Posted on 06/01/2006 6:35:06 PM PDT by blam
Ibuprofen can double risk of heart attack, says medical study
By Celia Hall, Medical Editor
(Filed: 02/06/2006)
Common painkillers such as ibuprofen can double the risk of suffering a heart attack, a study has found.
Research published in the British Medical Journal analysed results of 138 trials involving 140,000 patients over several years. It found that ibuprofen and diclofenac, two non-steroidal anti-inflammatory drugs (NSAIDs), could cause attacks when taken in high doses.
Vioxx: Banned in 2004
The drugs have been previously noted for increasing heart attack risk but experts say that this is the biggest and most definitive study of its kind.
Vioxx, which is part of a group of anti-inflammatories known as COX-2 inhibitors, was banned in 2004 after it was shown that patients on the drug were more than twice as likely to have heart attacks as those not taking it.
The latest study showed that, as expected, COX-2 inhibitors doubled the risk of an attack but so did NSAIDs.
When all "vascular events" - heart attacks, stroke, or vascular disease - were taken together, the risks increased by 40 per cent on the drugs.
Researchers from the University of Oxford and the University of Rome carried out the study. They examined the results of all trials in which vascular events had been recorded for COX-2 inhibitors and NSAIDs. By combining the results, they were able to estimate the effects of these drugs more reliably than any individual trial.
They found that there were three more heart attacks per 1,000 people every year in those who did not already have heart disease but who were taking COX-2 inhibitors or NSAIDs.
Colin Baigent, who directed the research for the Medical Research Council, said that people should not panic at the findings - which relate to the highest doses recommended by doctors. "The rate is three heart attacks in every 1,000 patients treated for a year," he said. "For a person who is unable to move unless they take these drugs, they may be willing to accept that risk if [the drug] is giving them back their life."
Prof Peter Weissberg, of the British Heart Foundation, said: "This study adds to the mounting body of evidence that taking high doses of NSAIDs increases the chances of having a heart attack. However, the increased risk is small and many patients with chronic debilitating pain may well feel that this small risk is worth taking to relieve their symptoms."
The International Ibuprofen Foundation said: ''The occasional and short-term use of ibuprofen for minor pain conditions, i.e. the way the majority of consumers use over-the-counter ibuprofen products, is not shown to be a risk factor."
If a doctor prescribes it and you have a MI because of his prescription, he is responsible (i.e., subject to a malpractice lawsuit). You have no recourse if you exceed the dosage warning on the OTC box. A doctor would presumbaly be monitoring your progress under his prescription. You're on your own with the OTC dosage. That's the difference.
I would assume high dosages of anything would cause problems. They wasted money on this survey?
I'm still taking a couple of Ibuprofen for headaches, minor illness or pain when needed. I've tried the others (advil, etc...) and this one seems to work best for me. If a choice between the conclusions of an unneccessary survey vs relief of a headache... Ibuprofen wins.
Aspirin (acetyl-salicylic acid or ASA) may cause allergy-type reactions in persons who develop this unusual sensitivity. This idiosyncratic type reaction can be very serious - sometimes even life-threatening.
Those people who have both moderate to severe asthma and chronic sinusitis are more likely to be aspirin sensitive.
The main types of reactions are:
1. SKIN REACTIONS- itching, rashes, hives, or swelling of extremities or mouth
2. RESPIRATORY / OCULAR - Acute or immediate: nasal congestion, itchy/watery eyes, swollen eyes, cough, difficulty breathing or wheezing (swelling of the inside of the throat and asthma attacks which can be mild to very severe). Chronic: nasal polyps, sinusitis (leading to loss of smell, cough, postnasal drip), and worsening of chronic asthma.
3. CARDIOVASCULAR - in very rare cases cardiovascular collapse (anaphylactic-type of shock) has occurred.
Stomach pains due to aspirin are not allergic or idiosyncratic types of reactions, but are usually due to irritation of the stomach lining.
One very important point is that most NSAID's (or Non-steroidal anti-inflammartory drugs) cross-react with aspirin - meaning that they can cause the same types of reactions in aspirin sensitive people. These drugs are mostly used for arthritis and other painful disorders. Common NSAID's (not a complete list) include: Advil, Anaprox, Ansaid, Butazolidin, Clinoril, Dolobid, Feldene, Ibuprofen, Indocin, Motrin, Naproxyn, Nuprin, Orudis, Rufen, Tolectin, and Voltaren.
A drug commonly used for aches and pains is Acetaminophen (TylenolÔ, e.g.) Acetaminophen, however, is very commonly safe in aspirin sensitive people when used at recommended doses. As with all medication decisions, you should discuss this with your doctor (you may want to ask the doctor about non-acetylated salicylates which are also mostly safe in ASA sensitive people.
ASPIRIN (acetyl salicylic acid or ASA) and NSAID's are found in many home remedies, over-the-counter (OTC) drugs, and prescription medications. Please check the list below. THIS IS NOT A COMPLETE LIST AS NEW PREPARATIONS ARE BEING ADDED ALL THE TIME. Look for ASA (aspirin) in medications for headaches, colds, coughs, allergies, sinus problems, arthritis, rheumatism (joint pain), menstrual cramps, stomach acidity, backache, or urinary pain. Please read all labels carefully, or ask the pharmacist before trying any medication. An over-the-counter medication label may say in small print "don't take this medicine if you are allergic to aspirin or NSAID's." Also, remember to tell your doctor, dentist, and nurse that you are sensitive to aspirin.
Artificial coloring, for example Tartrazine Yellow (FD&C No. 5), may rarely mimic aspirin sensitivity. This dye is present in many foods including alcoholic and soft drinks, candies, artificial orange juice (TANG), luncheon meats, preserves, jams, fruit gelatins, ice cream, colored baked goods, toothpaste, and mouth wash. Always read the labels on packaged foods and try to avoid those that contain this artificial coloring if you're sensitive to aspirin.
Tartrazine dyes are also present in some medicines including some antihistamine preparations used to treat allergies. Use only those medications prescribed by your doctor, and be suspicious of any colored pills if you develop an itch, rash, or stuffy nose after you start taking them.
MEDICATIONS CONTAINING ASPIRIN OR ASA-LIKE SUBSTANCE (NSAID's): (Again, please be aware that this is not a complete list)
Advil.,Alka-Seltzer, Alka-Seltzer Plus, A B C Compound, AC and C tabs, APC Tablets, Anacin, Anaprox, Anodynos, Ansaid, Arthralgen, Arthritis Pain Formula, Arthritis Strength, BC powder, Arthropan, ASA and Compound Ascriptin, Ascriptin A/D, Asperbuf, Aspergum, Aspirin and compounds, BC compounds, Bromo-Quinine, Bromo-Seltzer, Bufferin, Butazolidin, Cama, Chargers, Clinoril, Cogespirin, Cope, Coricidin, Coriforte, Cosprin, Cuprimine, Damason, Darvon compounds, Depen, Dia-Gesic, Dihydrocodeine Compound Tablets, Dolobid Dolprin #3 tablets, Dristan, Easpirin, Ecotrin, Empirin, Compoung, Equagesic, Excedrin, Duradyne, Empirin and compounds, Feldene, Fiorinal and compounds, Fiogesic 4 Way Cold Tablets, Hyco-Pap, Gemnisyn, Goody's Headache Powder, Haltram, Hyalex, Ibuprofen, Imuran, Indocin, Liquiprin tablets, Lodine, Measurin, Meclomen, Medipren, Mepro Compound tablets, Methocarbamol, Midol, Momentum, Motrin, Myochrysine, Nalfon, Naproxyn, Norgesic, Norwich aspirin, Novahistex with APC, Novahistine sinus tablets, Nuprin, Orudis, Oruvail, Oxycodone, Pabirin, Pediaprofen, Pepto-Bismol, Percodan compounds, Persisten, Penaphen compounds, Phenergan compound, Plaquenil, Ponstel, Pyroxte, Rheumatrex, Ridaura, Robaxisal family, Rufen, Saleto, Salflex, Sine-off, S K Oxycodone, S K 65 compound tablets, Solganal, Soma compounds, Stanback, St. Joseph Aspirin, Supac Synalgos - DC Talwin compound, Therapy, Bayer, Tolectin 200, Trac-tabs, Trendar, Triaminicin, Trigesic, Urisinus, Vanquish, Verin, Voltaren, Zactrin, Zorpin.
Treatment options includes use of antihistamines like benadryl or DPH elixir (H1 blockers) cimetidine ranatidine(H2 Blockers) . epinephrine sc , oral or intravenous steroids though more intense management may become necessary. Suggest seeing your doctor for optimal care! Continue to remind your doctor on every visit of your particular drug allergy. Ensure that your medical records clearly define all of your allergies as in the long run your are the one that benefits.
"http://idisk.mac.com/mirander/Public/Aspirin%20Allergy.html "
Actually Mike, the Seattle Seahawks had a player who was taking approximately double dosage Ibprouphen for his aches and pains and it cooked his liver - he had to retire early and was touch and go for a while whether he would make it.
Can't remember his name....Zeke???? Defensive back I think. Somebody help me out.
If a doctor prescribes it and you have a MI because of his prescription, he is responsible (i.e., subject to a malpractice lawsuit).
Not necessarily. No drug is effective in 100% of the population 100% of the time.
This is why Vioxx was banned in the US. IMO Vioxx was a great medication for those suffering from rheumatoid arthritis. It should not have been banned for a few adverse reactions.
A Get-Well Wish -- Ken Easley Gave A Lot
KENNY Easley, the finest defensive player to wear a Seattle Seahawks uniform, has faced more adversity than his 31 years deserve. If his kidney had not betrayed him, he'd surely still be the Pro Bowl safety he so often was.
Kidney disease cut short Easley's brilliant National Football League career two years ago. There'll be no football comeback. There will be a more important one - battling back from kidney deterioration after a weekend transplant.
Unresolved are the merits of a lawsuit filed against the Seahawks by Easley, now co-partner of a sports-management group. He alleges his kidney trouble was caused or aggravated by large doses of the pain reliever ibuprofen.
When word of the last week's transplant got out, many who remembered how much Easley gave to football wanted to help. Typically, he didn't want anything for himself. Instead, he suggested donations to the Northwest Kidney Foundation or to Friends of Youth......
He was a fine player, and a fine gentleman also!!!
Thanks for the research.
That's a fairly good representation of the discussions on the topic -- and if one is not paying close attention, thinks acetaminophen is just another NSAID -- but less effective and recommended.
One of its indications is that it is well-known to be safer and to produce fewer allergic/negative side-effects. Like any product, it doesn't work for everyone -- but if it does, one is in luck because generic Tylenol (acetaminophen) is the cheapest thing one can buy at the discount stores.
If it doesn't work, then one has to proceed up the ladder of risk and cost. But I wouldn't start there.
ASA gets on board quickly, and Acetominophen actually prolongs the pain reducing effects. I am especially fond of Exedrine Migraine in these cases.
I'm not attempting to promote one pain reducing medication over another, but I have found that plain old aspirin, in it's many forms, is still most effective in the majority of the population. Those who cannot tolerate NSAIDS have the option of using acetominophen.
I think the order should be reversed -- that one should try the acetamenophen first, and if it is not effective, the NSAIDS (aspirin, ibuprofen, naproxen, etc.), COX-2 inhibitors, etc.
The rationale for creating the COX-2 inhibitors in the first place was that they reduced the gastric irritation -- while acetaminophen is often prescribed for the treatment of gastritis. Especially in long time users, an extreme sensitivity can build up to a product.
Greybeard and I were on another discussion a few months ago of another wonder common remedy in which a doctor claimed that gauifenesin was the cure for fibromyalgia. Critical to the protocol was the recognition that aspirin blocked the effectiveness of all other medications.
This is a load of BS. Heroin = Bad, Oxycontin = Good. The only things that makes Oxy "good" are the facts that it is made by a legitimized drug company from synthetic substances to EXACTLY mimic the effects of Heroin.
Nothing inherently wrong with either drug. Heroin would be fine, as long as its purity is assured and the patients can get enough of it as tolerance builds. Don't think for one minute you can't develop tolerance/addiction problems with ANY synthetic opiate. Better to be a FUNCTIONING addict than debilitated by pain.
I never abused pain pills. I only took them when I was in a lot of pain, so I never got addicted to them. I prefer to use them after I have surgery or an accident. Doctors don't like to write prescriptions for narcotics because they are afraid they will get in trouble with the feds. It's really not worth the hassle. I can get relief from taking aspirin, so I'll just stick to them for pain. I have a very high tolerance level to pain so I'll be OK.:o)
It found that ibuprofen and diclofenac, two non-steroidal anti-inflammatory drugs (NSAIDs), could cause attacks when taken in high doses.
The source defined high dose diclofenac as " high dose diclofenac (75 mg twice daily)."
Thanks for the information -- great comment.
Absolutely. If you have a legitimate need, take the meds that work. Frankly, narcotics compare favorably to any NSAID, IMO, when taken as prescribed. Unfortunately, much pain goes untreated, undertreated, or treated with more dangerous and less effective medications because of the failed WOD and professional fear of the DEA.
It has been shown that swallowing small amounts of saliva over a long period of time is nearly always fatal.
" By the way, most stomach ulcers are not caused by NSAIDS"
Your information is only partly correct.
NSAIDs can certainly cause stomach ulcers all by themselves. There's lots of valid data on how NSAIDs destroy the lining of the stomach.
But most all commonly occuring stomach ulcers (outside of heavy NSAID users) are caused by Helicobactor pylori infection.
Instead I take Naproxen sodium (Alieve), two tablets twice a day. Mainly for my back, on recomendation of the surgeon who operated on it.
I recently flunked an arthritis screen test. Well that's what my doctor said I was getting, but I find they are testing for various types of inflammatory diseases. Given the two factors I failed on, it's probably something a mite worse, but it could just be arthritis. I haven't seen the Rheumatologist, it takes well over a month to get in, but I expect he'll want to put me on something or other. I'll do more research before I go, and will be ready with questions, but can't do much until I know what the problem is.
Heck all I had was some swelling of the ankles (like Hillary, but no so much) which concerned my wife, which I thought was a side effect from blood pressure medication (it's a listed side effect). So I asked my doc about it... maybe a mistake :). (Nah!).
As I've said previously in that discussion on pain relievers, other than deliberate abuse and attempts to commit suicide with deliberate overdosages (usually consumed with nearly fatal doses of alcohol) -- in normally recommended, reasonable therapeutic dosages for the purpose and intent of getting better, acetaminophen has notably fewer adverse reactions.
So much so that one has to wonder if these occasional and fabled Tylenol scares, is the best the competition can do.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.