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expert reaction to side effects of common painkillers

Research published The Lancet showed that higher-dose use of some non-steroidal anti-inflammatory drugs (NSAIDs), such as diclofenac and ibuprofen, increases major vascular events by around a third, mainly by increasing the risk of heart attacks. A Briefing on the research was held at the SMC.


Professor Simon Maxwell, member of the British Pharmacological Society and Professor of Student Learning/Clinical Pharmacology, University of Edinburgh, said:

“This study adds further information by confirming that commonly used standard NSAIDs such as diclofenac and ibuprofen appear to carry the same excess risk as the newer and more selective coxibs. The interesting finding is that a rather less commonly used NSAID, naproxen, appears to carry no excess risk of heart attack or stroke compared to placebo. This might lead to a review of prescribing advice by some NHS organisations who currently advocate the use of diclofenac and ibuprofen.”


Professor Donald Singer, member of the British Pharmacological Society and Professor of Clinical Pharmacology and Therapeutics at the University of Warwick, said:

“These findings confirm previous reports that newer painkillers – coxibs – are associated with a clinically important increase in risk of coronary disease. A major new finding is that among traditional non-steroidal anti-inflammatory painkiller drugs (tNSAIDs) – diclofenac, and possibly ibuprofen, but not naproxen – appear to be associated with a similar increase in fatal and non-fatal coronary heart events to the coxibs. However naproxen, like all coxibs and tNSAIDs studied, was associated with an increased risk of heart failure and gastro-intestinal complications such as bleeding. The authors themselves acknowledge they cannot be sure whether the reported risks would persist in patients on longer term treatment or on lower doses of these medicines. In addition, the extent of adjustments across treatment groups for different cardiovascular risk factors (e.g. smoking as a source of bias) is not revealed. Despite this, the findings underscore a key point for patients and prescribers: powerful drugs may have serious harmful effects. It is therefore important for prescribers to take into account these risks and ensure patients are fully-informed about the medicines they are taking.”



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