Cheap over-the-counter painkillers taken by millions of people could significantly raise the risk of fatal heart problems, a major study suggests.
People who take ibuprofen – which is available in corner shops, supermarkets and petrol stations – have a 31 per cent increased risk of cardiac arrest, researchers found.
The scientists, from Copenhagen University Hospital in Denmark, called for far tougher controls on the drugs.
Heart expert Professor Gunnar Gislason, who led the study, said they should only be available in pharmacies.
People who take ibuprofen – which is available in corner shops, supermarkets and petrol stations – have a 31 per cent increased risk of cardiac arrest
‘Allowing these drugs to be purchased without a prescription, and without any advice or restrictions, sends a message to the public that they must be safe,’ he said.
Cardiac arrest occurs when the heart suddenly stops pumping blood around the body – if it is not restarted with defibrillator the patient will die within minutes.
It is far more serious, for example, than a heart attack, in which a blood clot cuts the oxygen supply to the heart but patients often survive.
The Danish researchers analysed 29,000 cases of cardiac arrest between 2001 and 2010, assessing their drug use in the preceding 30 days, and compared the data to use of medicines among the general population.
Patients who had taken ibuprofen were 31 per cent more likely to suffer cardiac arrest within a month than those who did not take the drugs.
Other medicines from the same family of painkillers, known as non-steroidal anti-inflammatory drugs – or NSAIDs – were also assessed.
They included diclofenac, which raised the risk by 50 per cent, and was available over the counter in the UK until 2015.
Today, it can only be obtained on prescription. Three other NSAIDs, naproxen, celecoxib and rofecoxib, produced no statistically significant increase in risk.
Even over-the-counter painkillers like ibuprofen (pictured) are not ‘harmless’ and should be used with caution, says the study
Professor Gislason, whose work is published in the European Heart Journal, said: ‘The findings are a stark reminder that NSAIDs are not harmless.
‘Diclofenac and ibuprofen, both commonly used drugs, were associated with significantly increased risk of cardiac arrest.
‘They should probably be avoided in patients with cardiovascular disease or many cardiovascular risk factors.’
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Ibuprofen and diclofenac are the most common form of a class of painkillers called Non-Steroidal Anti Inflammatory Drugs, known in the medical profession as NSAIDs.
The drugs are most often taken as a pill or capsule, but are also available as creams, gels or injections.
They are widely used for pain, sprains, inflammation, colds, flu and period pains.
Until recently they were also used for arthritis and back pain – but several recent studies have suggested they could do more harm than good in such cases, and that patients are better off exercising. Ibuprofen can be sold by any supermarket or corner shop, often for as little as a penny a tablet. The more powerful diclofenac – widely bought under the brand Voltarol – was made prescription-only in 2015 because of concerns about possible risk of heart problems.
NSAIDs work by blocking the COX-2 enzyme which reduces pain and inflammation. This enzyme, however, is also important in regulating heart function
Sales of over-the-counter painkillers amounted to almost £600million in the UK in 2015, according to The Pharmaceutical Journal.
He added: ‘I don’t think these drugs should be sold in supermarkets or petrol stations where there is no professional advice on how to use them.
‘Over-the-counter NSAIDs should only be available at pharmacies, in limited quantities and in low doses.’
‘The current message being sent to the public about NSAIDs is wrong.
‘If you can buy these drugs in a convenience store then you probably think ‘they must be safe for me’.
The researchers suspect the drugs may raise heart risk in several different ways.
They may cause arteries to constrict, increase fluid retention and raise blood pressure.
Alternative theories include the possibility that they encourage the clumping of platelets and formation of blood clots.
Sales of over-the-counter painkillers amounted to almost £600 million in the UK in 2015, according to The Pharmaceutical Journal.
Prof Gislason warned people not to take more than 1,200 mg of ibuprofen in one day.
He added: ‘Diclofenac is the riskiest NSAID and should be avoided by patients with cardiovascular disease and the general population.
‘Safer drugs are available that have similar painkilling effects so there is no reason to use diclofenac.’
Dr Mike Knapton, associate medical director at the British Heart Foundation, said: ‘The most important point to take away from this study is to discuss all possible treatment options with your doctor, as well as the pros and cons of certain drugs, before you start taking any new medication.
‘Although not all NSAIDs were found to be associated with increased risk of cardiac arrest, discussion with your doctor is imperative to make informed choice about the best treatment for you.
‘For patients currently taking NSAIDS, including ibuprofen and diclofenac, the risks need to be reviewed and your specialist or GP will be able to advise on potential alternative treatments.’
But John Smith, chief executive of the Proprietary Association of Great Britain, which represents the over-the-counter medicine industry, said: ‘The authors admit that the study has several limitations and highlight that it reports only associations and therefore any conclusions should be made with caution.
‘NSAIDs available over the counter, such as ibuprofen, are an effective and appropriately safe way to provide short-term pain relief if used in accordance with the clear on-pack instructions and the patient information leaflet inside.’