- Cost: The Chinese source suggests asking a doctor or pharmacist once and describes no cost. Actual consultation charges and access vary and have not been checked.
- In plain language: The Chinese source describes gastrointestinal harm from drugs such as ibuprofen, naproxen and aspirin. Its approximately fourfold ibuprofen estimate concerns high-dose trial regimens; it is not an estimate for every short course at an over-the-counter dose.
- Benefit: The source cites a 2013 meta-analysis including 280 NSAID-versus-placebo trials and 124,513 participants. It reports upper gastrointestinal perforation, obstruction or bleeding risk ratios of 3.97 (95% CI 2.22–7.10) for ibuprofen, 4.22 (2.71–6.56) for naproxen, and 1.89 (1.16–3.09) for diclofenac, plus roughly doubled heart-failure risk. The author-institution repository abstract confirms these counts and estimates. Its endpoint combines perforation, obstruction and bleeding: these are not bleeding-only estimates. Selected methods and results pages in the original-layout PDF have now been checked: eligible trials lasted at least four weeks, and almost all primary outcomes came from coxib or high-dose regimens (diclofenac 150 mg/day, ibuprofen 2400 mg/day, naproxen 1000 mg/day). These are study descriptions, not recommended doses. The indexed 2014 comment and authors’ reply remain unread.
- US labeling scope: The cited US regulation requires an adult NSAID stomach-bleeding warning highlighting age at least 60, ulcer or bleeding history, anticoagulant or steroid use, other NSAIDs, at least three daily alcoholic drinks during use, and exceeding labeled amount or duration. This is a US labeling provision, not a claim that every country uses identical wording. The source’s Chinese “hormones” refers here to steroid drugs, not all hormone medications.
- Evidence grade: A, assigned by the Chinese source; not an independent RecheckNest approval.
- Sources: CNT Collaboration; Bhala N, Emberson J, Merhi A, et al. (2013). Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet, 382(9894):769–779. https://doi.org/10.1016/S0140-6736(13)60900-9; 21 CFR 201.326(a)(2)(iii)(A). https://www.ecfr.gov/current/title-21/chapter-I/subchapter-C/part-201/subpart-G/section-201.326
- Notes: The source says the paper does not separately quantify occasional one- or two-day use at labeled doses. FDA consumer guidance confirms that pain relievers and cough/cold medicines can share active ingredients: check labels and ask a pharmacist or clinician before combining products. Current UK NHS guidance advises continuing regular low-dose aspirin unless advised to stop, and warns against taking ibuprofen alongside another NSAID such as aspirin or naproxen. These are scoped US/UK references, not individual prescribing instructions or a universal rule covering every painkiller. Chapter 3, entry 25 addresses menstrual pain and needs its own review.
Editorial scope: Dose-specific research and country-specific labeling are distinct evidence. No individual medication regimen is supplied. The abstract supports the listed estimates, but the remaining paper/appendix, the comment/reply, applicability of US/UK clinical advice, cross-references and independent bilingual and L3 review remain unfinished. Not approved for publication.
Additional checked sources: NHS, Aspirin (reviewed 3 July 2026), https://www.nhs.uk/medicines/aspirin/; NHS, Ibuprofen for adults (reviewed 27 August 2025), https://www.nhs.uk/medicines/ibuprofen-for-adults/; FDA, OTC pain-reliever consumer brochure, https://www.fda.gov/drugs/safe-use-over-counter-pain-relievers-and-fever-reducers/best-way-take-your-over-counter-pain-reliever-seriously-four-panel-brochure.
Bibliographic correction: The earlier draft called DOI 10.1016/S0140-6736(14)60015-5 an erratum. The PubMed index classifies it as a Letter/Comment, “Coxibs and traditional NSAIDs for pain relief” (PMID 24411959); the linked authors’ reply is PMID 24411963 / DOI 10.1016/S0140-6736(14)60017-9. This discovery does not establish what either full text says, nor prove that no other correction exists. Their page content remains inaccessible here.
Original-layout paper copy checked for the above methods/results scope: https://www.natap.org/2013/HIV/PIIS0140673613609009.pdf, PDF pages 2 and 4. The mirror is not the publisher; this is not a claim of complete paper or appendix review.