Ibuprofen, one of the French’s favorite anti-inflammatory drugs, is regularly brought to the fore for the dangers associated with its abuse. Recently, ANSM has had its sights set on a 400mg box.
One less drug on television – at least for one version of it. Health authorities announced a ban on generic public advertising for ibuprofen 400mg on Thursday, February 8. Objective: To limit the share of abuse and its side effects, sometimes very serious, as much as possible.
For the second time in five years, one of the French’s favorite drugs is the subject of a warning. Will we have a toxic relationship with this everyday painkiller that we’ve consumed 34 million boxes of in 2022? Six questions to better understand this molecule.
• What is ibuprofen?
Whether it’s a small white pill, an oval or a blue capsule, ibuprofen is everyone’s family medicine. Non-steroidal anti-inflammatory drugs (NSAIDs).
The Agency for the Safety of Medicines (ANSM) explains on BFMTV.com, “This class of medicines includes many substances such as ibuprofen, but also acetylsalicylic acid (aspirin), niflumic acid, diclofenac, flurbiprofen, ketoprofen or tenoxicum.
“Ibuprofen” is the generic name for the active substance. Some companies market it under other names, for example Advil, sold by Halon Laboratories.
More sneakily, ibuprofen is sometimes used in products combining several molecules. Iprafeine, for example, is a combination of caffeine (100mg) and ibuprofen (400mg). which is not always clear to patients.
“We really have a lot of drugs with different names that belong to the same family,” warns Eric Mayon, secretary general of France’s National Union of Pharmacists.
“Spedifen, Nurofen, ibuprofen, iprafeine…” he lists. We are in the same family of anti-inflammatory drugs. Be careful, therefore! There are doses to respect so don’t put yourself at risk.”
• When should you take ibuprofen?
The ANSM explains that ibuprofen is the recommended product “in the treatment of pain, fever and inflammation”. Osteoarthritis, rheumatism, migraine, moderate pain, painful menstruation… The advantage of this molecule is that it allows to effectively reduce pain, although it is relatively safe. A favorable benefit-risk profile justifies its self-service availability and, therefore, without a prescription.
Self-service access does not mean that you have to take the medicine without following the instructions. “You should always take the lowest possible dose, for the shortest possible time”, and “preferably during a meal with a large glass of water”, reminds the health official.
Dose makes poison. The red line should be kept in mind: An adult should not consume more than 1200 mg of ibuprofen per dayAnd an interval of 6 to 8 hours should be observed between taking 400mg tablets.
“If after 3 days we tell ourselves that we are still very sad, it is better to consult a doctor than to be alone with 10 days of self-medicating anti-inflammation,” emphasizes Eric Mayon.
• Children, pregnant women… can everyone take it?
Ibuprofen is not intended for everyone. According to Health Insurance, non-steroidal anti-inflammatory drugs should generally be avoided:
- For children under 15 years of age, “unless the drug leaflet clearly states that it can be used in children and under what conditions”;
- People over 65 years of age;
- Lactating women.
One is denoted by “absolute contradiction”. Vidal For pregnant women, during the last four months of pregnancy.
People suffering from severe heart, liver or kidney failure should also avoid taking this anti-inflammatory drug.
As with any medication, consult the instructions for proper dosage, contraindications, and possible side effects. Finally, it is advisable to call your doctor or pharmacist to monitor the cocktail between ibuprofen and other ingested medications.
• What are the risks of side effects?
Thanks to pharmacovigilance, the Medicines Safety Agency has identified side effects – as with all medicines. For non-steroidal anti-inflammatory drugs, health insurance specifically mentions the risk of possible digestive disorders, skin rashes, asthma attacks, dizziness or drowsiness.
And what happens if the dose is not respected? Kidney or heart damage may occur, but gastro-digestive hemorrhages (bleeding) may also occur. “Inactive acute renal failure” particularly affects the elderly, dehydrated, following a low-salt diet or having other cardiac, renal or hepatic (liver) pathologies.
Anti-inflammatory drugs such as ibuprofen, “especially when used at high doses for a long time, are also associated with an increase in cardiovascular events (such as myocardial infarction or stroke)”, underlines the agency.
But why so many potentially harmful effects? They are a direct result of the action of these tiny tablets. As Dr. Tsoronis explained to the New York Times, ibuprofen blocks the activity of certain enzymes to relieve pain.
However, these enzymes contribute to “maintaining kidney and liver functions and regulating the balance of fluids and electrolytes in the body.”
Despite these identified risks, the balance between the service provided and the harmful effects is clear. “The Pharmacovigilance Risk Assessment Committee concludes that the benefits of ibuprofen are greater than the risks,” the European Medicines Agency assures.
• Can Ibuprofen Hide Illnesses?
Anti-inflammatory drugs “may mask signs and symptoms of infection, such as pain and fever, and delay initiation of adequate treatment, which may increase the risk of complications,” the agency assures the drug’s safety in its instructions. BFMTV.com.
An issue that raised eyebrows from the Secretary General of France’s National Union of Pharmacists:
“It is a remnant of the good old French medical education that says ‘be careful to hide the symptoms’, so no painkillers etc. Today we are in a world where access to care is not very easy (…) so to say people that when someone It would be better to endure to make sure that the diagnosis is not missed when the doctor is not available: it is of no use “, Eric Mayon takes the position.
In an interview with France 3, the director of analgesic drugs at ANSM, Dr. Philip Vella noted that from 2000 to 2018, “337 cases of infectious complications, including 32 deaths, were reported for ibuprofen and 46 cases, including ten deaths, with ketoprofen.
• Why are health authorities imposing restrictions?
In 2019, health officials decided to move boxes of ibuprofen, aspirin and paracetamol – also known as doliprane – behind pharmacy counters. The aim is to control the consumption of these products by patients, without the need for a prescription.
Almost four years later, in a “continuation” of the 2019 measures, the authorities announced a ban on the advertising of ibuprofen 400mg to the general public. The move will come into effect from April 2.
for what Because “reports of serious adverse effects associated with doses of ibuprofen (…) have paralleled the increase in the number of advertisements in favor of ibuprofen 400 mg to the general public”. According to our information, they have even doubled.
These measures will also prove to be effective. In recent years, pharmacists have noticed a marked decline in the use of these small pills, as Eric Mayon explains.
“Almost the good news is that the general population has retained the idea that we shouldn’t be consuming so many anti-inflammatory drugs, our distribution has been broken post-Covid,” he asserts.
A more reasonable intake that may also be consistent with recommendations taken at the height of the pandemic, when it was once believed that ibuprofen could cause more severe forms of infection. A point disproved many times since.
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