Published: Sun, March 26, 2017
Health | By Jay Jacobs

Calls for ibuprofen sale restrictions after study finds cardiac arrest risk

Calls for ibuprofen sale restrictions after study finds cardiac arrest risk

Using a database covering 10 years, they matched all people in the country who experienced a cardiac arrest while not in a hospital with their use of NSAIDs in the preceding month. Data was collected on all redeemed prescriptions for NSAIDs from Danish pharmacies since 1995, including the non-selective NSAIDs (diclofenac, naproxen, ibuprofen), and COX-2 selective inhibitors (rofecoxib, celecoxib). Diclofenac, a particular type of NSAID that is available only by prescription, raised users' risk of cardiac arrest by up to 50 percent.

Diclofenac, available over the counter in the United Kingdom until 2015 and still taken on prescription, raised the risk to 50%. The drug that was easily available over the counter till 2015, became a prescription-only medicine after it was found that it increases the risk of a cardiac arrest by 50 per cent.

"The findings are a stark reminder that NSAIDs are not harmless", said study leader Professor Gunnar Gislason, from the University of Copenhagen. "They should probably be avoided in patients with cardiovascular disease or many cardiovascular risk factors", Prof Gislason said.

While other NSAIDs naproxen, celecoxib, and rofecoxib were included in the study, these pain relievers did not seem to increase the risk of cardiac arrest.

He advised patients to take no more than 1,200mg of ibuprofen a day - about six small tablets - and added: 'Diclofenac is the riskiest NSAID and should be avoided by patients with cardiovascular disease and the general population.

Over-the-counter NSAIDs should only be available at pharmacies, in limited quantities, and in low doses'.

The findings move the debate around the use of NSAIDs on from previous studies showing they are linked to increase a cardiovascular risk to actually having a heart attack.

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The Therapeutic Goods Administration recently completed a rigorous review of the cardiovascular risks associated with OTC NSAIDs, concluding that: "These drugs provide effective pain relief when used according to the label at recommended doses for short durations", and that; "The use of OTC NSAIDs was safe when they were used according to the recommended doses for short durations, as instructed on the label". NSAIDs have been found to influence platelet aggregation, cause blood clots, cause arteries to constrict, increase fluid retention and raise blood pressure.

Prof Gislason asserted that the current message being sent to the public about NSAIDs was wrong. They then looked at information covering another 30-day period that took place before the start of the "case period". One popular painkiller, diclofenac, which is often prescribed to relieve back pain and inflammation, is so unsafe it should not be taken at all, scientists said.

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