Cataflam, Voltaren Linked to Increased Heart Risks: Study

The findings of new research have some experts recommending that certain anti-inflammatory drugs, such as Cataflam and Voltaren, be removed from essential medicines lists (EMLs) because of a potential increased risk of heart problems. 

In a study published in the journal PLoS Medicine on February 12, researchers found that diflofenac, one of the most widely used non-steroidal anti-inflammatory drugs (NSAIDs), causes an increased risk of heart attack and stroke, especially among patients with a high risk of cardiovascular events.

Researchers performed an analysis of randomized trials and controlled observational studies to determine the relative risk of many medicines. They obtained EMLs from the World Health Organization along with sales and prescription data for 15 low, middle and high income countries from the Intercontinental Medical Statistics Health (IMS).

NSAIDs are common pain medications often used to treat pain and inflammation. The first NSAID to be developed was Aspirin. The class of NSAID drugs are made up of medications such as ibuprofen and naproxen, common over-the-counter drugs available in most countries.

Common adverse effects of NSAIDs include gastrointestinal and renal problems, along with cardiovascular issues such as stroke myocardial infarction.

Cataflam and Voltaren May Be More Dangerous Than Vioxx

Cataflam and Voltaren were ranked highest for cardiovascular risk compared to nonuse of an NSAID, but are listed on 74 national EMLs. Diclofenac’s market share is equal to medications like ibuprofen, naproxen and mefanamic acid combined, the three next most popular NSAIDs.

The study goes on to indicate diclofenac is one-third of the total NSAID usage across 15 countries and compares Cataflam and Voltaren to Vioxx. A Vioxx recall was initiated in 2004, after just two years on the market, due to its high cardiovascular toxicity.

Merck has had to pay $4.85 billion to settle Vioxx lawsuits filed on behalf of individuals who suffered an injury after using the medication.  The lawsuits accused the company of failing to warn patients about the potential Vioxx side effects, even though evidence suggested Merck was aware of the risks long before the recall was issued.

The researchers are saying some NSAIDs are more likely to cause heart attacks and other heart problems than Vioxx; including Cataflam and Voltaren. They advise considering the risks of taking drugs such as Voltaren in comparison to the risk profile of the patient, especially since it is associated with complications involving cardiovascular events even when taken in low doses.

Use High Among Those From Nonwestern Countries

Many of the studies reviewed found diclofenac to increase the risk of cardiovascular events between 38% and 63%. While the use of Cataflam and other NSAIDs is not as high among U.S. patients, those in nonwestern countries such as Vietnam and Pakistan commonly use these medications.

Other recent studies have also linked the use of NSAIDs to an increased risk of heart problems among healthy users. Taking common over the counter medications like Advil or Motrin greatly increase a person’s risk of heart related death. Another study published in 2011 found people suffering from hypertension are at a greater risk of heart attack, stroke and death if taking common over the counter NSAIDs.

Results of the new study cause more concern considering diclofenac is commonly prescribed to patients because of physician familiarity with the drug. The researchers advised diclofenac be removed from EMLs. They also cautioned doctors to advise patients with high risk of cardiovascular events to avoid taking medications like Cataflam and Voltaren.