Neurofen – The Small Print
The writs are flying in Los Angeles after a six year old girl, Sabrina Brierton Johnson, developed Stevens Johnson Syndrome – a devastating inflammatory disease that can result in serious gastrointestinal problems, blindness and death – soon after being given a children’s ibuprofen manufactured by Johnson & Johnson for a mild fever. Since her case was made public, other similar cases have been reported.
Ibuprofen is an over the counter nonsteroidal anti-inflammatory drug (NSAID) widely used for headache, period pain, dental pain, migraine, backache, muscular pain, rheumatic pain, neuralgia cold and fly symptoms and fevers. It is generally considered safe and free from the adverse effects associated with stronger anti-inflammatories such as azapropazone, indometacin, naproxen and diclofenac. However because ibuprofen is generally taken over shorter periods of time for self-limiting disorders, it may simply appear safer than it actually is. In fact, like all NSAIDs, ibuprofen comes with a catalogue of potential adverse effects, in adults and children, which most of us never hear anything about.
The manufacturers of Nurofen, the UK’s best selling adult ibuprofen, list the following adverse effects in their packaging:
Stomach discomfort or pain, nausea, stomach ulcer with or without bleeding, black tarry stools, worsening of asthma, unexplained wheezing or shortness of breath, liver and kidney problems, headache, dizziness, hearing disturbance and rarely skin rash, itching, peeling, easy bruising and facial swelling.
The British National Formulary, the drugs bible published by the British Medical Association and the Royal Pharmaceutical Society of Great Britain, and used by physicians throughout the land, adds the following to that list:
Depression, drowsiness, insomnia, vertigo, photosensitivity and haematuria [blood in the urine]. Blood disorders have also occurred. Fluid retention (rarely, precipitating congestive heart failure in elderly patients); blood pressure may be raised. Renal [kidney] failure may be provoked by NSAIDs especially in patients with pre-existing renal impairment. Hepatic [liver] damage, alveolitis [inflammation of the alveoli, tiny air sacs in the lungs], pulmonary eosinophilia [lung inflammation associated excess eosinophils, a type of white blood cell that increases in number in response to allergies or inflammation], pancreatitis [inflammation of the pancreas], eye changes, Stevens-Johnson syndrome and toxic epidermal necrolysis [blistering and peeling of the top layer of skin] are other rare side-effects. Induction of or exacerbation of colitis [inflammation of the colon ] has been reported. Aseptic meningitis has been reported rarely with NSAIDs; patients with connective-tissue disorders such as systemic lupus erythematosus may be especially susceptible.
The tablets may be easy to swallow, but don’t be lulled into a false sense of security. There is almost no way to know how often such adverse effects occur. Chances are they are underreported; certainly they are under investigated. Most people take NSAIDs when they are feeling unwell, and may simply put any symptoms down to the illness rather than the ‘cure’. Score one for the drug dealers.
- This news update was written for the Ecologist February 2005.
