Analgesic use before endurance sports can cause serious medical events, according to a study published online April 19 in BMJ Open.

Michael Küster, MD, from the Pain Management Center in Bonn, Germany, and colleagues analyzed survey data from 3,913 participants in the 2010 Bonn marathon regarding the ingestion of over-the-counter analgesics before a sports performance.

The researchers observed no significant difference between the premature race withdrawal rate in the analgesics cohort and those who did not take analgesics, although race withdrawal because of gastrointestinal adverse events (AEs) was significantly more frequent in the analgesics cohort than in the control group. Premature withdrawal because of muscle cramps was rare but occurred significantly more frequently among controls.

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The incidence of AEs was almost five times higher among the analgesics cohort (overall risk difference of 13%), and the incidence increased significantly with increasing analgesic dose. Nine respondents had post-analgesic AEs requiring temporary hospital admittance: three with temporary kidney failure (post-ibuprofen ingestion), four with bleeds (post-aspirin ingestion), and two with cardiac infarctions (post-aspirin ingestion).

“The use of analgesics before participating in endurance sports may cause many potentially serious, unwanted AEs that increase with increasing analgesic dose,” the authors write.