Study: Most Painkillers Up Heart Attack Risk
But Researchers Say Risk Is Minimal for Low Doses of Painkillers
WebMD News Archive
June 15, 2005 -- A new study shows that most prescription and
over-the-counter painkillers increase the risk of heart attacks.
In the wake of the largest study to date showing most nonsteroidal
anti-inflammatory drugs (NSAIDs) -- including ibuprofen, naproxen, and Celebrex -- increase the risk of heart attacks in
people with arthritis, experts are once again
urging all involved to weigh their individual risks when choosing a
"This is a class effect of all the drugs," researcher Gurkirpal Singh, MD,
professor of medicine, immunology, and rheumatology at Stanford University
Medical School in Palo Alto, Calif., tells WebMD. Singh's study was presented
at the Annual European Congress of Rheumatology in Vienna, Austria.
But the study shows the risk is minimal at lower doses.
This controversy over painkillers and heart attacks first focused on drugs
like Vioxx, Bextra, and Celebrex -- so called Cox-2 drugs. But Singh points out
that even traditional anti-inflammatory painkillers carry this heart risk.
"All the hysteria was over the Cox-2 drugs, and we are saying that it's not
just Cox-2 ... drugs that are doing it. It could occur with any NSAID." He says
that some of the older, traditional NSAIDs are associated with the highest
Last April, the FDA issued new label warnings for all anti-inflammatory
painkillers -- prescription and over the counter.
Prescription painkillers will now carry "black box" alerts warning of heart
disease and stroke risk. Over-the-counter brands -- usually taken at lower
doses and for a shorter amount of time -- must alter their labels to include
more risk information. At the same time, the FDA stressed that there was no
increased risk from short-term use of over-the-counter painkillers. They
recommend checking with your doctor if you need over-the-counter painkillers
for more than 10 days.
Aspirin is not included in the warnings as there is strong evidence that it
can help prevent heart disease. Acetaminophen (Tylenol) is not an
anti-inflammatory drug and also is not included in the warnings.
Drugs With the Highest Risk
Indomethacin (Indocin) and sulindac (Clinoril) -- both traditional NSAIDs --
had the highest risk in the new study. Indomethacin increased heart risk by 71%
and sulindac by 41%.