Wednesday, September 16, 2009

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Ask the doctor Dear Dr. Eneas, A few weeks ago I had temporary dental crowns put in. They hurt pretty badly everyday and I was told by my dentist to take Advil for them. Well, the new crowns came in but they did not fit right. In the meantime, I have to take a pain reliever to tolerate the pain. Is it safe to take ibuprofen everyday for three weeks? My dentist says it is, but he is not an MD so I do not trust his word on this. I am not taking large amounts — at most, four to five daily, but I do not want to harm my body. Can this hurt my liver? Do you think it might be better to alternate Advil and Tylenol? Answer: Advil is ibuprofen, an NSAID (non steroidal anti-inflammatory drug). The OTC (over the counter) dose is 200 mgs. and is a mild dose. It should be taken with food in the stomach, but has the capacity to cause small amounts of bleeding from the lining of the stomach. Certain drugs can protect the stomach from harm, called Proton Pump Inhibitors or PPI's. These are drugs like Nexium, Prilosec, or Ogastro. These can be taken once a day to protect your stomach from the harmful effects of Advil. Higher doses can give better pain relief. The prescription dose of Ibuprofen is 400 to 800 mgs. every four hours as needed for pain relief. NSAID's can also affect other organs. They can make high blood pressure medication less effective. In patients who have heart or kidney disease, NSAID's can make the condition worse, but in an otherwise healthy individual, the side effects can be minimal if you have no history of gastritis or ulcer disease. Drinking alcohol can make the side effects much worse and n See Doctor on L11 should not be taken with medication. Tylenol would be safer for the stomach. And taking four or five Tylenol tablets a day is relatively safe. Very large doses of Tylenol can be injurious to the liver but this only happens over a longer period of time. The usual dose of Tylenol is two tablets or 650 mgs. every four to six hours for pain relief. If you can get adequate pain relief with Tylenol this would be a safer course of action for you. If two regular tablets of Tylenol are not giving you sufficient pain relief, then Tylenol Extra Strength comes in a 500 mgs. dose and two of these can be taken quite safely three to four times a day. Judson Eneas, MD Internal Medicine Specialist Do you have a medical question that needs answering? We would love to hear from you. Send us your question and look out for the next "Ask the Doctor" column. You can send your question via email to askthedoctor@doctorshosp.com, or to Doctors Hospital P.O. Box N 3018, Nassau, Bahamas or The Nassau Guardian. This informative column is intended to educate the community about important issues regarding their health and is not intended as a substitute for consultation with a primary physician. For more information or for a physician referral, please call 302-4707. Monday, August 17, 2009