Medication education

As runners, we all experience aches and pains as we progress through our training. But, did you know - not all medications are created equal? Most runners take an ibuprofen here or an acetaminophen there, but what are these medications really doing to our bodies? As a pharmacist and a runner, let me help.

Non-steroidal anti-inflammatory medications, or NSAIDs, are commonly used over-the-counter medications for the treatment of pain. These include products, like Motrin or Advil (both ibuprofen) and Aleve (generic name: naproxen). I have known several athletes who pop these medications like they are candy (literally, like candy - without even a swallow of water! PLEASE don't do this! Take your NSAIDs with a glass of water and with food). These medications can be very dangerous to runners. NSAIDs cause decreased blood flow to the kidneys. Combine that with dehydration from sweating, and we now have a very dangerous situation for the kidneys. NSAIDs can also cause blood pressure to increase. Exercise also causes a mild increase in blood pressure -this combined, especially in a person with high blood pressure to begin with, can be unsafe. Also, when NSAIDs are used during longer runs, like a marathon, they can cause a condition called hyponatremia (low sodium levels in the blood). This is a potentially deadly condition that causes the brain to swell. NSAIDs are simply too risky to be using in conjunction with long runs.

Acetaminophen, or Tylenol, is a safer option, but also must be used appropriately. Acetaminophen is toxic to the liver at too high of doses. The current recommendation is no more than 4 grams of acetaminophen per day (this is 8 of the 500 mg tablets) - even less when the drug is taken with alcohol (post-race celebration anyone?). Anything higher than this can cause fatal liver toxicity. And remember - acetaminophen is found in several OTC cough, cold, flu, and allergy products. Make sure to read the labels of the medications you are taking to avoid too much. Acetaminophen is a safer option to use during or after exercise because it lacks the adverse effects on the kidneys.

It's important to remember that all medications have adverse effects. Even though these medications are over-the-counter, it doesn't mean they are 100% safe. We need to use these medications properly and at the correct doses.

Please do not hesitate to ask questions about this topic - failure to do so can be dangerous!

Next week: the day before the race.

Happy and safe running,
Jennifer