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Over-The-Counter Pain Medication Carry Heart Attack Risk

January 19, 2011

SirNatural

New evidence has surfaced adding fuel to the theory that several common prescription and over-the-counter pain drugs may increase the risk of heart attack and stroke.

Among those targeted in the study by Swiss researchers: ibuprofen (sold as Advil, Motrin), naproxen (sold as Aleve) and prescription drugs including Celebrex and Vioxx, which has been withdrawn from the market in the U.S. over safety concerns.

Scientists from Bern University in Switzerland analyzed the findings of 31 trials covering more than 116,000 people taking one of the following pain medications: naproxen, ibuprofen, diclofenac, Celebrex made by Pfizer (celecoxib), Arcoxia made by Merck (etoricoxib), Merck’s Vioxx (rofecoxib), Prexige by Novartis (lumiracoxib), or a placebo.

They were looking at older non-steroidal anti-inflammatory drugs, known as NSAIDS, and a newer set called COX-2 inhibitors to measure heart disease and stroke risks.

Ultimately, what they found was that while the painkillers’ chances of contributing to cardiovascular disease were relatively low, there were still significant risks — except with naproxen according to their study published Wednesday in the British Medical Journal.

“Naproxen in multiple studies has not [been shown to have a risk],” said AOL Health’s cardiology expert Dr. Christopher Cannon. “That is definitely the first drug of choice to use. That’s a very strong take-home message.”

The team led by Peter Juni, of the Institute of Social and Preventive Medicine at Bern, said that Vioxx and Prexige had double the risk of heart attack as a placebo, and taking ibuprofen more than tripled the risk of having a stroke.

Cardiovascular-related death was four times more likely in patients taking Arcoxia and diclofenac, the authors said.

“Although uncertainty remains, little evidence exists to suggest that any of the investigated drugs are safe in cardiovascular terms,” said Juni, according to Reuters.

He said doctors should be careful before suggesting or prescribing painkillers to patients and must consider the heart disease and stroke risks associated with them.

Still, the rate of cardiovascular conditions was relatively low in the participant pool, with only 554 heart attacks, 377 strokes and 676 deaths among the 116,000 participants.

Both NSAIDs and COX-2 inhibitors have been under scrutiny for their risk of heart problems.

The Swiss scientists said naproxen seemed to be the least risky painkiller, though it can upset the stomach and even cause ulcers and bleeding. Celebrex, taken in 400-milligram increments once a day, is a good second choice, they concluded.

Cannon, who took part in one of the trials the scientists used for their analysis, said there are specific reasons for naproxen’s benefits. But he disputed the researchers’ recommendation to take Celebrex as an alternative if stomach troubles persist with Alleve.

“Naproxen has an anti-clotting effects, similar to the way aspirin does. That may be how it is protective,” he told AOL Health. “I would counter [the suggestion to use Celebrex]. It’s been a little less studied … but Celebrex has similar risks to Vioxx and the others, so one has to be aware of that.”

Previous studies have provided mixed results on the drugs’ potential link to cardiovascular problems, according to the researchers. Vioxx was pulled from shelves in 2004 after one clinical trial revealed a higher risk of heart attack in those taking it.

Click here for the full report from AOL Health

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