NSAIDs Increase Risk of Heart Attacks
On Thursday, the FDA announced stricter warnings on NSAIDs, including Motrin (Ibuprofen) and Aleve (Naproxen) as a result of a new study demonstrating increased risk for heart attacks and stroke. In this Annapolis Primary Care spotlight, we look to dispel the myth that Ibuprofen and Naproxen are safer than Tylenol.
The FDA has had a warning on NSAIDs for years and doctors have (or should have) warned patients that Tylenol (Acetaminophen) is a safer pain reliever (assuming one does not exceed the dosing guidelines). But now, new evidence shows that drugs like Aleve, Advil and Motrin increase the risk of heart attack as soon as the first week of taking these medications.
The FDA warnings are summarized:
- Risk for heart attack begins as early as the first week of use
- Risk for heart attack increases with higher doses
- People who’ve had a heart attack in the past are at even higher risk
- Patients treated with NSAIDs following a first heart attack were more likely to die in the first year
- There is also an increased risk of heart failure
Dr. Steven Nissen, chairman of cardiovascular medicine at the Cleveland Clinic, was asked ‘Should I stop taking my occasional Motrin?’ ” His answer is “No,” according to this NPR article.
What About Aspirin?
The non-aspirin NSAIDs work in a different way than aspirin, says Mark Creager, MD, president of the American Heart Association, according to an article published in WebMD. He continued, “Aspirin as we know from many, many studies, is protective against heart attacks,” he says. Aspirin blocks an enzyme that prevents platelets from clumping together and forming dangerous clots that can block a vessel and cause a heart attack or stroke. The non-aspirin NSAIDs work on that enzyme, too, but also affect another enzyme that promotes clotting.
What If I Have to Take NSAIDs?
Evolve Medical recommends using the lowest effective dose for the shortest possible time. Also, consider an alternative. Although Tylenol (Acetaminophen) can be extremely dangerous if used in higher doses, it actually is a very safe medication if one follows the FDA guidelines. Specifically, no more than 3,500mg Tylenol per day and no more than 1000mg Tylenol at any given time. Tylenol dosing is maximum of 1000mg every 8 hours.
The FDA suggests you get medical attention right away if you notice any of the following:
- Chest pain
- Shortness of breath
- Trouble breathing
- Slurred speech
- Weakness on one side or part of the body
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