The People's Perspective on Medicine

Are NSAIDs Linked to the Ultimate Side Effect, Cardiac Arrest?

A Danish study shows that people taking an NSAID such as diclofenac or ibuprofen are at a greater risk of out-of-hospital cardiac arrest.

Most people think of ibuprofen as a safe and handy pain reliever. Here in the US, it is sold without prescription in convenience stores and supermarkets as well as pharmacies. Some side effects, such as digestive tract irritation, have been recognized, although most people imagine this is more of a problem with prescription NSAIDs (non-steroidal anti-inflammatory drugs). But what about cardiac arrest?

NSAIDs Are Not Harmless:

A new study from Denmark suggests that we shouldn’t be taking ibuprofen or any other NSAIDs for granted. The researchers used extensive medical and prescription records to track cardiac arrest among 28,947 Danish adults.

Those who were taking a prescription NSAID like ibuprofen or diclofenac were significantly more likely to suffer a cardiac arrest, the ultimate side effect. The relative risk increased by 50 percent for those taking diclofenac and by 31 percent for those on ibuprofen.

Prescription vs OTC NSAIDs:

This study looked only at prescription drug use, but over-the-counter drug sales of NSAIDs in Denmark are quite limited. Only ibuprofen is available, and even that is sold only in small packages of 30 pills each. One of the authors concluded that, “The findings are a stark reminder that NSAIDs are not harmless.”

European Heart Journal-Cardiovascular Pharmacotherapy, April 2017

We have written more more extensively about this study. You can read that essay here. If you are wondering what you can do for bursitis, tendinitis or arthritis pain, you may be interested in our online resource, Guide to Alternatives for Arthritis. Solutions for headache pain can be found in our downloadable Guide to Headaches and Migraines.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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I take Ibuprofen and Tylenol for pain and fever. I will mix doses such as Tylenol 500 mg. 2 tabs & Ibuprofen 200 mg. 1 tab. Then the next time I can have a dose I will take 4 Ibuprofen. I am a retired nurse. The difficulty I have. is locating the maximum daily dose on the bottle. I’m 65, with visual changes. I used to know the maximum daily dose. I think the daily doses have changed. Is this true?

I was prescribed Naproxen after 3 pills my BP hit 245/115 Its obvious if you take a NSAID you had better take it with a BP pill

With all the hype about opioid abuse, and now ibuprofen causes cardiac arrest what is a person to do about chronic arthritis pain? It is all so frustrating.

This study doesn’t talk about Celebrex – what are the statistics on heart problems with Celebrex?

Since having two knee replacements and one hip with 3 transplants I have depended on Aleve at night to help pain from poor posture necessitated by using cane all the time now. Never more than once a night is necessary. I still keep active, driving, swimming, shopping (though I must say the electric carts in stores now are great), housework; can’t mow my yard any longer myself which is aggravating, but can mess with flowers on the deck.

This program is Great. Good luck, and keep up the great medical information
.

I have been taking Naproxen for a couple of years for osteoarthritis. It has worked well, but I thought I’d go back to aspirin – two before bedtime.

I woke up in a lot of pain and have gone back to naproxen. Do not have any known heart problems, so am taking the chance.

None of the information given tells how much of these meds were taken. Do they mean if you take more than what is prescribed these problems will happen? Many people have been taking these for years without any problems. Information about anything is only good when ALL of the information about the subject is given and not just part. How much of any medication is IMPORTANT for one to make a decision. If these are REALLY as bad as they say, why are there not people dropping like flies all around us, and hospitals full of them? Points to ponder!!!!!!

What is a safe amount of Ibuprofen to take in 24 hours?

You quote relative risk % I believe. How about absolute risk for consistency. You previously have made a big point about knowing the difference.

I was taught that you dose Ibuprofen 200mg in this way (with a small amt. of food with each dose).
2 every 4 hours OR 3 every 6 hours OR 4 every 8 hours. You can take 4 before bedtime and 8 hours later take 2 with 2 more mid day also. NEVER exceed 2400 mg in 24 hours and check with your doctor if pain exceeds 24-48 hours.

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