Following a Europe-wide study, people with heart problems in the UK have been advised to stop using diclofenac, the most commonly prescribed painkiller. This advisory notice follows a recent Europe-wide study that confirms at-risk patients as much as 40% more likely to have a heart attack or stroke while on the drug.
Diclofenac is a drug belonging to a wide class of medications called non-steroidal anti-inflammatory drugs (NSAIDs). These drugs include aspirin, ibuprofen, and naproxen, just to name a few. They are typically used to treat pain and inflammation, especially associated with arthritis, gout, back pain, and headaches. Many are available over the counter, including diclofenac in some areas.
Increased risk of heart attack is a well-documented side effect of NSAIDs, which includes diclofenac. In fact, there has been a push by some doctors to remove diclofenac from the market entirely because they feel the risks outweigh the benefits. Opponents to this idea note that the drug is perfectly safe for most users, and only those at risk of heart disease need to be taken off the medication.
The European Medical Agency has ruled that diclofenac’s risks are now similar to COX-2 inhibitors (coxibs) such as celecoxib. Anyone showing risks of heart disease should be given alternatives to diclofenac, or at the very minimum be given a smaller dose.
Symptoms of being at risk of heart disease and no longer eligible to use diclofenac include:
- history of heart attack
- history of stroke
- high blood pressure
- high cholesterol
On the issue of the updated safety advice, Sarah Branch of the Medicines and Healthcare Regulatory Agency (MHRA) said, “Whilst this is a known risk and warnings have been included in patient and healthcare information for some time, this advice is now being updated.”
Alternatives to diclofenac may include NSAIDs with lower risk of heart disease, but it’s safer to find alternative medications as all NSAIDs except aspirin carry similar risks. For pain, acetaminophen (paracetamol) would be an effective option. For severe inflammation associated with arthritis, it might be necessary to take specialized arthritis drugs or corticosteroids.
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