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Study finds ingredient in popular painkiller increases heart attack risk

An ingredient in a popular pain killer could increase the risk of suffering a heart attack, new research has found.

A study published in the British Medical Journal has examined the cardiovascular risk of taking diclofenac which is used in anti-inflammatory medications including Voltaren.

The Danish nationwide study examined 6.3 million patients over the age of 18 on the Danish National Patient Registry between January 1996 until December 2016.

More than 1.3 million of that sample took diclofenac after visiting a doctor, 3.8 million took ibuprofen. Others used paracetamol and naproxen, while 1.3 million took nothing after visiting their healthcare practitioner.

The study monitored what cardiovascular events patients reported within 30 days of initiating their script.

Patients in Denmark were excluded from the study if they had a previous history of heart, kidney or liver diseases, or had dementia or alcoholism related illnesses.

The study, undertaken by Dr Morten Schmidt at Aarhus University in Denmark, found patients who took diclofenac had 50 per cent more likelihood of “major adverse cardiovascular events” within 30 days than those that took nothing; a 20 per cent more likelihood than patients taking ibuprofen or paracetamol; and 30 per cent more than those taking naproxen.

A study in the British Medical Journal has examined cardiovascular risk of diclofenac, the key ingredient of anti-inflammatories including Voltaren. Source: 7 News
A study in the British Medical Journal has examined cardiovascular risk of diclofenac, the key ingredient of anti-inflammatories including Voltaren. Source: 7 News

Diclofenac should not be available over counter, study concludes

The study concluded: “Diclofenac poses a cardiovascular health risk compared with non-use, paracetamol use, and use of other traditional non-steroidal anti-inflammatory drugs”.

In concluding, Dr Schmidt wrote, treatment of pain and inflammation with non-steroidal anti-inflammatory drugs (NSAIDs) “may be worthwhile for some patients”, and diclofenac should not be available over the counter and should come with a warning label.

“Considering its cardiovascular and gastrointestinal risks, however, there is little justification to initiate diclofenac treatment before other traditional NSAIDs,” he wrote.

In Australia, some diclofenac anti-inflammatory products including Voltaren Rapid 25 do not require a prescription but come with a warning only be taken for a few days.

Australian review of diclofenac

In 2014, the Therapeutic Goods Administration did a full safety review of diclofenac in Australia.

It found there was a need to raise awareness about cardiovascular issues associated with NSAIDs among medical professionals and consumers.

The report also recommended consumers check labels and read instructions before taking diclofenac.

A consumer healthcare spokeswoman from GlaxoSmithKline, which engineers Voltaren, told Yahoo7 in a statement diclofenac is “generally recogonised as well-tolerated and effective” when used via the labelling instructions.

“These medicines have a well-established safety profile and are approved as being an effective option for the short-term treatment of pain,” she said.

In fact, another recent study in the Journal of Cardiovascular Pharmacology and Therapeutics that examined NSAID use found that, ‘there is little cardiovascular risk when over-the-counter formulations of these agents are used as directed in their labels.”