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NSAID Painkillers May Increase Heart Failure Risk: Study

Potential side effects of Motrin, Aleve, Voltaren, Midol and other popular pain killers may increase the risk of heart failure, according to the findings of recent research. 

In a study published in the medical journal The BMJ on September 28, researchers from across Europe conducted looked at 27 different drugs classified as non-steroidal anti-inflammatory drugs (NSAIDs), which include popular over-the-counter painkillers, and found that a number of them appear to increase the risk of hospitalization for heart failure. In many case, the higher the dose of the NSAID painkiller, the higher the heart failure risk.

NSAIDs have long been linked to an increased risk of heart problems, and some already carry warnings about a heart attack and stroke risk. However, this latest study sought to weed out which specific NSAIDs had the highest correlation to heart failure risks.

The study looked at patients across Europe who began NSAID treatment between 2000 and 2010. They cross-referenced that with more than 92,000 hospital admissions for heart failure and more than 8.2 million controls.

According to the findings, current use of any NSAID was linked to a 19% increased risk of hospitalization due to heart failure. Researchers found seven specific NSAIDs that were associated with the increased risks, including diclofenac, the active ingredient in Voltaren and Cataflam; Motrin (ibuprofen); Indocin and Tivorbex (indometacin); Toradol (ketorolac) also sold as Acular and Acuvail; Aleve and Midol (naproxen); nimesulide; Feldene (piroxicam); etoricoxib (not sold in the U.S.); and Vioxx, which was recalled due to heart problems in September 2004. Both etoricoxib and Vioxx belong to a class of drugs known as selective COX 2 inhibitors.

The highest association was with Toradol, known generically as ketorolac, which was associated with an 83% increased risk of heart failure hospitalization. Some of the drugs had more than double the risk at very high doses.

“Our study offers further evidence that the most frequently used individual traditional NSAIDs and selective COX 2 inhibitors are associated with an increased risk of hospital admission for heart failure,” the researchers concluded. “Moreover, the risk seems to vary between drugs and according to the dose.”

Researchers said knowing which drugs were linked to the strongest risks of heart failure could help clinicians in prescribing to patients, and health regulators decide which drugs should carry more stringent warnings.

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