If you regularly take a nonsteroidal antinflammatory drug (NSAID) for arthritis pain, you may be wondering if it’s safe. Here’s our advice.
We’ve known for some time that NSAIDs are linked to potentially serious gastrointestinal (GI) and heart troubles. A study published in The Lancet helps characterize and quantify the cardiovascular and GI risks of particular regimens.
Investigators analyzed data from 639 studies of coxibs and traditional NSAIDs. All NSAIDs were associated with an increased risk of hospitalization for heart failure. NSAIDs in general increased the risk of upper GI complications two- to four- fold. Coxibs (such as Celebrex) caused the fewest such complications. Coxibs and high doses of diclofenac increased the risk of nonfatal heart attacks, stroke and vascular death by about one-third. Ibuprofen significantly increased the risk for heart attacks, too, though the authors say that link needs further study. A 500-mg dose of naproxen daily did not increase the risk of heart attack or stroke, though the authors caution that some uncertainties about this drug’s heart safety remain.
What to do. If you are at low risk for cardiovascular disease, the chances of experiencing a major event are small, irrespective of the NSAID used. If you have heart disease or are at high risk for it, the chances that you could experience a major, in some cases potentially fatal, event are higher. Either way, discuss your NSAID use with your doctor. She or he can help you choose the safest regimen based on your health history.
Posted in Arthritis on November 10, 2014