Common Painkiller, Diclofenac, Associated With a Higher Risk of Heart Problems

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The study explored the cardiovascular risk of one prescription drug Diclofenac and found it can cause serious problems for heart patients if taken for an extended period of time.

The researchers believe its high time that the potential health risks of the drug are recognised and that its usage is reduced, including not making it available over the counter.

The researchers concluded that diclofenac should not be available over the counter, but should have to be prescribed by a doctor, with warning labels on the packaging to ensure patients are aware of the risk before they begin to take the drug. During the follow-up period, between 1996-2016, the scientists eliminated other risk factors for cardiovascular diseases in the subjects who participated in the study.

This is not the first study to have linked diclofenac with coronary disease.

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A study carried out by researchers in Denmark looked at nearly 1,400,000 patients who were started on diclofenac between 1996 and 2016, as well as patients who were initiated on other types of NSAIDs and patients who weren't initiated on any NSAIDs.

To conduct this study, the researchers utilized the national registry data containing details on the 6.3 million adults residing in Denmark.

One of the world's most-used painkillers, diclofenac, the active component in Difene, has been linked to an increased risk of heart attack and stroke in a major study published on Wednesday morning. Diclofenac is a traditional NSAID that has similar selectivity for cyclo-oxygenase-2 (COX 2) as COX 2 inhibitors, but the cardiovascular risks of diclofenac in comparison with other traditional NSAIDs have not been investigated through a randomized controlled trial.

They said in the paper: 'Treatment of pain and inflammation with NSAIDs may be worthwhile for some patients to improve quality of life despite potential side effects.

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Starting diclofenac was also associated with an increased rate of cardiac death compared with no NSAIDs, and an increased risk of upper gastrointestinal bleeding compared with no NSAIDs, starting ibuprofen or paracetamol, but not with naproxen.

The authors say their results also indicate that using diclofenac as a reference for demonstrating the safety of selective COX-2 inhibitors represents "a potential flaw in safety trials".

The researchers pointed out the absolute risk of heart attack, stroke or other cardiovascular disease still remained low for individual patients. They are now advocating that low dose ibuprofen or naproxen should be considered as comparators. Considering its cardiovascular and gastrointestinal risks, however, there is little justification to initiate diclofenac treatment before other traditional NSAIDs. On the other hand, paracetamol, another common painkiller, as well as ibuprofen, showed reduced risks of heart problems, compared with diclofenac.

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