Common painkillers linked to heart attack and strokes

Painkiller tablets

Painkiller tablets

A commonplace painkiller could increase the risk of heart attack or a stroke by 50 per cent, a major new study has found. These risks remained regardless of the diclofenac dose.

Potential influencing factors were taken into consideration, and the researchers found that starting diclofenac during the study period (1996-2016) resulted in an increased rate of major adverse cardiovascular events within 30 days compared with starting other traditional NSAIDs (ibuprofen or naproxen) or starting paracetamol.

Diclofenac, marketed as Voltarol in the United Kingdom, has been linked with heart failure and irregular heartbeats, and has recently been withdrawn from sales over the counter in the United Kingdom due to concerns about side effects.

The researchers believe its high time that the potential health risks of the drug are recognised and that its usage is reduced, including not making it available over the counter.

Reporting on their study in thebmj, the Aarhus University Hospital researchers say diclofenac shouldn't be available over-the-counter, and should only be prescribed with boxfront warnings. "Treatment of pain and inflammation with NSAIDs may be worthwhile for some patients to improve quality of life despite potential side effects". Diclofenac is a traditional NSAID that has similar selectivity for cyclo-oxygenase-2 (COX 2) as COX 2 inhibitors, but the cardiovascular risks of diclofenac in comparison with other traditional NSAIDs have not been investigated through a randomized controlled trial.

Diclofenac initiators were also at 20% increased risk compared to patients taking ibuprofen or paracetamol, and at 30% increased risk compared to those taking naproxen.

The British Heart Foundation (BHF) have previously said that patients should be on the lowest dose possible of NSAIDs for the shortest possible time.

The risk of gastrointestinal bleeding at 30 days increased 4.5-fold in patients who started diclofenac compared to those who didn't.