Common painkillers linked to heart, stoke and gastrointestinal risks!

Do you think twice before popping in a painkiller analgesic  in your mouth. If no, read this!

A recent meta-analysis was done to study the effects of analgesics like ibuprofen, diclofenac and coxibs on heart risks, stroke risk, and gastric bleeding risks.

The meta-analysis included  280 randomized trials of analgesics (non-steroidal, NSAID)  versus placebo  with 124 513 participants, 68 342 person-years. It also included 474 trials of one NSAID versus another NSAID 229 296 participants, 165 456 person-years. It was published recently in the Lancet.

The main outcomes were major vascular events like heart attacks, stroke, or vascular death and  gastrointestinal complications like perforation, obstruction, or bleed.

Findings

Major vascular events like heart attacks and strokes were increased by about a third by all the analgesics like coxib, diclofenac.  Ibuprofen also significantly increased major coronary events. Compared with placebo, of 1000 patients allocated to a coxib or diclofenac for a year, three more had major vascular events, one of which was fatal.

Naproxen did not significantly increase major vascular events.

Heart failure risk was roughly doubled by all NSAIDs.

All NSAID regimens increased upper gastrointestinal complications like bleeding and perforation.

The vascular risks of high-dose diclofenac, and possibly ibuprofen, are comparable to coxibs, whereas high-dose naproxen is associated with less vascular risk than other NSAIDs.

 

Although NSAIDs increase vascular and gastrointestinal risks, the size of these risks can be predicted, which could help guide clinical decision making

 

In view of the above findings it would be advisable not to pop in a pain killer for mild aches and pains. Patients who need pain killers for chronic pain should take them strictly under medical supervision. 

 

via Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials : The Lancet.

Beware! Analgesics can kill!

medicine       We never think  twice before popping in an analgesic pill for aches and pain. But now Beware!

There is increasing evidence to show that analgesics can increase cardiac mortality and cardiovascular event rates. A recent journal publication reports that Diclofenac was found to increase cardiac events by 38 to 67%. The increased risk with diclofenac was similar to the COX-2 inhibitor Rofecoxib (Vioxx, Merck), a drug withdrawn from worldwide markets because of cardiovascular toxicity. Diclofenac is the most widely prescribed analgesic in over 15 south asian countries.

In the meta-analysis, Rofecoxib, etoricoxib, and diclofenac were the three agents that were consistently associated with a significantly increased risk when compared with nonuse.  Rofecoxib increased the risk of serious cardiovascular events between 27% and 45%, and Etoricoxib increased the risk more than twofold compared with nonuse. In two observational studies, Diclofenac increased risk of acute heart attacks by approximately 38% and 39%, respectively.

In a paper published earlier in the premier journal Circulation, analgesic use in 43000 patients with heart attack was associated with a 59% increased risk of death after one year and a 63% increased risk of death after 5 years of use.

Currently, Naproxen, is one of the analgesic found to be safe and not increase cardiac event rates in the analysis.

Next time, think twice before you pop in that analgesic pill! More so, if you have suffered a heart attack before! Instead, try some local application like hot fomentation or balms to relieve the pain!