But the authors of a new study argue that diclofenac shouldn't be allowed as an over-the-counter drug, or at the very least, should be accompanied by appropriate warnings. But given the cardiovascular and gastrointestinal risks, there is little justification for starting a diclofenac treatment before testing other traditional NSAIDs, "the researchers concluded".
It's always important to discuss medication and the potential risks it will have on your health with a GP or health professional.
During the study period, the researchers examined the cardiovascular risks of taking up diclofenac and compared them with the risks of starting paracetamol, ibuprofen, or naproxen.
Schmidt and team examined 252 national studies for information on over 6.3 million Danish people over a period of 20 years in 1996-2016.
"Treatment of pain and inflammation with NSAIDs may be of value to some patients to improve their quality of life despite possible side effects".
In those who took diclofenac for 30 days, the risk rose by a huge 50% - compared to those not taking any drugs.
Shock new findings show Diclofenac - a drug used to treat back pain, headaches and arthritis - is linked to "major cardiovascular events".
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Unfortunately, besides heart attacks, the study links diclofenac to cardiovascular disease which includes arrhythmic heartbeats, ischemic stroke, and heart failure.
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.
For those at moderate risk at the start, they found 7 extra cardiovascular events with diclofenac compared with ibuprofen or naproxen; 8 extra events compared with paracetamol; and 14 extra events compared with no NSAIDs. The researchers' paper is titled, "Diclofenac use and cardiovascular risks: series of nationwide cohort studies".
However, while the relative risk increased, the absolute one remained low for the individual patient. For people at high risk of cardiovascular disease, that number would shoot up to 40, with half dying.
The researchers worked to assess the cardiac risk associated with diclofenac in individuals who weren't taking any NSAIDs, who had started taking other common NSAID pain relievers, and who were taking paracetamol (acetaminophen), commonly sold under the brand name Tylenol.
However, they add: "This is an observational study, so no firm conclusions can be drawn about cause and effect".
The authors say their results also indicate that using diclofenac as a reference for demonstrating the safety of selective COX-2 inhibitors represents "a potential flaw in safety trials".
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