Businessman with chest pain

On July 9, 2015, the FDA issued another warning about non-aspirin NSAIDs (nonsteroidal anti-inflammatory drugs). We have been warning about cardiovascular complications for years and now the FDA is strengthening its safety announcement:

“Patients taking NSAIDs should seek medical attention immediately if they experience symptoms such as chest pain, shortness of breath or trouble breathing, weakness in one part or side of their body, or slurred speech.”

NSAIDs and Heart Attacks

That’s because non-aspirin NSAIDs increase the risk for heart attack and stroke, either of which can cause death. The FDA advises that these life-threatening events could occur “as early as the first weeks of using an NSAID. The risk may increase with longer use of the NSAID.”

The FDA cannot tell if there are any differences in risks between drugs such as celecoxib, diclofenac, ibuprofen, meloxicam or naproxen. Notice, that aspirin, although an NSAID, does NOT increase the risk for heart attacks or strokes caused by blood clots.

Don’t Take OTC NSAIDs for Granted!

Millions of people take over-the-counter pain relievers without thinking twice. They certainly never connect NSAIDs and heart attacks. The very idea that such drugs could cause deadly heart attacks or strokes comes as a shock to most people. After all, the FDA says that nonprescription drugs are both safe and effective. We find it hard to understand how drugs that kill people regularly could be considered safe.

Another Deadly NSAID Hazard

The new warning about heart attacks and strokes deals with blood clots in arteries that feed the heart and the brain. It doesn’t address the issue of blood clots that lodge in the veins. These are called deep vein thromboses (DVTs) and they can also become lethal. When a blood clot breaks loose and gets stuck in the lungs it is called a pulmonary embolism (PE).

We warned about this scary complication here.

For reasons that are mysterious to us the FDA has not yet seen fit to warn people about these deadly hazards. One reader discovered this problem by first hand experience.

“Naproxen almost killed me. After three doctor visits and two ER visits for shortness of breath and leg pain, I was finally diagnosed with severe anemia from internal bleeding, DVT [deep vein thrombosis] and PE [pulmonary embolism] in both lungs. This all occurred within the last four months, with the life threatening PE 6-1/2 weeks ago.

“The ER doc who saved my life immediately took me off the naproxen which I’d been taking twice a day for the past three years to treat osteoarthritis and degenerative disc disease in my back. I loved that med for easing the pain and was unaware of any side effects.

“I had no stomach discomfort and no idea I had an ulcer. My doctors never told me that I should only take it a short time, although I had other risk factors and possible drug interactions. Actually, had they, I would have resisted because it works.

“The three doctors who missed this were treating me for worsening asthma and prescribing stronger asthma meds. (My heart was tested and is fine.) The leg pain and the fact that the affected leg was swelling more than the other were discounted and ignored. I am grateful to have lived to make it to the ER and through the crisis.

“I am slowly getting stronger, but I’m only able to work a couple of hours three days a week. Even that exhausts me. For several weeks I couldn’t work at all, so that’s a big improvement.

“I’m now on a blood thinner, iron and B-12 shots. My leg still hurts sometimes. My doctor says the valves in my leg are damaged and not pumping the blood back up very well.

“I’m hoping that improves and I have no lasting effects from this. My breathing is so much better, but only time will tell if I have permanent lung damage. My pain level is actually pretty good without pain meds, but I’m not moving my joints or back yet as much as I normally would. So time will tell on that one too. (It is an ironic thought in other research that the meds we take for pain might actually be causing more pain.)

“I am so glad to have lived through it and be recuperating well. But this damage due to the drug was a life changer at least for several months. I am left with big medical bills in spite of insurance and vastly reduced income with which to pay them. Due to lack of early symptoms I can understand it all being missed and ignored, but I sure do wish someone had caught it before it got so serious. Please all of you taking NSAIDS, take these risks seriously.”

Take Home Message About NSAIDs and Heart Attacks

The FDA has no idea how many people have been harmed by NSAIDs over the last few decades. We suspect that hundreds of thousands of heart attacks, strokes and DVTs have been triggered by these pain relievers and tens of  thousands of people have died.

When an older person has a heart attack or a stroke it is often blamed on their age or the state of their arteries. The medicine they were taking for arthritis, a bad back or a headache is overlooked. Perhaps this new warning will wake some people up to the dangers of non-aspirin NSAIDs.

But what should people do for their aching joints or head pain? We offer a great many non-drug options in our book The People’s Pharmacy Quick & Handy Home Remedies. They have  the benefit of not costing much and not causing heart attacks, strokes, DVTs or bleeding ulcers.

 

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  1. william
    Katy, TX
    Reply

    How long after stopping the use of NSAIDs would the possibility of a severe reaction continue? I’m thinking mainly of heart and breathing complications.

  2. Sarah
    Washington
    Reply

    Sometimes the ibuprofen is the only thing that relieves my muscle and joint aches and allows me to sleep at night. Would taking an aspirin 30 minutes before the ibuprofen help reduce the risk of these heart, pulmonary and thrombosis side effects? I say 30 minutes before because I’ve heard ibuprofen can block the absorption of other pain relievers if taken together.

  3. CLIF
    APPLE VALLEY, CA
    Reply

    it’s frustratingly impossible to read your articles because of the absolute plethora of……abbreviations.

    If these articles are designed for doctors and pharmacists then you are doing what Tony the Tiger would say: a grrrrrreat job!!!

    • Laurie Matson
      Waseca MN
      Reply

      I have to agree at Times it is hard to know what Abbreviations stand for. Not everyone knows what everybody else does so please spell out words rather than Abbreviate. Thank You!!!

  4. Vicky
    FL
    Reply

    I have one of your books which has home remedies, and after reading this article, I went to see which home remedies you recommend for headaches. NSAID’s are recommended on several pages.
    Publication dates were 2006 and 2007. Was the information not available at that time?
    I bought this book during this last year, maybe it shouldn’t still be in publication?

  5. J. David A.
    Springfield, MO, USA
    Reply

    I developed a DVT in my left calf while on a flight from St. Louis to Las Vegas 10 years ago – I had taken only one dose of Vioxx. Like women taking estrogens, hormonal pills for bones or certain cancer hormones, it is probably a good idea to stop the clot promoting drug a day or two before a day on the plane or in the car. I take Aspirin for arthritis mostly now but make sure to take Aspirin before any trips. Americans, especially, seem to be more prone to clot than they were 25 years ago – I think it is caused by the industrial oils but comparison studies could still be done while there are a few places where the klepto conglomerates have not contaminated the food system.
    Vioxx also caused enough clotting, after a dose when I was 52, I had my first migraine.
    Vioxx, on the other hand kept older people who were “stove up” with arthritis out of the nursing home when other drugs didn’t work. The premature deaths from lack of Vioxx in Nursing homes when the drug was removed from the market are not recorded anywhere. In the elderly, the half-life of the drug was so long, it could be dosed in small amounts 2 or three times a week.

  6. Bob
    Chapel Hill, NC
    Reply

    After three years of twice daily naproxyn, my renal function began to fail – rising creatinine. I stopped naprosyn and it recovered. My doctor didn’t realize that this was a side effect too.

  7. Kris
    Blairsville, GA
    Reply

    My husband is a critical care heart patient. He is on several Rx blood thinners, “stroke prevention” (or help at least) and more. WHAT are you supposed to take if you get a headache? I have heard several dos and donts… Tylenol? Hard to know what to do, what to take sometimes. Thanks!

    • Ginny
      Durham, NC
      Reply

      Kris,
      Ask your husband’s cardiologist what he/she would suggest he take for headaches. I would guess Tylenol, but you need to check with the Doc. Also find out what you can use as a back up if that doesn’t work. Sometimes something simple like a heating pad works well for some pains, but not for most headaches. For that I’d suggest trying an ice pack. I often suggest to people that they keep a couple bags of frozen peas in the freezer. Covered with a light weight dish towel, they are great for headaches in some people and for most people for about 24 hours after spraining an ankle. Good luck to you both!

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