered this thread when a GP was telling me about something they'd been told at a recent conference. I don't have any medical training but the gist of it was (I think) that there is a risk associated with ibuprofen taken during muscle injuries where the person also has a strep throat infection, which can lead to flesh-eating bacteria. This is apparently the kind of thing they were talking about:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4775098/
The basic idea I got was: don't take ibuprofen if you have a pulled muscle and a sore throat; take something else. Sorry if that sounds simplistic but that's how I understand it. I am going to find out more myself, if only because the workings in the body sounded fascinating, but for now I will add it to my list of reasons for avoiding NSAIDs during physical activity etc.
Jon
In reply to drunken monkey:
Ibuprofen is regarded as safer than it is by many IMO. It's a possible factor in bringing on problems as serious as ulcerative colitis. I certainly would never take it without food. Some of the instructions are along the lines of take it with food or take it with food if problems occur without. Personally I wouldn't chance it.
Also limit intake of food stabilisers / emulsifiers when you take it such as xanthum gum as they dissolve the protective layer of mucus in your guts.
Ibuprofen is regarded as safer than it is by many IMO. It's a possible factor in bringing on problems as serious as ulcerative colitis. I certainly would never take it without food. Some of the instructions are along the lines of take it with food or take it with food if problems occur without. Personally I wouldn't chance it.
Also limit intake of food stabilisers / emulsifiers when you take it such as xanthum gum as they dissolve the protective layer of mucus in your guts.
Post edited at 12:21
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