Taking too many NSAIDs could cause heart trouble

WASHINGTON – To many people, they are wonder drugs, but a class of common painkillers can do real damage when used to excess.

“These drugs have been on our radar screen for some time,” said Dr. Stuart Seides, physician executive director of the MedStar Heart Institute, which is based at MedStar Washington Hospital Center.

British researchers synthesized data from a series of studies on these popular pills, commonly known as NSAIDs — non-steroidal anti-inflammatory drugs. The results, published in the journal Lancet, show heavy users increase their risk of cardiovascular trouble by as much as a third.

Seides says he wasn’t surprised by the findings. NSAIDs are among the most potent drugs available to the public without a prescription.

Occasional use of the drugs isn’t a problem.

“This is really a warning for the patient, for example, who has some sort of chronic pain problem, who may have some form of arthritis,” said Seides.

These people tend to take the maximum dosage almost every day. For them, finding the right balance between protecting their heart and managing their pain is crucial.

The goal is to take as few NSAIDs as possible, for as short a time as possible. Some are riskier in large doses than others.

Naproxen, for example, does not appear to increase the risk of heart attacks, but it is more likely to cause gastrointestinal problems than other drugs in its class. Seides says it is his treatment of choice for those who can tolerate it.

He also warns that NSAIDs can blunt the effectiveness of low-dose aspirin therapy to prevent heart disease. Seides says he urges his patient to take the tiny aspirin and wait an hour before taking an NSAID. Other doctors say they urge people on an aspirin regimen to avoid NSAIDs entirely.

Here is a list of common NSAIDs:

  • ibuprofen (motrin, Advil)
  • aspirin Salsalate (Amigesic)
  • celecoxib (Celebrex)
  • diclofenac (Voltaren)
  • etodolac (Lodine)
  • indomethacin (Indocin)
  • ketoprofen (Orudis)
  • ketorolac (Toradol)
  • nabumetone (Relafen)
  • naproxen (Aleve, Naprosyn)
  • oxaprozin (Daypro)
  • piroxicam (Feldene)
  • sulindac (Clinoril)
  • tolmetin (tolectin)

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