Tuesday, 10 March 2015

Before You Take That Painkiller (NSAIDs)


Did you know taking NSAIDs (like ibuprofen, naproxen, diclofenac, rofecoxib, lumiracoxib, celecoxib) can put you at risk of having a stroke and  heart attack, regardless of how healthy you are. They also increase your risk of dying if you have a stroke.

Researchers say, you are at least, three times more likely to have a stroke when you use ibuprofen compared to people who don't. You are also twice more likely to have a heart attack if you take rofecoxib and lumiracoxib, and diclofenac use is associated with four times  the risk of cardiovascular death.

The study examined whether taking a Cox-2 inhibitor like celecoxib or other NSAID increases the risk of death among people who have a stroke. Researchers looked at data for more than 100,000 people who were admitted to the hospital for stroke during the last decade. Researchers used data from the national health care system in Denmark. This allowed them to collect complete survival information on a large number of patients. They also knew what prescription medicines people took.

The researchers learned:

  • About 10.4% of those taking a Cox-2 inhibitor died within 30 days of having a stroke. Among those not taking NSAIDs, 8.7% died. This represents a 19% increased likelihood of death for those taking a Cox-2 inhibitor.
  • The increased risk of death was primarily among those who recently started to take an older Cox-2 inhibitor, such as etodolac or diclofenac. Among stroke survivors taking these drugs, the increased risk of death was 42%.
  • The link between stroke and Cox-2 inhibitor use was limited to ischemic stroke. This is the most common type of stroke. It is caused by a blockage of blood flow that damages a portion of the brain.
  • No increased risk of death after stroke was seen among those taking "nonselective" NSAIDs, such as naproxen or ibuprofen. They suppress both Cox-1 and Cox-2 enzymes.
Rofecoxib was withdrawn from the market in 2004. Since then, much research and debate have been ongoing on the cardiovascular safety of NSAIDS. 

 Doctors have been using these drugs for decades without thinking about cardiovascular side effects and remain reluctant to limit prescribing them.

My advice is watch your medication for these drugs because sometimes they are manufactured in combination with other agents.  Discuss other alternatives with your doctor but don't dictate because drugs are often prescribed on the delicate balance of their benefits and associated risks. 

Thank you.




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