Prophylactic Use of NSAIDs by Athletes: A Risk/Benefit Assessment

Warden, Stuart J.

doi:10.3810/psm.2010.04.1770

Cited by 144Inflammatory mediators and NSAID effectsDoping in SportsSports injuries and prevention

Prophylactic Use of NSAIDs by Athletes: A Risk/Benefit Assessment

Warden, Stuart J.·2010·The Physician and Sportsmedicine

DOI 10.3810/psm.2010.04.1770

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Abstract

Athletes often seek artificial means to gain advantage and prolong participation when competing. This often involves taking naturally occurring or chemically synthesized compounds. The World Anti-Doping Agency does not prohibit the use of nonsteroidal anti-inflammatory drugs (NSAIDs) because these agents are not performance enhancing, and their analgesic and anti-inflammatory effects are at best performance enabling. Consequently, athletes have relatively unrestricted access to NSAIDs, which are readily available as over-the-counter drugs. However, concern has been raised on athletes' prophylactic use of these agents. Data from many sporting fields have consistently demonstrated that many individuals self-administer NSAIDs prior to athletic participation to prevent pain and inflammation before it occurs. However, scientific evidence for this approach is currently lacking, and athletes should be aware of the potential risks in using NSAIDs as a prophylactic agent. These agents are not benign, and can produce significant side effects, including gastrointestinal and cardiovascular conditions, as well as musculoskeletal and renal side effects. The latter side effects appear paradoxical to the rationale for prophylactic use of NSAIDs. This article discusses current observations regarding athlete use of NSAIDs, and the possible benefits and potential risks of their use.

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Ultra-marathon runners commonly use analgesics including NSAIDs, non-opioid analgesics, and compound analgesics to mitigate extreme peripheral stress associated with competition.
“To mitigate the extreme peripheral stress associated with competition, ultra-marathon runners commonly use analgesics including NSAIDs (Ibuprofen or aspirin), non-opioid analgesics (paracetamol), and compound analgesics (co-codamol) [179].”
From International Society of Sports Nutrition Position Stand: nutritional considerations for single-stage ultra-marathon training and racing (2019) · cites this paper as [179]

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Authors: Warden, S. J.
Affiliations: Indiana University Indianapolis (US)
Corresponding author: Warden, Stuart J.
ORCID: Warden, Stuart J.
Venue: The Physician and Sportsmedicine
Publisher: Informa UK Limited
Published: 2010-04
Volume: 38
Issue: 1
Pages: 132-138
ISSN: 0091-3847 (ISSN-L)
2326-3660
DOI: 10.3810/psm.2010.04.1770
OpenAlex: W2034077814
Cited by: 144
References: 72
Citations by year: 2026: 5 · 2025: 3 · 2024: 7 · 2023: 6 · 2022: 4 · 2021: 16 · 2020: 13 · 2019: 7 · 2018: 12 · 2017: 15 · 2016: 7 · 2015: 9 · 2014: 12 · 2013: 17 · 2012: 7
FWCI: 6.34
Type: journal article
Language: en
Open access: closed
Locations: The Physician and Sportsmedicine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pharmacology › Inflammatory mediators and NSAID effects
Social Sciences › Sociology and Political Science › Doping in Sports
Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
Keywords: nonsteroidal anti-inflammatory drugs, athletes, anti-doping regulations, performance-enhancing drugs, NSAID adverse effects, gastrointestinal adverse effects, cardiovascular adverse events, renal adverse effects, musculoskeletal adverse effects
MeSH terms: Anti-Inflammatory Agents, Non-Steroidal, Athletic Injuries, Glomerular Filtration Rate, Gastrointestinal Hemorrhage, Humans, Inflammation, Pain, Physical Endurance, Risk Assessment

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Prophylactic Use of NSAIDs by Athletes: A Risk/Benefit Assessment

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