Common painkiller linked to major heart problems

Alicia Farmer
September 8, 2018

These risks applied to both men and women of all ages and even at low doses of diclofenac.

The researchers said that given the risks, doctors should be initiating treatment where indicated with other types of NSAIDs before considering diclofenac.

"Treatment of pain and inflammation with NSAIDs may be worthwhile for some patients to improve quality of life despite potential side effects", they write.

The researchers found that starting diclofenac during the study period was linked to increased rate of cardiovascular events such as heart failure, heart attack, irregular heartbeat, and ischaemic stroke within a month compared with starting paracetamol, or other traditional NSAIDs such as ibuprofen or naproxen.

The researchers believe its high time that the potential health risks of the drug are recognised and that its usage is reduced, including not making it available over the counter.

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When all these simulated trials was averaged out, people who took diclofenac were 50 per cent more likely to have cardiovascular problems in the first 30 days after use than were people who took nothing.

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The new study, however, examined this common painkiller's negative impact on the circulatory system and found out that this drug is indeed increasing the risks of cardiovascular conditions, heart attack and stroke included, as reported by the leading author Morten Schmidt at Aarhus University Hospital in Denmark.

Writing in The BMJ, he says diclofenac should only be available with a prescription, like in the United Kingdom - and only them when also accompanied with an appropriate warning on the front of the pack.

Unfortunately, besides heart attacks, the study links diclofenac to cardiovascular disease which includes arrhythmic heartbeats, ischemic stroke, and heart failure. Diclofenac is a traditional NSAID that has similar selectivity for cyclo-oxygenase-2 (COX 2) as COX 2 inhibitors, but the cardiovascular risks of diclofenac in comparison with other traditional NSAIDs have not been investigated through a randomized controlled trial. The researchers looked at records between 1996 and 2006.

The additional cardiovascular events increased further in the high-risk group, with extra cardiovascular events seen in 39 out of 1000 patients per year, compared with no NSAIDs.

The authors point out that, although the relative risk was increased, the absolute risk remained low for the individual patient.

And compared to those using ibuprofen, the risk of using diclofenac increased by 20%. The Medicines and Healthcare products Regulatory Agency said the anti-inflammatory tablets carried a "small but increased" risk of heart problems. They are now advocating that low dose ibuprofen or naproxen should be considered as comparators.

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