• February 2, 2023

Painkillers can damage the heart Not everything that is good for pain is also

Painkillers can damage the heart: not everything that is good for pain is also good for the heart

Certain COX-2 inhibitors a class of anti-inflammatory drugs belonging to the non-steroidal anti-inflammatory drug (NSAID) family, may increase the risk of heart failure and depending on the dose. This also applies to drugs such as ibuprofen and diclofenac, which are available without a prescription in pharmacies. This is the result of a study funded by the European Union, which was published in the journal BMJ. These are the group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs).

These include the nonsteroidal, first-generation anti-inflammatory agents (NSAIDs) and the new generation of anti-inflammatory agents, the selective COX-2 inhibitors. They are depending on the drug, taken for pain, inflammation and fever and some can be prescribed without a prescription in pharmacies, are. It is already known that painkillers can end up in the heart muscle. A large Danish study, showed that existing heart failure worsened in subjects taking NSAIDs and was also associated with an increased risk of heart attack or death.

But even without previous illness would increase the risk. An international research team, led by Giovanni Corrao of the University of Milan-Bicocca, sought to understand for which drugs and at what doses there would be a risk of cardiac damage. This study evaluated data from nearly ten million adults from Germany, the Netherlands, England, and Italy who were prescribed painkillers between 2000 and 2010.

Here 23 were conventional NSAIDs and $ the COX-2 inhibitors included in the’analysis. The comparison group consisted of 8.246.403 patients and covered the following drugs:

ketorolac, Etoricoxib (Arcoxia), Indomethacin (various. Generic), Rofecoxib (Vioxx withdrawal 2004), sulindac, Piroxicam. (Various generic drugs), Acemetacine (Rantudil and generics), Diclofenac (Voltaren and generics), Dexibuprofen (Deltaran), nimesulide, Ibuprofen (e.g., Aktren, Nurofen, Dolormin and various. Generic), Naproxen (Aleve and various. Generic), Valdecoxib (Bextra Withdrawal 2005), Nabumetone (Arthaxan, Relifex), Thiaprofenic (Surgam), Lornoxicam, tenoxicam, Ketoprofen (Gabrilen), Aceclofenac (Beofenac), Meloxicam (Mobec and various.

Generic), diclofenac combinations, Proglumethacin (Protaxon), Flurbiprofen.

In the group of painkillers, there were 92.163 hospitalizations for heart failure. If the patient had taken some NSAIDs in the past 14 days, the risk increased by 19 %, regarding diclofenac, ibuprofen, indomethacin, ketorolac, naproxen, nimesulide, piroxicam, and the COX inhibitor etoricoxib 2 and rofecoxib. For diclofenac, etoricoxib, indomethacin, piroxicam and rofecoxib at very high doses, the risk was doubled. Already average doses of a indomethacin and etoricoxib have also contributed negatively. Celecoxib, however, the most prescribed COX-2 inhibitor, was inconspicuous in this regard in normal doses.

It should be mentioned that the subjects’average age of 77 years was quite high and is a limitation to the research. The researchers pointed out that this was an observational study, so the cause and effect relationship could not be clearly inferred. Yet there would be an undeniable link between the most commonly used NSAIDs and COX 2 inhibitors with an increased risk of hospitalization for heart failure.

Moreover, the risk seems to depend on the active ingredient and the dose used. The authors hope the study will help inform physicians and regulators about the risk. In an editorial on the study conducted by Danish cardiologists, it was indicated that a small increase in cardiovascular risk for health care is already of concern because the active ingredients are used massively.

Moreover, painkillers are available in many countries in supermarkets and without consultation. This leads to the widespread misconception that NSAIDs are harmless and safe for everyone, it is pointed out. Therefore, the fact that cardiologists are calling for stricter regulation is justified. They also see the need for advice from a physician or pharmacist, patient information on proper use, and potential risks.

Beyond the absence of scientific certainty about the actual harmfulness of painkillers, One thing is certain, points out Giovanni D’Agata, president of the “Sportello dei Diritti”: excess can cause harm and individuals at risk of heart disease should pay close attention. Indeed, as the Danish cardiologists were keen to point out, it is always best to consult a physician, perhaps a family doctor, before taking these drugs frequently.