Ibuprofen inceases risk of cardiac arrest

76544567

http://www.breakingnews.ie/world/ibuprofen-linked-to-increased-risk-of-cardiac-arrest-781634.html

As a user of ibuprofen for arthritic flare ups this worries me.
I try not to use them at all, but when the pain in the joint gets bad it was my go to drug.

It is really the only drug that works for me.

Just posting this in case anyone else is interested.

byhookorbycrook

Diclac is actually worse !

Gatling

I'd regularly use 8 + over a 24 period when i get severe flare up's usually get a higher​ dose on prescription
Time for a change i think

echo beach

This is what is known as a 'class effect' so all drugs in this class, called NSAIDs or non-steroidal anti-inflammatory drugs, cause this to a greater or lesser extent. There is variation between these drugs and between the individuals in the way they respond to the drugs but the most important link is to the dose you take and the length of time you take it for. It is something you need to discuss with your doctor.

Graces7

I use brufen maybe once a day ; more if I am out and in pain and cannot take tylex

I refused diclofenac when I was offered it as they co-prescribed a proton pump inhibitor to take an hour before you take it and that really put me off .

Aspirin is good .

echo beach

Graces7 wrote: »

I refused diclofenac when I was offered it as they co-prescribed a proton pump inhibitor to take an hour before you take it and that really put me off .

A co-prescription of a proton pump inhibitor can be very useful if diclofenac, or other NSAIDs, cause stomach problems. Unfortunately there isn't as easy a solution to the problem of the increased risk of cardiac problems.

Arbie

The reporting around this is a bit sensationalist. It's a case-control study, not a randomised trial, so it's limited from the offset - results should be considered in that context.

The absolute risk of cardiac arrest for anyone in the population observed is about 0.035%. This report suggests that with NSAIDs the risk increases to around 0.05%. So it's a high relative risk increase but a low absolute risk increase.

Looking at the numbers alone ignores the many benefits of NSAIDs. If everyone stopped taking them to avoid cardiac arrest it could cause inadvertent pain/disability/death from using no meds or alternative meds with worse side effects profile.

Graces7

echo beach wrote: »

A co-prescription of a proton pump inhibitor can be very useful if diclofenac, or other NSAIDs, cause stomach problems. Unfortunately there isn't as easy a solution to the problem of the increased risk of cardiac problems.

I understand but to take a second drug for the side effects of the first is not a path I will go down.

I was given this at an OPD clinic after I broke my wrist and the young ones were talking as if it were a wonder cure all..

went back to codeine.

echo beach

Arbie wrote: »

The reporting around this is a bit sensationalist. It's a case-control study, not a randomised trial, so it's limited from the offset - results should be considered in that context.

This is a link to the original research if anybody is interested. https://academic.oup.com/ehjcvp/article/doi/10.1093/ehjcvp/pvw041/2739709/Non-steroidal-anti-inflammatory-drug-use-is
The authors do caution against jumping to conclusions about cause and effect.

The main limitation of the study is inherent in the observational nature of the analyses. The treatment allocation is not randomized and the study reports only associations and therefore any conclusion on causality should be made with caution.

Exileire

The level of evidence in most of these studies is not particularly good. However, if you are worried about your cardiovascular health and in particular, ischemic events such as heart attacks / angina, you can consider taking Naproxen if you want to take NSAIDs. Naproxen is an NSAID with probably the least adverse cardiovascular events reported.

Exileire

The level of evidence in most of these studies is not particularly good. However, if you are worried about your cardiovascular health and in particular, ischemic events such as heart attacks / angina, you can consider taking Naproxen if you want to take NSAIDs. Naproxen is an NSAID with probably the least adverse cardiovascular events reported.

echo beach

Exileire wrote: »

Naproxen is an NSAID with probably the least adverse cardiovascular events reported.

It has the least adverse effects reported because it isn't used as much as the others. That point was made in that report and in other studies where there isn't enough data to draw a conclusion. It may be safer or it may be more dangerous. Nobody knows.
The best choice is to use what works best for you.

Kurtosis

Even though this is an observational study, that's not to say its findings aren't necessarily true. There's actually good evidence of adverse effects of various anti inflammatory drugs from randomised trials, and these studies have been pooled in reviews e.g. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60900-9/abstract. The main limitation is participants in these trials may be younger and healthier than typical people taking NSAIDs. In any case, it provides evidence that naproxen may not carry the same cardiovascular risk as ibuprofen/diclofenac, so may be a less bad option for people with heart disease who need an anti inflammatory. The issue is that naproxen is more likely to cause gastrointestinal events such as ulcers compared to the alternatives. For anyone taking NSAIDs frequently (even over the counter), it's important to discuss the options and risks with your doctor.

Exileire wrote: »

However, if you are worried about your cardiovascular health and in particular, ischemic events such as heart attacks / angina, you can consider taking Naproxen if you want to take NSAIDs.

Mod note

Please keep in mind medical advice is not permitted on boards. As mentioned, for someone at risk of gastric ulcers, doing as you suggest could cause serious harm. If you need any clarification, please drop me a PM.

Exileire

Anyone who takes NSAIDs chronically is at risk of gastric bleeding (except more selective COX-2 inhibitors which is reduced risk compared to non-specific NSAIDs; however they have their own set of cardiovascular issues). Naproxen can be taken as vimovo (with a proton pump inhibitor) to help offset the GI effects. Not telling anyone to take NSAIDs for osteoarthritis (naproxen OR otherwise); in fact, NSAIDs are generally recognized as NOT the best 1st line medical therapeutic strategy for osteoarthritis.