Taking ibuprofen? Don't panic!
A new study suggests that taking ibuprofen, the common non-steroidal anti-inflammatory drug (or NSAID), increases your risk of heart attack or stroke by more than a third. But before you rush to the bathroom cabinet to throw out every painkiller you've ever owned, read on for the whole picture.
Almost a decade ago, another painkilling medicine called Vioxx® was withdrawn after studies showed it might double the risk of heart attack. Several studies over recent years have suggested that another NSAID, diclofenac, increases the risk of heart attack or stroke if taken regularly. In many areas of the country, doctors are being advised to consider changing patients from diclofenac to other alternatives. What's worrying for me is that one of the alternatives we thought it was safer to use was ibuprofen - the very drug that is now under the spotlight.
This study looked at patients taking very high doses of ibuprofen - 2400 mg a day (twice the maximum dose recommended for people buying ibuprofen over the counter and much higher than the doses I usually prescribe). They also looked at people taking daily diclofenac at a dose of 150 mg. For every 1,000 people who took these medicines at this dose every day for a year, three would have a heart attack when they wouldn't otherwise have had one and would die as a result. For a single person, the risk isn't great - but when over 10 million prescriptions are written a year for ibuprofen and diclofenac in England alone, and more are bought over the counter, the potential dangers stack up.
Even that isn't the whole picture. When doctors prescribe medicines they're always weighing up the risks and the benefits. Osteoarthritis and rheumatoid arthritis affect more than 7 million Britons, and in some cases the pain they cause can rule your life. NSAIDs have been used by doctors for many years as part of our quest to help patients control their pain and get their life back. There are alternatives, including paracetamol and codeine-based medicines. Another NSAID, naproxen, doesn't appear to carry the same risks. But just as all medicines cause side effects in some patients, all work better for some people than for others. For some patients, life is hardly worth living without NSAIDs. If you're one of these, don't panic and don't stop taking your medicine. Instead, speak to your GP about whether there's a safer alternative that might work for you.
What about the majority of us, who take an occasional dose of ibuprofen when we have a headache or the odd ache and pain? All NSAIDs can irritate your stomach lining and cause indigestion or, rarely, bleeding from the stomach. They can also make asthma worse, so should be used with caution if you have asthma. But this study isn't suggesting there's any significant risk to your heart from an occasional dose of ibuprofen. Likewise, ibuprofen is extremely effective at reducing pain and fever in children, and there's no evidence the heart risks extend to kids. So what does this mean for most of us, who just reach for occasional pain relief? If they haven't caused problems so far, keep taking the tablets.