Tag Archives: ‘precaution’

Why it might be best to avoid painkillers as a precaution before your COVID-19 vaccine

Billions of people worldwide will receive vaccines to protect against COVID-19 and some will temporarily feel a sore arm, fever or muscle aches. But reaching for some common painkillers could blunt the effect of the vaccine, experts say.

Mahyar Etminan, an associate professor of of ophthalmology, pharmacology and medicine at the University of British Columbia, looked at data on taking medications like acetaminophen (Tylenol) and anti-inflammatories like ibuprofen (Advil, Motrin) before or close to the time of vaccination.

“Given that a lot of people would probably resort to using these drugs once they’re vaccinated, if they still have aches and pains, I thought to put the data into perspective,” said Etminan, who has a background in pharmacy, pharmacology and epidemiology. 

The jury is out on what happens to a person’s immune system after a COVID-19 vaccine if the person has taken those medications. But based on research on other vaccines like for the flu, there may be a blunting effect on immune response from the pills.

“If you tell people not to take them and they don’t like the side-effects they’re experiencing, that may lead to non-compliance with the second dose,” Etminan said. “I think it is an important sort of question to look at scientifically and also to tell patients.”

Why might fever-reducing meds interfere with our immune response after vaccination?

It has to do with what’s happening when our temperature rises to fight off an infection.

Dr. Dakotah Lane, a member of the Lummi Nation, right, raises his arms in a traditional motion of thanks after receiving a COVID-19 vaccination from registered nurse Alyssa Lane on Dec. 17, 2020, on the Lummi Reservation, near Bellingham, Wash. Arm pain after vaccinations may be uncomfortable but is generally mild, doctors say. (Elaine Thompson/Associated Press)

Dr. Sharon Evans, a professor of oncology at Roswell Park Comprehensive Cancer Center in Buffalo, N.Y., works on training the immune system to attack cancer. She became interested in fever because it is such a common response across animals that walk or fly, even cold-blooded ones.

Before the pandemic, Evans and her colleagues wrote a review on how fever generally helps to reduce the severity and length of illness.

Evans called fever “incredible” for its ability to boost all the components needed for a protective immune response.

Fever “literally mobilizes the cells, it moves them in the body into the right place at the right time,” Evans said.

There’s also good evidence that inflammation, even without fever, can boost immune responses, she said.

Fever pills generally not recommended before vaccines

In a preprint to be published in the journal CHEST, Etimanan and his colleagues noted that a randomized trial looking at infants given acetaminophen immediately following vaccination showed lowered antibody levels compared with other infants who had not been given acetaminophen.

Another study in adults did not find their antibody levels fell after being vaccinated and taking acetaminophen. Immune responses can differ between children and adults.

Mahyar Etminan wants people to know about recommendations on avoiding painkillers around the time of COVID-19 vaccination. (Submitted by Mahyar Etminan)

Evans said the ability to mount a strong immune response also tends to go down as we age.

“What’s the difference between different age groups, different types of anti-inflammatory or antipyretics?” Evans said. “They’re all likely to be important and we just don’t know the answer.”

In the absence of those answers, authorities such as the U.S. Centers for Disease Control and Prevention (CDC) and World Health Organization say the use of antipyretics or fever-reducing medications is not recommended before or at the time of vaccination. They are approved in the days after vaccination.

For COVID-19 vaccines, Canada’s National Advisory Committee on Immunization (NACI) gives similar advice.

“NACI recommends that prophylactic oral analgesics or antipyretics (e.g., acetaminophen or ibuprofen) should not be routinely used before or at the time of vaccination, but their use is not a contraindication to vaccination,” according to the Government of Canada’s website. “Oral analgesics or antipyretics may be considered for the management of adverse events (e.g., pain or fever, respectively), if they occur after vaccination.”

The side-effects of vaccination such as a sore arm at the site of injection or wider effects like headache, fatigue, fever, muscle and joint soreness, while uncomfortable, are generally mild.

Bright side of mild vaccine side-effects

“All those side-effects are like a bell ringer telling you that your body is ramping up immune response,” Evans said. “It’s what you want. It’s sometimes disappointing if you didn’t get that response.”

If you do spike a fever after receiving the COVID-19 vaccination, Evans said the best advice is to stay home and ride it out.

If the temperature reaches 39.4 C or 103 F, redness or tenderness in the arm increases after a day or if side-effects don’t go away after a few days, the CDC says call your doctor.

WATCH | How Canada’s other vaccine candidates for COVID-19 stack up:

Canada has other vaccines in line for approval — how they compare to the ones already being rolled out and how COVID-19 variants are a complicating factor. 2:03

Likewise, if you’re regularly taking anti-inflammatory or pain and fever-relieving medications for a chronic condition, Evans suggests contacting your doctor about what to do about taking the medications around the time of COVID-19 vaccinations.

The CDC suggests holding a cool, wet washcloth over the area of the shot and exercising that arm. For fever, drink lots of fluids and dress lightly.

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‘Tiger King’s Joe Exotic Quarantined as Precaution After Being Transferred to New Federal Prison

‘Tiger King’s Joe Exotic Quarantined as Precaution After Being Transferred to New Federal Prison | Entertainment Tonight

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Johnson & Johnson recalls baby powder in U.S. as a precaution

Johnson & Johnson is recalling a single lot of its baby powder in the U.S. as a precaution after government testing found trace amounts of asbestos in one bottle bought online.

The recall comes as J&J fights thousands of lawsuits in which plaintiffs claim its iconic baby powder was contaminated with asbestos and that it caused ovarian cancer or another rare cancer.

At multiple trials, J&J experts have testified asbestos hasn’t been detected in the talc in its baby powder in many tests over 40 years.

On Friday, J&J said the U.S. Food and Drug Administration found minuscule amounts of asbestos in one bottle. The company is investigating whether the bottle is counterfeit and how the contamination occurred.

The FDA said the affected product is Johnson’s Baby Powder Lot #22318RB. The lot number can be found on the back of the bottle, directly underneath the cap.

The recall only applies to the United States, a spokesperson said.

The recalled lot contained 33,000 bottles.

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Heartburn drug Zantac recalled as a ‘precaution’

GlaxoSmithKline on Tuesday said it is recalling the popular heartburn medicine Zantac in all markets as a “precaution,” days after the U.S. Food and Drug Administration found “unacceptable” levels of probable cancer-causing impurity in the drug.

Zantac, also sold generically as ranitidine, is the latest drug in which cancer-causing impurities have been found. Regulators have been recalling some blood pressure and heart failure medicines since last year.

Britain’s medicines watchdog said GlaxoSmithKline (GSK) was recalling four prescription-only Zantac medicines: a syrup, an injection and tablets of 150 and 300 milligram (mg) dosages. 

Over-the-counter 75 mg dosage Zantac products are produced by a different company and are not affected by the recall, it added.

“GSK informed the MHRA of our decision to suspend the release, distribution and supply of all dose forms of Zantac products,” a company spokesman confirmed to Reuters.

“GSK is continuing with investigations into the potential source of the NDMA,” he said, adding that the investigations include continued engagement with its suppliers and with external laboratories to conduct tests on finished product batches of Zantac.

The Medicines and Healthcare products Regulatory Agency (MHRA) said health-care professionals were told on Monday to “stop supplying the products immediately, quarantine all remaining stock and return it to their supplier.”

“We are advising that patients should not to stop taking their medication, and do not need to see their doctor until their next routine appointment but should seek their doctor’s advice if they have any concerns,” the MHRA said.

U.S. and European health regulators said last month they were reviewing the safety of ranitidine, after online pharmacy Valisure flagged the impurities.

The FDA said Valisure’s higher-temperature testing method generated very high levels of NDMA from the ranitidine drugs.

NDMA had previously been found in some blood pressure medicines from a class of drugs known as angiotensin II receptor blockers, or ARBs.

Distribution halted

After checking the over-the-counter drugs using a low-heat method of testing, the FDA said it found much lower levels of NDMA than was discovered with a higher temperature test employed by Valisure.

The U.S. regulator has asked ranitidine makers to conduct their own testing to assess levels of the impurity and to send samples of their products for testing by the agency.

Swiss drugmaker Novartis halted global distribution of its ranitidine drugs last month.

Canada’s health authorities have asked makers of the drugs to halt distribution as they gather more information. Last month, regulators in Hong Kong pulled four products, while in Ireland 13 products containing ranitidine were recalled.

The impurity was believed to have been introduced by changes in the manufacturing process.

Over-the-counter ranitidine is approved to prevent and relieve heartburn associated with acid indigestion and sour stomach. The prescription versions are used to reduce stomach acid to prevent and treat conditions, such as heartburn, ulcers of the stomach and intestines, and gastroesophageal reflux disease or GERD, Health Canada said. 

Health Canada advised consumers:

  • Talk to your doctor or pharmacist at your earliest convenience about alternative, non-ranitidine treatment options appropriate for your health circumstances. 
  • Individuals taking a prescription ranitidine drug, including a recalled product, should not stop taking it unless they have spoken to their health-care provider and obtained alternative treatment, as the risk of not treating the condition may be greater than the risk related to NDMA exposure.

Ranitidine works by blocking the action of acid-producing cells in the stomach. 

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