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Randomized Controlled Trial
. 2011 Mar;300(3):R655-62.
doi: 10.1152/ajpregu.00611.2010. Epub 2010 Dec 15.

Influence of Acetaminophen and Ibuprofen on Skeletal Muscle Adaptations to Resistance Exercise in Older Adults

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Randomized Controlled Trial

Influence of Acetaminophen and Ibuprofen on Skeletal Muscle Adaptations to Resistance Exercise in Older Adults

Todd A Trappe et al. Am J Physiol Regul Integr Comp Physiol. .
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Abstract

Evidence suggests that consumption of over-the-counter cyclooxygenase (COX) inhibitors may interfere with the positive effects that resistance exercise training has on reversing sarcopenia in older adults. This study examined the influence of acetaminophen or ibuprofen consumption on muscle mass and strength during 12 wk of knee extensor progressive resistance exercise training in older adults. Thirty-six individuals were randomly assigned to one of three groups and consumed the COX-inhibiting drugs in double-blind placebo-controlled fashion: placebo (67 ± 2 yr; n = 12), acetaminophen (64 ± 1 yr; n = 11; 4 g/day), and ibuprofen (64 ± 1 yr; n = 13; 1.2 g/day). Compliance with the resistance training program (100%) and drug consumption (via digital video observation, 94%), and resistance training intensity were similar (P > 0.05) for all three groups. Drug consumption unexpectedly increased muscle volume (acetaminophen: 109 ± 14 cm(3), 12.5%; ibuprofen: 84 ± 10 cm(3), 10.9%) and muscle strength (acetaminophen: 19 ± 2 kg; ibuprofen: 19 ± 2 kg) to a greater extent (P < 0.05) than placebo (muscle volume: 69 ± 12 cm(3), 8.6%; muscle strength: 15 ± 2 kg), when controlling for initial muscle size and strength. Follow-up analysis of muscle biopsies taken from the vastus lateralis before and after training showed muscle protein content, muscle water content, and myosin heavy chain distribution were not influenced (P > 0.05) by drug consumption. Similarly, muscle content of the two known enzymes potentially targeted by the drugs, COX-1 and -2, was not influenced (P > 0.05) by drug consumption, although resistance training did result in a drug-independent increase in COX-1 (32 ± 8%; P < 0.05). Drug consumption did not influence the size of the nonresistance-trained hamstring muscles (P > 0.05). Over-the-counter doses of acetaminophen or ibuprofen, when consumed in combination with resistance training, do not inhibit and appear to enhance muscle hypertrophy and strength gains in older adults. The present findings coupled with previous short-term exercise studies provide convincing evidence that the COX pathway(s) are involved in the regulation of muscle protein turnover and muscle mass in humans.

Figures

Fig. 1.
Fig. 1.
Change in quadriceps muscle volume and muscle strength from the beginning to the end of the 12-wk resistance exercise training and drug intervention. *Significant increase from pretraining across all three groups, P < 0.05; †ANCOVA revealed a significant increase compared with placebo, P < 0.05.
Fig. 2.
Fig. 2.
Skeletal muscle (vastus lateralis) water content and protein content at the beginning and the end of the 12-wk resistance exercise training and drug intervention. There was no influence of drug consumption or resistance training on either parameter. Acetamin, acetaminophen.
Fig. 3.
Fig. 3.
Skeletal muscle (vastus lateralis) cyclooxygenase (COX)-1 and COX-2 protein content at the beginning and the end of the 12-wk resistance exercise training and drug intervention. *Significant increase from pretraining across all 3 groups, P < 0.05. There was no influence of drug consumption on COX-1 protein. The image for the COX-1 protein reflects a representative Western blot showing an increase from pre- to posttraining in each of the 3 groups. The image for the COX-2 protein reflects a representative Western blot showing a lack of detectable COX-2 protein migrating with the human recombinant COX-2 positive control protein pre- or posttraining in any of the 3 groups. See materials and methods and Burd et al. (5) for further description of the analytical considerations and the two lower migrating bands, which also did not change over the 12 wk, AU, arbitrary units.

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