Diclofenac, a widely used global drug with anti-inflammatory and analgesic properties, is associated with an increased risk of heart attack, stroke and other serious cardiovascular problems, so its use should be done with moderation rather than for a long time.
And while treatment of pain and inflammation with NSAIDs may be worthwhile for some patients, they concluded: "Considering its cardiovascular and gastrointestinal risks, however, there is little justification to initiate diclofenac treatment before other traditional NSAIDs".
A study published in the British Journal of Clinical Pharmacology focusing on 57,000 people residing in Taiwan also found that taking painkillers such as ibuprofen and naproxen could be linked to having an irregular heartbeat.
There was an increased incidence of serious cardiovascular events among those who had taken diclofenac for one month.
Diclofenac is an NSAID (non-steroidal anti-inflammatory drug), used to treat pain and is used widely across the world.
They suggested diclofenac be prescribed with a warning label attached and banned as an over-the-counter drug in countries like the United States where it's available as such. On the other hand, paracetamol, another common painkiller, as well as ibuprofen, showed reduced risks of heart problems, compared with diclofenac. Current concerns about the cardiovascular safety of NSAID use mean that such a trial would now be unethical, but regulators including the European Medicines Agency are still calling for the safety of diclofenac to be assessed.
Experts have analyzed the cardiovascular risks that come together with diclofenac compared to other non-steroidal anti-inflammatory drugs (NSAIDs).
Both men and women were at higher risk for heart problems, as were those taking low doses of the drug.
Study researcher Morten Schmidt, from Aarhus University Hospital, and colleagues looked at the medical records of over 6 million adults in Denmark spanning the period between 1996 and 2016.
They found an increased rate of major adverse cardiovascular events within 30 days compared with starting other traditional NSAID or starting paracetamol.
The results also suggested that although the absolute risks associated with diclofenac use were highest in individuals who already demonstrated high baseline cardiovascular risk, the relative risk was actually highest in people with the lowest baseline risk.
This is an observational study, so no firm conclusions can be drawn about cause and effect. The problems included cardiac arrhythmia, heart failure, ischemic stroke, stroke, premature death of cardiovascular disease and gastrointestinal haemorrhage.
'It is time to acknowledge the potential health risk of diclofenac and to reduce its use.
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