High
doses of some commonly used pain drugs like ibuprofen can increase heart
attacks, strokes and related deaths by about a third, a study warned on
Thursday.
The
drugs, known as non-steroidal anti-inflammatory drugs (NSAIDs), are widely used
to manage pain caused by inflammatory disorders.
"NSAIDs
are very commonly used for both acute and chronic pain," Marie Griffin of
the Vanderbilt University Medical Centre in Nashville
Over-the-counter
doses are lower and generally recommended for short periods for acute painful
conditions. Chronic use of more than about a week or 10 days can be prescribed
for back, knee, hip or neck pain, or chronic headaches.
Earlier
research had linked the drugs' use to a risk of serious gastrointestinal
problems. This led to a new generation of NSAIDs called coxibs that were
designed to reduce these complications, but instead came under scrutiny for
increasing the risk of heart attacks.
The
new study, published in The Lancet, found that high doses of not only coxibs
but also older-generation NSAIDs like ibuprofen (Advil) or diclofenac
(Voltaren) were associated with heart disease risk.
"For
every 1,000 individuals with a moderate risk of heart disease allocated to one
year of treatment with high-dose diclofenac or ibuprofen, about three would
experience an avoidable heart attack of which one would be fatal," said a
press statement accompanying the study.
"In
addition, all NSAIDs double the risk of heart failure and produce a 2-4 times
increased risk of serious upper gastrointestinal complications such as bleeding
ulcers," said the statement.
A
high dose of diclofenac is indicated as 150 milligrammes per day and of
ibuprofen about 2,400 milligrammes per day.
"High
doses are generally doses available only with a prescription," said Griffin
The
study authors studied the data of 353,000 patients gathered in 639 trials.
They
said the increased heart attack risk from NSAIDs rose in proportion to a
patient's underlying risk, so it was highest in those with a previous history
of heart disease, high blood pressure or cholesterol.
Similar
results had been published before, which is why some of the drugs are not
available in some countries, said Griffin
The
reason for the heart attack link was not clear, she added, "but likely
because they increase likelihood of clotting. These drugs also increase blood
pressure."
Alternative
medicines include acetaminophens (Tylenol) or opioids.
In
a comment on the study, British Pharmacological Society member Donald Singer
said the findings underscored a key point: "Powerful drugs may have
serious harmful effects.
"It
is therefore important for prescribers to take into account these risks and
ensure patients are fully informed about the medicines they are taking,"
Singer said.
But
it was also important to note, he said, that the authors themselves were not
sure whether the risks would persist in longer-term treatment or on lower doses
Safe
and effective chronic pain treatments were sorely needed, said Griffin
"In
the meantime, long-term use of high-dose NSAIDs should be reserved for those
who receive considerable symptomatic benefit from the treatment and understand
the risks," she said.
Source: ph.she.yahoo.com
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