FDA strengthens warning on NSAIDs

FDA strengthens warning that NSAIDs increase heart attack and stroke risk – Harvard Health Blog – Harvard Health Publications – July 2016

Back in 2005, the FDA warned that taking nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen increased the risk of having a heart attack or stroke.

Last week it took the unusual step of further strengthening this warning.

This was done on the advice of an expert panel that reviewed new information about NSAIDs and their risks. Because NSAIDs are widely used, it’s important to be aware of downsides of taking an NSAID and to take steps to limit the risk.  

Many people take NSAIDs to relieve mild to moderate pain. These medications may be particularly effective in conditions in which pain results primarily from inflammation, such as arthritis or athletic injury

Aspirin is also an NSAID, but it does not pose a risk of heart attack or stroke and is not covered by this new warning.

Once again, a medication derived from nature (aspirin is from White Willow Bark) is safer than our modern “improved” pills. 

This is also true of opioids. All the other  “new and improved” medications for pain relief have frightening side-effects, many of which will remain unknown until many people have taken these drugs for many years.

For more than 15 years, experts have known that NSAIDs increase the risk of heart attack and stroke.

They may also elevate blood pressure and cause heart failure.

The new warnings from the FDA point out:

  • Heart attack and stroke risk increase even with short-term use, and the risk may begin within a few weeks of starting to take an NSAID.
  • The risk increases with higher doses of NSAIDs taken for longer periods of time.
  • The risk is greatest for people who already have heart disease, though even people without heart disease may be at risk.
  • Previous studies have suggested that naproxen may be safer than other types of NSDAIDs, but the new evidence reviewed by the expert panel isn’t solid enough to determine that for certain.

Using NSAIDs safely

In view of the new warnings, it is best for people with heart disease to avoid NSAIDs if at all possible, and for everyone who is considering taking an NSAID to proceed with caution.

Here are some strategies:  

  • It’s important to take the lowest effective dose, and limit the length of time you take the drug.
  • Never take more than one type of NSAID at a time. There appears to be risk associated with all types of NSAIDs.
  • Try alternatives to NSAIDs such as acetaminophen. It relieves pain but does not appear to increase heart attack or stroke risk. However, acetaminophen can cause liver damage if the daily limit of 4,000 milligrams is exceeded, or if you drink more than three alcoholic drinks every day.
  • If nothing else works and you need to take an NSAID for arthritis or other chronic pain, try taking week-long “holidays” from them and taking acetaminophen instead.
  • If you experience chest pain, shortness of breath, or sudden weakness or difficulty speaking while taking an NSAID, seek medical help immediately.

 

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