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NSAIDs: take with food or after fasting?
Kim D Rainsford1, Ingvar Bjarnason
1Biomedical Research Centre, Sheffield Hallam University, UK.
The Journal of Pharmacy and Pharmacology
|March 17, 2012
Summary
For over-the-counter use, taking nonsteroidal anti-inflammatory drugs (NSAIDs) on an empty stomach may be more effective. This approach prioritizes the rapid onset of action crucial for immediate pain relief.
Area of Science:
- Pharmacology
- Gastroenterology
Background:
- Regulatory guidelines recommend taking nonsteroidal anti-inflammatory drugs (NSAIDs) with food or fluids.
- The scientific basis for this recommendation, particularly concerning over-the-counter (OTC) use, remains unclear.
Purpose of the Study:
- To investigate the rationale behind the recommendation to consume NSAIDs with food.
- To evaluate the impact of food intake on NSAID efficacy and safety, especially for OTC applications.
Main Methods:
- Literature search of published studies.
- Review of personal files and experimental animal data.
- Analysis of NSAID pharmacokinetics and pharmacodynamics in relation to food intake.
Main Results:
- Animal studies suggest fasting increases NSAID gastric side effects, while food can exacerbate small bowel damage.
- Food generally delays NSAID peak plasma concentrations, potentially reducing the rapid onset of action.
- The safety profile of OTC ibuprofen and naproxen is comparable to paracetamol.
Conclusions:
- The rapid onset of action is a key factor for OTC NSAID use.
- Taking NSAIDs on a fasting stomach might be more appropriate to achieve a faster therapeutic effect for OTC indications.
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