Wednesday, 12 December, 2018

'Little justification' for prescribing diclofenac, researchers warn

Melissa Porter | 08 September, 2018, 12:29

"Considering its cardiovascular and gastrointestinal risks, however, there is little justification to initiate diclofenac treatment before other traditional NSAIDs".

It's always important to discuss medication and the potential risks it will have on your health with a GP or health professional.

It found that people who use diclofenac, a non-steroidal anti-inflammatory drug (NSAID), are more likely to come down with cardiovascular disease than people who take other NSAIDs or acetaminophen. Then, the researchers followed and studied these individuals for the next two decades from 1996 to 2006.

Controversial pill diclofenac also increases rates of heart failure and irregular heartbeat or flutter among men and women of all ages, according to the study.

Now a groundbreaking study of more than six million people, the biggest of its kind, has linked them to "major cardiovascular events".

The study included more than 6.3 million adults with an average age of 46-49 in Denmark with at least one year of continuous prescription records from 1996 to 2016.

Diclofenac, a widely used worldwide drug with anti-inflammatory and analgesic properties, is associated with an increased risk of heart attack, stroke and other serious cardiovascular problems, so its use should be done with moderation rather than for a long time.

"Treatment of pain and inflammation with NSAIDs may be worthwhile for some patients to improve quality of life despite potential side effects", the team wrote in a statement regarding the study. Diclofenac should not be available over the counter, and when prescribed, should be accompanied by an appropriate front package warning about its potential risks'.

Furthermore, a connection between taking diclofenac and the increased rate of upper gastrointestinal bleeding and cardiac death was found. The Medicines and Healthcare products Regulatory Agency said the anti-inflammatory tablets carried a "small but increased" risk of heart problems.

And while it has previously been thought that NSAIDs are safe to use over the short term, the new study found that cardiovascular risk was elevated even within just 30 days of starting to take the drug. The researchers add that while the relative risk for heart issues was seen to increase, the absolute risk for patients stayed low. They are now advocating that low dose ibuprofen or naproxen should be considered as comparators. On the other hand, paracetamol, another common painkiller, as well as ibuprofen, showed reduced risks of heart problems, compared with diclofenac. "In conclusion, our data support that initiation of diclofenac poses a cardiovascular health risk, both compared with no use, paracetamol use, and use of other traditional NSAIDs", they state.