The Ibuprofen Alternative That's Better For Your Stomach (But You Need A Prescription For It)

Ibuprofen relieves aches and inflammation that can put a halt to your day. Most people will take ibuprofen every once in a while, but sometimes you might need to take it several times a day after an injury or a procedure. Like any drug, ibuprofen comes with several side effects, particularly for your digestive tract. People taking ibuprofen can experience gas, bloating, heartburn, diarrhea, or constipation.

You're not supposed to take ibuprofen on an empty stomach to avoid these stomach issues, but ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) can wreck your digestive system even if you take them with food. That's because most NSAIDs, like ibuprofen, are COX-1 inhibitors, which block prostaglandins that produce inflammation. However, prostaglandins also protect your stomach lining (per the National Institutes of Health).

To protect your stomach, you could consider a COX-2 inhibitor like Celebrex because it blocks inflammation while keeping intact the prostaglandins that protect your stomach and intestines. You need a prescription for COX-2 inhibitors, and they also come with their own risks.

It might seem simple to ditch COX-1 inhibitors such as ibuprofen or naproxen for a COX-2 inhibitor, but COX-2 inhibitors have risks of their own. A 2011 study in The BMJ compared the safety of these pain relievers and found that rofecoxib, a COX-2 inhibitor also known as Vioxx, had posed more than double the risk of a heart attack compared to a placebo. Lumiracoxib, a COX-2 inhibitor not available in the United States, had a similar increased risk for heart attack. Vioxx was removed from the market in 2004 for its risk for stroke and heart attack. Another COX-2 inhibitor, valdecoxib (Bextra), was pulled in 2005 for the same reason.

The study also found that Celebrex poses a lower risk for a heart attack than ibuprofen. Among all the NSAIDs studied, Ibuprofen has the highest risk for stroke and poses a slightly higher risk for overall mortality compared to Celebrex. Etoricoxib, a COX-2 inhibitor that's not approved in the United States, has four times the risk of cardiovascular death compared to a placebo. As you can see, COX-2 inhibitors can increase your risk of cardiovascular problems.

When it comes to relieving pain, Celebrex is comparable to ibuprofen, according to a 2017 study in the Journal of International Medical Research. People with osteoarthritis of the knee who took Celebrex or ibuprofen for 6 weeks had about the same amount of improvement in their symptoms. Those who took Celebrex had fewer stomach issues compared to those taking ibuprofen. Compared to other NSAIDs, Celebrex had a lower risk of causing GI bleeding, GI ulcers, swelling, and high blood pressure, according to a 2013 article in Expert Opinion on Drug Safety. However, Celebrex can lead to high blood pressure when compared to a placebo.

Celebrex can interact with other medications, so you should let your doctor know about any other prescriptions, supplements, or OTC pain relievers you might be taking. For example, if you're taking lithium, Celebrex can increase the amount of lithium in your system, which can be toxic. Celebrex can also come with serious side effects, such as liver or kidney problems.