15 August 2010

Painkillers and Stroke Risk

Common painkillers include two groups of mostly over-the-counter (OTCs) medications like NSAIDs and COX-2 inhibitors.

Non-steroidal anti-inflammatory drugs (NSAIDs) examples are mefenamic acid, ketorolac, ibuprofen, and naproxen, which are frequently advertised by famous personalities as effective in relieving muscular and joint pains.

A COX-2 inhibitor example is celecoxib (Celebrex), which is still in the market today, after other COX-2 inhibitors like rofecoxib (Vioxx) and valdecoxib (Bextra) were removed from the market in 2004 and 2005 because of their reported association with increased risk of heart attacks.

Now comes a recent study among more than 30,000 Taiwanese stroke patients showing an association between the use of NSAIDs and the risk of both hemorrhagic and ischemic stroke episodes.

The study found that for ischemic stroke, there was a modest increased risk evident for all oral NSAIDs ranging from 20 percent to 90 percent. For hemorrhagic stroke, oral ketorolac had been shown to be associated with a significantly higher risk.

Pointers to remember:

  • Limit the use of painkillers, especially in the elderly and those with identified stroke risk factors like hypertension, diabetes, and smoking.
  • If it cannot really be avoided, initially try taking paracetamol or acetaminophen using a low dose of 325mg before proceeding with 500mg, if pains still persists.
  • Always consult a doctor before self-medicating. It is tempting to buy over-the-counter medications, but long-term side effects will also prove to be a problem later on, if proper professional advice is not taken. 
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