Over-the-counter painkillers more likely to cause heart attacks than banned drug Vioxx

Jun 12 2005

Researchers in the UK are saying that some of the most commonly used painkillers are more likely to cause heart attacks than Vioxx, the arthritis drug withdrawn from the market last year after it was linked to heart disease.

In the study, the researchers looked at 9000 people aged 25 to 100 who had suffered a heart attack and found that people taking diclofenac, commonly sold as Voltaren, had a 55per cent higher risk of heart attack than those not taking the drug.

Vioxx, before its withdrawal, had a 32per cent higher risk.

According to the study Ibuprofen, sold commonly as Nurofen and Brufen, increased the risk of heart attack by 24 per cent.

Both Voltaren and Nurofen are non-steroidal anti-inlammatory drugs (or NSAIDs), and are used to treat arthritis and muscle pain and are sold over the counter without a prescription.

Vioxx and Celebrex are among the latest generation of NSAIDs called Cox-2 inhibitors, and were considered safer because they give pain relief with fewer side effects.

After it was linked to a higher incidence of heart attack, Vioxx was removed from the market in September.

The FDA and other regulators ordered that other Cox-2 inhibitors, including Celebrex, should carry warnings about heart disease.

University of Nottingham researchers who conducted the study, warn that enough concern exists to warrant a reconsideration of the cardiovascular safety of all NSAIDs.

This is the second study in recent weeks to question the safety of NSAIDs.

A Danish study in May also found that all NSAIDs other than aspirin were associated with a higher heart attack risk.

A number of experts are now questioning the safety of the whole class of non-steroidal anti-inflammatory drugs, and some feel that all NSAIDs should become prescription-only drugs.

Jo-Dee Lattimore, a cardiologist at the Royal Prince Alfred hospital in Sydney, says people should use the drugs with caution, and that non-steroidal anti-inflammatories are under a shadow.

Professor Ric Day, professor of clinical pharmacology at Sydney's St Vincent's Hospital, says the message for doctors is that everything should be done to treat arthritis and muscle pain without using anti-inflammatories. He says the study highlights the need for further investigation into NSAIDs, and calls on the Australian Government to grant Australia's drug regulator, the Therapeutic Goods Administration (TGA), the power to order companies to conduct trials on drugs after they are approved.

A TGA spokeswoman said it would ask the Government to grant it such powers.

Researchers from the University of Bristol are more cautious about totally condemming NSAIDs, they question the interpretation of the results, and claim the study did not outline what dosages were used or whether patients had a pre-existing risk of heart disease.

The study appears in the current edition of the British Medical Journal.