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NSAIDs Might Be Risky For People With Heart Problems

As if people with the combination of high blood pressure and heart disease don’t already have enough to worry about, a new study suggests that common painkillers called nonsteroidal anti-inflammatory drugs (NSAIDs) pose special problems for them.

Among participants of an international trial called INVEST, those who often used NSAIDs such as ibuprofen (Advil, Motrin and others), naproxen (Aleve, Naprosyn, and others), or celecoxib (Celebrex) were 47% more likely to have had a heart attack or stroke or to have died for any reason over three years of follow-up than those who used the drugs less, or not at all. The results were published in the July issue of the American Journal of Medicine.

Millions of people take NSAIDs to relieve pain and inflammation. They are generally safe and effective. The main worry with NSAIDs has always been upset stomach or gastrointestinal bleeding. During the last few years, researchers have raised concerns that Read more »

*This blog post was originally published at Harvard Health Blog*

Heart Attack Survivors Should Avoid Certain Pain Medicines (NSAIDs)

New information published in Circulation advises against using any nonsteroidal anti-inflammatory drugs (NSAIDs) in patients who have had a prior heart attack.  These over-the-counter drugs are commonly used  like Advil, Aleeve, Diclofenac, Ibuprofen.  Using NSAIDs for even as little as one week was associated with a 45% increase for death or recurrent myocardial infarction (MI).  The researchers could not identify a period that seemed to be safe, no matter how short.

The study used the Danish National Patient Registry and identified 83,675 patients who had a first MI between 1997 and 2006.  The average age was 68 years and 65% were men.   All the NSAIDs (except Naprosyn) used during the observation period were associated with an increased risk for death or new heart attack.  Diclofenac (brand name Voltaren) was the worst.

Readers should not go away thinking NSAIDs cause heart attacks.  This study looked at patients who had already had an MI.  But for those patients, the over-the-counter pain relievers should be avoided.  Many patients with heart disease also have arthritis or other pain syndromes.  We need to come up with safe treatments for pain or use “safer” NSAIDs like low dose Naprosyn or Ibuprofen only when the benefit is weighed with the risk.

Just because something is sold without a prescription does not mean it is without risk.  Tell your doctor every medication you take.

*This blog post was originally published at EverythingHealth*

Pain Medicines Used More Frequently By Men With Erectile Dysfunction?

The use of Motrin, Aleve and other non-steroidal anti-inflammatory drugs (NSAIDS) is associated with erectile dysfunction, according to a study by scientists affiliated with Kaiser Permanente.

cantgetenough 300x200 NSAIDs Linked to Erectile DysfunctionThe apparent link surprised the scientists. They had hypothesized that the commonly used pain-killers would actually reduce the risk of erectile dysfunction since NSAIDS protect against heart disease, which has in turn been linked to the troubling condition.

To reach their surprising conclusion, Steven Jacobsen and colleagues used data from Kaiser’s HealthConnect EHR, an associated pharmacy database, and self-reports about NSAID use and erectile dysfunction from an ethnically diverse population of 80,966 men between the ages of 45 and 69.

After controlling for age, ethnicity, race, body mass index, diabetes, smoking status, hypertension, high cholesterol and coronary artery disease, the scientists found that men who used NSAIDS at least 3 times per day for at least 3 months were 2.4 times more likely to experience erectile dysfunction than those who did not consume them on a regular basis. The link persisted across all age categories.

Remarkable in its own right was the finding that overall, 29% of the men in the study reported some level of erectile dysfunction.

The authors emphasized that their findings do not prove that NSAID use causes erectile dysfunction. For example, the study findings could have been confounded by factors not considered by the scientists (such as subclinical disease or the severity of the comorbid conditions that were studied), and the chance that NSAID use was actually an indicator for other conditions that caused erectile dysfunction.

In addition, the scientists recognized that their study had some limitations. These included an inability to temporally link NSAID use and the development of ED, and possible selection bias.

As a result, they cautioned men against discontinuing NSAIDs based solely on the findings of their study. “There are many proven benefits of non steroidals in preventing heart disease and for other conditions. People shouldn’t stop taking them based on this observational study. However, if a man is taking this class of drugs and has ED, it’s worth a discussion with his doctor,” Jacobsen said in an interview.

The write-up appears in the Journal of Urology.

*This blog post was originally published at Pizaazz*

Your Pharmacist’s Role In Safe, Effective Prescription Drug Treatment

This is a guest post from Dr. Mary Lynn McPherson.

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Rescuing Patients On Darvon Or Darvocet With Zero Tolerance For Pain

On November 19, 2010 the Food and Drug Administration (FDA) called for a halt in the use of the popular opioid pain relievers Darvocet and Darvon. These products contain the opioid propoxyphene, and it has been used to treat mild to moderate pain for over 50 years. However, concerns have long been raised about the effectiveness of this drug, and the risk of death (accidental and suicide). Darvon and Darvocet were banned in Britain in 2005, followed by the European Union in 2009. Over the past 30 years, the FDA has received numerous petitions to take these drugs off the U.S. market.

Research has shown that Darvon and Darvocet are no more effective for treating moderate pain than over the counter drugs like acetaminophen, aspirin or ibuprofen. Unfortunately, Darvon and Darvocet cause a lot more side effects such as dizziness, drowsiness, nausea and vomiting, hallucinations and constipation (all pretty typical of opioids used to treat pain). But, the side effects don’t stop there. The data is in, and it’s not a pretty picture. A recent study requested by the FDA showed that when used at the recommended doses, Darvon and Darvocet cause significant changes in the electrical activity of the heart, which can lead to a fatal irregularity in your heartbeat, even after only short-term use.

Among those advocating for the removal of these drugs from the market were pharmacists. The American Society of Health-System Pharmacists approved a policy in 2007 advocating for the withdrawal of Darvon and Darvocet from the U.S. market, and recently testified at the FDA Advisory Committee to this effect. As an often overlooked member of the medical team, pharmacists have a vital role to play in providing safe and effective treatments. We serve as the last line of defense against improper or unwise prescribing of drugs — especially those for pain. We are drug experts, and we can help patients and doctors switch from Darvon or Darvocet to safer and more effective treatments. Read more »

Broken Arm? Try Some Ibuprofen

Pain management is a hot topic in medicine in general and certainly in medicine for the outdoors. Injuries in particular, and many illnesses, cause pain, which in turn causes the victim to suffer. To a great extent, pain is subjective, but regardless of whether your pain is a “1” or a “10,” it can be disabling and even dangerous, particularly if it causes you to be distracted in a situation of risk (e.g., climbing, swimming, walking along a ridgeline).

Broken bones usually hurt a great deal. It’s commonly believed that the pain is always of a severity to require the administration of “strong” pain medicine, notably, something containing a narcotic compound. This may not be true. Read more »

This post, Broken Arm? Try Some Ibuprofen, was originally published on Healthine.com by Paul Auerbach, M.D..

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