Non Steroidal Anti-Inflammatory Drugs (NSAIDs) include popular brands such as Aleve and Advil. The market for all NSAIDs is huge at about 12 billion dollars a year. The primary indication for their use is the relief of pain and swelling from inflammation. Most of those who take these medications long term are aware that they cause an increased risk of bleeding but very few know that these popular medications may cause you to have a heart attack or a stroke.
Do you remember Vioxx. It was a NSAID, a COX2 inhibitor, manufactured by Merk and had a brief moment of popularity until it was discovered that it was responsible for about 140,000 heart attacks. It was quickly taken off of the market as were other COX2 inhibitors manufactured by Pfizer, Novartis and Merk. Celebrix has been retained on the market but with “black box” warning
The reason that COX-2 inhibitors can cause heart attacks and strokes is that they suppress the production of prostacyclin in the body. This in turn increases the tendency for blood to clot, and intravascular clotting can impede the blood flow to the heart and brain.
With these facts in mind he FDA issued this warning and advisory regarding taking NSAIDs
1) The heart attack and stroke risk from NSAIDs increase even with short term use and may begin within a few weeks.
2) The risk increases with higher doses taken for longer periods of time
3) The risk is greater for people who already have heart disease
The advice is:
1) Take the lowest dose that helps and limit the length of time that you take it
2) Never take more than one type of NSAID at a time
3) If you are taking a NSAID long term, periodically take a week long holiday from the medication
The best advice as always with all medication is don’t take it unless you really need it.