Q. Earlier this year, I heard that ibuprofen can contribute to heart disease, but I’ve heard no more about this. Are you aware of any information about this?
I have also heard that ibuprofen use can block the benefits of low-dose aspirin. Is that true?
Do you have any recommendations for OTC analgesics? As a dentist, I want to make the best recommendation for my patients.
A. There isn’t much difference in pain relief from aspirin, ibuprofen or naproxen. Our choice for occasional, temporary pain relief is aspirin for those who can tolerate it and acetaminophen for those who cannot. Regular use of a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen can increase the possibility of a heart attack (Basic & Clinical Pharmacology & Toxicology, online, April 25, 2014) and counteract the heart-healthy effects of low-dose aspirin (Thrombosis and Haemostasis, online, Dec. 13, 2012).
Naproxen may be somewhat less likely than ibuprofen to contribute to cardiovascular risk. NSAIDs such as ibuprofen and naproxen (as well as diclofenac and other prescription pain relievers) raise the risk of a heart rhythm disturbance called atrial fibrillation (BMJ Open, online April 8, 2014). NSAIDs can also raise blood pressure, so you may want to ask about antihypertensive medication before recommending one for pain relief (Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, June, 2014).
