WARNING: Over The Counter Painkillers Linked To Cardiovascular Deaths, Strokes, Liver Damage and Kidney Failure
Almost more than 400 million people globally use over-the-counter nonsteroidal anti-inflammatory drugs
) to treat pain. At the same time each year worldwide, NSAID
use is attributed to approximately 1.4 million hospitalizations and more than 350,000 deaths.(far more than the coronavirus death toll), yet there is very little media coverage of even public awareness of these data. NSAIDS
include drugs like Acetaminophen
However after emerging studies, the U.S. Food and Drug Administration recently strengthened its warning about risks of non-aspirin NSAIDs
on heart attacks
Though each over-the-counter and prescription pain reliever
has benefits and risks, deciding which one to use is complicated for health care providers and their patients. Individuals as a whole should always consult a doctor before taking any NSAIDs
as any unknown underlying health problem could prove fatal when one takes OTC drugs like NSAIDs
In order to provide guidance to health care providers and their patients in their clinical decision-making, researchers from Florida Atlantic University's Schmidt College of Medicine have published a review in the Journal of Cardiovascular Pharmacology and Therapeutics addressing cardiovascular risks and beyond, which include gastrointestinal and kidney side effects of pain relievers
They researchers examined the benefits and risks of over-the-counter and prescription drugs for pain relief such as aspirin, ibuprofen
), and prescription drugs such as diclofenac
), a non-aspirin NSAID
, and selective cyclooxygenase-2 inhibitors such as celecoxib
) as well as acetaminophen
Traditional non-aspirin NSAIDs include ibuprofen
) and diclofenac
n) as well as selective cyclooxygenase 2 inhibitors (COXIBs), such as celecoxib
), and acetaminophen
is also a NSAID.
Healthcare providers and individuals have to basically understand that all of these drugs have benefits and risks. Aspirin decreases inflammation as well as coronary events and stroke, but increases gastrointestinal symptoms and bleeding, however, without adverse hepatic or renal consequences.
decrease inflammation, but have been associated with adverse major coronary events and stroke with long-term use as well as major upper gastrointestinal and kidney side effects, as well as electrolyte imbalances such as high sodium or potassium and even heart failure.
COX2 or Cyclooxygenase 2 inhibitors were developed primarily because of their more favorable gastrointestinal side effect profile relative to aspirin
and traditional non-aspirin NSAIDs
, but confer adverse cardiovascular as well as hepatic and renal effects.
) has no clinically relevant anti-inflammatory properties and accounts for more than 50 percent of drug overdose related liver failure and about 20 percent of liver transplant cases, as well as kidney disease.
First author of the study, Dr Manas Rane, M.D., from the FAU's Schmidt College of Medicine told Thailand Medical
News, "With respect to the benefits and risks of pain relievers, the totality of evidence suggests that health care providers and their patients should make individual clinical judgements based on the entire risk factor profile of the patient. The judicious individual clinical decision-making about the prescription of NSAIDs
to relieve pain based on all these considerations has the potential to do much more good than harm."
Dr Charles H. Hennekens, M.D., Dr.P.H., corresponding author, first Sir Richard Doll Professor and senior academic advisor in FAU's Schmidt College of Medicine further commented, "The factors in the decision of whether and, if so, which drug to prescribe for relief of pain and inflammation, should not be limited to risks of cardiovascular or gastrointestinal side effects. These considerations should also include potential benefits including improvements in overall quality of life resulting from decrease in pain or impairment from musculoskeletal pain syndromes."
Meanwhile individuals are strongly advised against adopting any attitude of self-prescribing or simply getting incomplete information from pharmacists and purchasing painkillers
to consume to treat their pain conditions as it can end up being fatal. Always consult a doctor prior to taking any drugs.
Reference: Manas A. Rane et al, Risks of Cardiovascular Disease and Beyond in Prescription of Nonsteroidal Anti-Inflammatory Drugs, Journal of Cardiovascular Pharmacology and Therapeutics (2019). DOI: 10.1177/1074248419871902