Common painkiller increases heart attack risk

Diclofenac was the most commonly prescribed non-steroidal anti-inflammatory drug (NSAID) in Britain last year, with six million prescriptions written by doctors, but it is also available over the counter.

A study published in the journal Plos Medicine found that patients taking the drug were 40 per cent more at risk of a heart attack or stroke than non-users.

Researchers from the Hull York Medical School and the Institute for Clinical Evaluative Sciences in Canada looked at the results of 51 international studies into the impact of a range of NSAIDs on more than 2.7 million patients.

Lead researcher Dr Patricia McGettigan said: “In choosing which one of the many available NSAIDs to use, patients and doctors would benefit from knowledge of the balance between benefit and harm for individual NSAIDs.

At high doses of diclofenac, the increase in risk was almost doubled. Dr Patricia McGettigan

“For the first time, we have enough data to make direct comparisons between NSAIDs to determine which are most risky and which are relatively safe.

“At high doses [of diclofenac], the increase in risk was almost doubled. An alternative, naproxen, prescribed only half as often, was not associated with increased risk at any dose.”

Use of NSAIDs

NSAIDs are used for pain relief and anti-inflammatory effects in conditions including arthritis, back pain, gout, headache, and the aches and fever associated with flu. In 2010, almost 17 million prescriptions were filled out for NSAIDs including diclofenac.

The Medicines and Healthcare products Regulatory Agency (MHRA) warned patients not to stop taking their medicines and to consult their doctor if they have concerns.

An MHRA spokesman said: “Our priority is to ensure that people are taking acceptably safe medicines. We monitor all suspected adverse drug reactions and take action to address any safety concerns.

“All medicines have side effects – no effective medicine is without risk. To minimise the risk of side effects, all NSAIDs should be used at the lowest possible dose for the shortest period necessary to control symptoms. People should not stop taking their NSAID medicine, but if they have any questions about their treatment they should speak to their doctor.”