Want to Maintain a Healthy Heart? Avoid the Most Dangerous Drugs in (Almost) Everybody’s Medication Cabinet
Most adults and many children have taken Non-Steroidal Anti-inflammatory Drugs (NSAIDS) for pain or fever or both. These drugs are recommended for the pain of arthritis and are widely used for headaches, dental pain, muscle and joint pain, and other types of acute and chronic pain. This class includes prescription drugs such as celecoxib (Celebrex), diclofenac (Voltaren), and meloxicam (Mobic) and also many formulations available without a prescription including ibuprofen (Motrin, Advil) and naproxyn (Aleve). All of these drugs increase the risk of a gastrointestinal (GI) bleed, although Celebrex may have a lower risk.
Two other widely-used NSAIDs, Vioxx and Bextra were removed from the market in 2004 and 2005 respectively due to an increased risk of heart attacks. This class of drugs also may increase the risk of stroke and worsen heart failure by increasing blood pressure and affecting kidney function.
However, the risk of these cardiovascular side effects varies depending on the drug used. Clearly Vioxx and Bextra carried the most risk, but celecoxib (Celebrex), diclofenac (Voltaren), ibuprofen (Motrin, Advil) and possibly meloxicam (Mobic) also carry significant risk especially for person with high blood pressure, heart failure, and kidney disease. Naproxyn (Aleve) may be a safer alternative along with acetaminophen (Tylenol).
These risks also appear to increase significantly with increasing daily doses. Avoid doses of celecoxib above 200mg/day and ibuprofen above 1200mg/day. Finally, patients with diabetes appear to be at increased risk for the cardiovascular and kidney effects of NSAIDS.
Remember, that medication-related adverse events are a leading cause of predictable and preventable hospitalizations and even death. Maintaining a healthy heart can be helped by consulting your physician or pharmacist before taking any medication including non-prescription drugs especially if you are diabetic or have any form of heart disease including heart failure and high blood pressure.
Source: Cardiovascular Risks of NSAIDs and COX-2 Inhibitors Pharmacist’s Letter/Prescriber’s Letter Detail Document # 221003 October 2006
