Abstract

The use of over-the-counter (OTC), non-steroidal antiinflammatory drugs (NSAIDs) has become commonplace in the western world. NSAIDs increase the risk of heart failure in elderly patients as well as other thrombotic events [1]. This has led the Food and Drug Administration (FDA) in the United States of America to report that the use of non-selective NSAIDs potentially increases cardiovascular risks [2]. In Australia, cardiovascular disease is one of the largest health problems, affecting more than 3.4 million Australians [3]. A large Australian study of 3569 subjects, 1492(41.8%) who reported an upper GI problem had used NSAIDs [4]. Further, NSAIDs alone or in combination with diuretics and/or ACE inhibitors were found to be involved in over 50% of iatrogenic acute renal failure cases [5]. These data stress the need for precautions with the use of NSAIDs especially in people with risk factors. Owing to reasons, such as the availability of the OTC NSAIDs for self-care of many health conditions and the limited knowledge of NSAIDs by purchasers. There is potential that NSAIDs are inappropriately used. Two American surveys were conducted to identify patterns of use and public perceptions of OTC pain relievers. One with more than 9000 respondents reported that participants using OTC NSAIDs exclusively, 60% were unaware of the risks of side effects from NSAIDs and approximately 30% did not believe they were at risk [6]. A second survey conducted in 2002 found that approximately 50% of the participants were not worried about possible side effects [6]. This survey also indicated that 30% believed there were few risks associated with taking OTC NSAIDs.