New Questions About Safety of Pain Relievers

here’s more bad news for people in pain. First we learned that Vioxx could increase the risk of heart attack and stroke. Then Bextra and Celebrex came under similar scrutiny.
Now the entire category of pain relievers called NSAIDs (non-steroidal anti-inflammatory drugs) is under a cloud. Research published in the British Medical Journal (June 11, 2005) suggests that drugs like ibuprofen (Advil, Motrin IB), naproxen (Aleve, Naprosyn) and diclofenac (Cataflam, Voltaren) are also associated with cardiovascular complications.
The scientists studied 9,000 patients who had first heart attacks between 2000 and 2004. They were compared to more than 86,000 other people.
Those who took Vioxx were 32 percent more likely to suffer a heart attack. This statistic resembles what the manufacturer discovered just before it took Vioxx off the market.
More surprising was the discovery that ibuprofen raised the risk of a heart attack by 24 percent. Diclofenac increased a patient’s likelihood of suffering such a complication by 55 percent.
The real shocker was that naproxen also appeared to pose a problem. During recent hearings at the FDA, experts testified that naproxen might protect the heart, almost like aspirin. But the data from England led researchers to conclude, “No evidence was found to support a reduction in risk of myocardial infarction [heart attack] associated with current use of naproxen.” In fact, their data indicate that naproxen carries a risk similar to that of ibuprofen.
Most people think over-the-counter pain relievers like ibuprofen or naproxen are extremely safe. Why else would the FDA allow them to be purchased without a doctor’s prescription?
It comes as a huge shock for people to realize that a medicine they take for granted to relieve the pain of a bad back, tennis elbow or arthritis could affect kidney or liver function, raise their blood pressure, cause a bleeding ulcer or increase their risk of a heart attack.
Although millions take NSAIDs without serious side effects, some people experience unexpected complications. And the possibility of a serious problem poses a dilemma for patients. A person in pain wants relief. But what can a person take?
People with chronic pain need to discuss this double-bind with their doctors. Old-fashioned aspirin is still the gold standard for pain relief and heart protection. A doctor might prescribe aspirin in conjunction with a stomach-protecting medicine called Cytotec. An acid-suppressing drug might also prevent the development of stomach ulcers.
Others may find that alternative therapies such as glucosamine offer relief. We have gathered information on a range of home remedies and other approaches in our Guide to Alternatives for Arthritis. Anyone who would like a copy, please send $3 in check or money order with a long (no. 10) stamped (60 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. AA-2, P. O. Box 52027, Durham, NC 27717-2027.
People in pain deserve relief. For some, NSAIDs may be the best solution. But those at risk for heart disease may have to rely on other approaches to ease their discomfort.