The People's Perspective on Medicine

What Can You Do If Ibuprofen Triggers Atrial Fibrillation?

People in pain should be told that ibuprofen triggers atrial fibrillation, as do other NSAIDs. Home remedies may be safer for relieving pain.

Nonsteroidal anti-inflammatory drugs (NSAIDs) like diclofenac, ibuprofen, meloxicam or naproxen are extremely popular pain relievers. Ibuprofen (Advil, Motrin IB) and naproxen (Aleve) are even available over the counter. As a consequence, most people assume that these drugs are extremely safe. However, research shows that such an NSAID triggers atrial fibrillation.

Ibuprofen Triggers Atrial Fibrillation.

Q. Ibuprofen is the pain reliever that always worked best for me. However, out of nowhere I began having episodes of atrial fibrillation.

I underwent an ablation and was on the heart rhythm regulating medications flecainide and metoprolol. Nothing seemed to help until one day I read about research in Europe to determine if there was a connection between NSAIDs and AFib. They found convincing evidence that there was.

I immediately stopped taking ibuprofen and any other NSAID meds. Shortly thereafter my AFib episodes ceased. I’m still on a strong dose of flecainide and very light dose of metoprolol and ZERO NSAIDs.

More Evidence That Ibuprofen Triggers Atrial Fibrillation:

A. Dutch investigators followed more than 8,000 adults for over a decade. They found that people who took NSAIDs such as ibuprofen were more likely to develop atrial fibrillation, abbreviated AF or AFib (Krijthe et al, BMJ Open, April 1, 2014).

Other investigators have concluded:

“These findings suggest that AF needs to be added to the cardiovascular risks to be considered when prescribing NSAIDs” (Liu et al, American Journal of Cardiology, Nov. 15, 2014).

Because the consequences of atrial fibrillation can include strokes, we think both doctors and patients should be aware of this potentially serious complication.

What Else Can People Use for Pain Relief?

Acetaminophen does not appear to trigger heart rhythm disturbances. Neither does aspirin. So a person at risk for Afib might choose one of those rather than a common NSAID. Such an individual might do even better with a home remedy to relieve pain without increasing the risk of Afib. You can learn more about such remedies in our book, The People’s Pharmacy Quick & Handy Home Remedies.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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Thank you for this article, although too late for me! I have chronic pain-Fibromyalgia and osteoarthritis and frequent headaches and was taking Aleve and Aleve PM in order to sleep every night for about a year, which my cardiologist was aware of.

I developed upper GI bleeding, and while in the emergency room, they found that I was in AFib. Because of the AFib, my Gastroenterology Doctor could not do an endoscopy to find where the bleed was coming from, but we suspected it was from taking Aleve.

I did have an ablation, stopped the Aleve (I was put on Medical Marijuana which works) and had the endoscopy, which a stomach ulcer was found as the cause of the bleed. I feel I went through hell because my doctors are not well versed on the effects of OTC pain relievers, which I would not have taken if I had known.

I am still on Eliquis for the Afib, unfortunately. I have printed this article and will be giving a copy to every one of my doctors. Thank you for this article; I now know to avoid these OTC drugs!

I was unable to find the cited article in BMJ Open. Could you please provide a specific link? Your article implies causality was shown. Was that the intent?

Here is the link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987714/
A population-based study like this one cannot establish cause and effect. It does show a strong association.

As an Anti-inflammatory agent, and pain reliever, I recommend Turmeric capsules [2×1000 Mlg./day] along with Celery Seed Extract tablets [2×150 Mlg/day]

It has done wonders, for both my wife and myself. Side effects are ALL positive.

Whoa. You might want to reconsider your mentioning aspirin as a substitute pain reliever instead of NSAID’s for AFib patients. Many Afib patients on coumadin (warfarin) are specifically told not to take aspirin while they’re on a course of coumadin. I hate to say it, but it certainly seems to me that there are real downsides to every over-the-counter pain-relief medication.

It all depends on what the patient can tolerate in terms of side-effects (ibuprofen gave me bleeding ulcers – twice) and the approval of their physician. (That’s a once-a-year brief discussion at your annual checkup, not a consult every time you need to take pain relief.)

To me, the only really good advice on over-the-counters is: never take pain relief *before* you have pain, only *after* it has shown up. And take as little as is effective for you.

I would like to see a study that investigates whether Premature Ventricular Contractions (PVC) are connected to long term use of Meloxicam (Mobic). I was on Meloxicam for at least three decades. In my late 70s I was diagnosed with PVC. If meloxicam is connected to the irregularity of heart rhythms such as AFib, when will a connection or lack thereof to PVC be determined?

Does anyone know how many NSAIDs/day are too many? I would hope that one wouldn’t get the same side effects from taking, say two/day. I assume these warnings about NSAIDs would relate to people with chronic problems relieved by them (such as arthritis) not just infrequent usage.

In general, if you are taking NSAIDs every day, you might be at risk. If you take them only occasionally, probably not.

Do you have any pain remedies or treatments for CRPS (Chronic Regional Pain Syndrome)? It is thought to be the most painful syndrome in the world, and is nicknamed “The Suicide Syndrome” since so many patients are driven to that extreme. My best friend’s 11 year old daughter was recently diagnosed with it, so we are anxious for all possible remedies and treatments–thank you.

I use Voltaren gel for back pain and have for a few years. I developed atrial fib but have not heard nor read that the gel can cause side effects such as this. What is the research on the gel especially compared to the oral NSAIDS? Thanks for all you do.

Voltaren gel is an NSAID. It always hurt my stomach when I used it.

You didn’t mention aspirin. It I also an NSAID.

A friend recently told me about OTC Lithium which can decrease the chance of dementia. What do you know about this?

Thanks for the update on NSAIDS causing AF; what are the symptoms of AF?

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