Research from the European Society of Cardiology released recently stated that over the counter painkillers may be associated with an increase of cardiac arrest. Non-steroidal anti-inflammatory drugs (NSAIDs), aspirin, and acetaminophen are used widely for pain and can be purchased without medication. The study was published in the journal of European Heart Journal – Cardiovascular Pharmacotherapy.
Painkillers or analgesics are a group of drugs used to gain relief from pain. The medication acts on the peripheral and central nervous systems which provide a temporary effect. Among the most commonly used over the counter medications, NSAIDs are among the most widely used.
Gunnar H. Gialason, author and professor of cardiology at Copenhagen University Hospital Gentofte, Denmark said that because over the counter painkillers can be purchased without a prescription it “sends a message to the public that they must be safe.” In studies previously done, NSAIDs have been shown to increase cardiac arrest.
Participants in the study were selected from the Danish Cardiac Arrest Registry between 2001 and 2010. Using the data collected from prescriptions filled for NSAIDs, the researchers then designed a case looking between NSAIDs’ association with cardiac arrests. According to the press release from the European Society of Cardiology, each patient served as “both case and control in two different time periods.” This, the researchers said stopped the “confounding effect of chronic comorbidities.” The data of the case time, which was 30 days before a cardiac arrest, was compared to the control period, which was the 30 days without cardiac arrest while using NSAIDs.
No other information were used in the study. In Denmark, ibuprofen is the only over the counter drug available and is limited to small packages. Of the participants in the study, almost 30,000 patients experienced cardiac arrest outside the hospital in the ten years of the study. Of these patients, over 3,000 were treated with NSAIDs 30 days before the cardiac arrest.
Caridac arrest risk was increased to 31 percent while other medications (diclofenac and ibuprofen) were between 31 and 50 percent. Naproxen, celecoxib, and rofecoxib, according to the press release, not “associated with the occurrence of cardiac arrest.” The researchers theorized this because of the “low number” of cardiac arrests.
Gislason stated that the data from the study was a “stark reminder that NSAIDs are not harmless.” NSAIDs and other over the counter medications should be used with “caution and for a valid indication.” For those with cardiovascular disease, he went on, NSAIDs should be “avoided.” Because of NSAIDs’ effects on the cardiovascular system, the researchers theorized that this could be the cause of the increased cardiac arrests. The effects of NSAIDs include blood clots, artery constriction, fluid retention, and elevated blood pressure.
According to the press release, Gislason believes that NSAIDs should not be sold in supermarkets or over the counter. Pharmacists should be on hand to give professional advice on the use and NSAIDs should only be available in “limited quantities, and in low doses.” The daily dose should not exceed 1200 mg with naproxen being the safest NSAID to take. Gislason stated that the drug could be taken “up to 500 mg a day” with patients avoiding diclofenac.
By Cheryl Werber