Common painkillers such as ibuprofen and diclofenac can double the risk of heart attack, according to a new study. The increased risk only occurs with high doses and leads to attacks in an extra three people per thousand compared with those not taking the drugs.
Colin Baigent, an epidemiologist at Oxford University, who led the research, said people should not be unduly panicked by the findings, which relate to the highest doses given by doctors in extreme cases. "The rate is three heart attacks in every 1,000 patients treated for a year," he said. "For a person who is unable to move unless they take these drugs, they may be willing to accept that risk if [the drug] is giving them back their life."
[Guardian, 02 June 2006]
Ever since Vioxx was banned in 2004 because of studies showing that patients taking the drug were more than twice as likely to have heart attacks, there has been much concern about other painkillers in the market.
The recent study above, published in full in BMJ's current issue, is a meta-analysis that includes analysis of results of 138 separate trials which compared cox-2 inhibitor drugs with a placebo or a cox-2 inhibitor with traditional non-steroidal anti-inflammatory drugs (NSAIDs) such as diclofenac and ibuprofen.
For the brand-conscious: Diclofenac is marketed locally under several brand names, the most notable are Cataflam, Acuflam, Dycon SR, Lofenax, and Voltaren. Ibuprofen, on the other hand, is easily recognized as Advil, Alaxan, Medicol, Midol, and Skelan.
Should you be scared when taking these painkillers? Being scared won't help you a bit, but being cautious can be beneficial. My advice is for you to take note of these essential points:
- 3 heart attacks in every 1,000 patients treated for a year - that was the established rate in the study; I would say that the occurrence can still be qualified as rare.
- The increased risk was associated with high doses - Dr Baigent said a high dose was considered to be "about twice what the normal person would take." If you are taking any of these painkillers for your headache or an occasional muscular pain, you need not worry.
- Arm yourself with common sense - if your pain is too great, and you are already unable to perform your daily tasks, it might be prudent to accept the (small) risk if that means relief and getting back to what you used to do. If you are still in doubt, consult your physician.
- Naproxen - of all the painkillers studied, naproxen carried the least risk. If you have a choice, you might opt to go for this drug. Ask your doctor if that's ok.