Common painkillers, including ibuprofen, increase a person’s risk of cardiac arrest by a third, experts have warned.
The drugs should not be sold in supermarkets or petrol stations, and should only be available on prescription, they said.
Non-steroidal anti-inflammatory drugs (NSAIDs) as a group were linked to a 31 percent increased risk of cardiac arrest. But, ibuprofen – the most common NSAID – increased that risk by a staggering 50 percent.
Professor Gunnar Gislason, a cardiology prof at Copenhagen University Hosptial Gentofte, said people should only take the drug when absolutely necessary and should be cautious. And he added patients with cardiovascular disease or other heart problems should avoid them altogether.
“The findings are a stark reminder that NSAIDs are not harmless,” he warned.
“Diclofenac and ibuprofen, both commonly used drugs, were associated with significantly increased risk of cardiac arrest.
“The current message being sent to the public about NSAIDs is wrong. If you can buy these drugs in a convenience store then you probably think ‘they must be safe for me.’
“Our study adds to the evidence about the adverse cardiovascular effects of NSAIDs and confirms that they should be taken seriously, and used only after consulting a healthcare professional.” NSAIDS are among the most commonly used drugs across the world. While some do require a prescription, others like ibuprofen, don’t.
Gislason said: “Allowing these drugs to be purchased without a prescription, and without any advise or restrictions, sends a message to the public that they must be safe.
“Previous studies have shown that NSAIDS are related to increased cardiovascular risk, which is a concern because they are widely used.”
As part of the new study, researchers identified all patients who suffered a cardiac arrest in Denmark between 2001 and 2010. A person suffering a cardiac arrest will pass out unconscious after the electrical fault suddenly stops the heart beating. It differs from a heart attack, where a blockage or clot, stops oxygenated blood reaching the heart, causing it to affect the heart muscle.
The researchers also looked at all prescriptions for NSAIDS in Danish pharmacies since 1995. These included the non-selective NSAIDS diclofenac, naproxen and ibuprofen, as well as COX-2 selective inhibitors, rofecoxib and celecoxib.
NSAIDs were linked to a 31 percent greater risk of cardiac arrest, the findings, published in the European Heart Journal Cardiovascular Pharmacotherapy, showed. But the researchers found ibuprofen – the most commonly used of the drugs – increased the risk of cardiac arrest by 50 percent. And diclofenac – marketed under the brand name Voltaren – were the second most common NSAID used, had a 31 percent increased risk.
Naproxen, celecoxib and rofecoxib were not linked to a greater risk of cardiac arrest, but researchers said it was likely to do with fewer people using the drugs. The drugs are known to have various effects on the heart, which could explain the increased risk of cardiac arrest, Gislason’s team noted. They have been found to cause blood clots, cause the arteries to constrict, increase fluid retention and raise blood pressure.
Gislason said: “I don’t think these drugs should be sold in supermarkets or petrol stations where there is no professional advise on how to use them. “Over-the-counter NSAIDs should only be available at pharmacies, in limited quantities, and in low doses.”
He said people should never take more than 1,200mg of ibuprofen a day. “Naproxen is probably the safest NSAID, and we can take up to 500mg a day,” he added. “Diclofenac is the riskiest NSAID and should be avoided by patients with cardiovascular disease and the general population.
“Safer drugs are available that have similar painkilling effects so there is no reason to use diclofenac.”
Dr. Mike Knapton, associate medical director for the British Heart Foundation, said the most important message from this new evidence is to discuss taking these painkillers with your GP.
“Discuss all possible treatment options with your doctor, as well as the pros and cons of certain drugs, before you start taking new medication,” he told The Sun Online.
“Although not all NSAIDs were found to be associated with increased risk of cardiac arrest, discussion with your doctor is imperative to make informed choice about the best treatment for you.”
And he urged patients taking ibuprofen and diclofenac to go back to their doctors to review their treatment.
“Your GP will be able to advise on potential alternative treatments,” he added.