The use of diclofenac more than 7 days a month increases the incidence of stroke and myocardial infarction. The results, published in the British Medical Journal, confirm the concerns expressed by the European Medicines Agency (EMA).
Why is diclofenac dangerous?
Diclofenac is a common non-steroidal anti-inflammatory drug (NSAID) developed in the 1960s. According to studies, 1/5 of women and almost 1/3 of men take analgesics for longer than 4 days. Overuse of pain medication leads to gastrointestinal bleeding and kidney damage.
In the fall of 2004, it became known that a drug with a similar mechanism of action (refecoxib) led to an increase in heart attacks.
Diclofenac, along with other NSAIDs, is also suspected of increasing the risk of blood clots.
The half-life of the drug is very short - from 1 to 2 hours. Long-term pain relief requires relatively high dosages, which leads to severe blockade of COX enzymes. Therefore, diclofen increases the risk of developing cardiovascular disease similarly to rofecoxib.
Epidemiological studies have already shown that diclofenac is more dangerous for blood vessels and the heart than other NSAIDs. Therefore, EMA has long been calling for limiting the use of diclofenac.
Dispensing a prescription drug can significantly reduce the number of myocardial infarctions and strokes. In 2020, Russia also intends to limit the sale of painkillers.
Is the harm finally proven?
In 2017, a Danish study was conducted that put an end to the degree of harm of an anesthetic. In Denmark, diclofenac was always prescribed by prescription. Researchers were convinced that only prescription people took painkillers.
Scientists compared consumers of diclofenac and other NSAIDs, as well as people who did not need pain medication. They estimated the number of severe cardiovascular diseases in the next 30 days. Between January 1996 and December 2016, 252 clinical trials were conducted.
In all estimates, diclofenac when taken in the first 30 days was more dangerous than paracetamol or other analgesics.
Atrial fibrillation, ischemic stroke, heart failure and myocardial infarction are the main consequences of the medication.
Clinical consequences were 50% more frequent among diclofenac users. Compared to paracetamol or ibuprofen, the risk was 40–50% higher.
Diclofenac was also not good for gastrointestinal complications. The risk of upper gastrointestinal bleeding was 4.5 times higher in the first 30 days than those who did not take NSAIDs.
Also, the risk was 2.5 times higher after therapy with ibuprofen or paracetamol. Bleeding occurred as often as after treatment with naproxen, which is usually explained by worse gastrointestinal tolerance.
The numbers confirm the EMA estimate, which has already called for a limit on sales of diclofenac in June 2013. However, for an individual consumer, the risk remains undetectable. The absolute risk of developing atrial fibrillation or heart failure after taking diclofenac is 1%.
Is taking diclofenac in the first week the most harmful?
Dutch scientists have concluded that the risk of cardiovascular disease increases in the first week of use. Therefore, even a short-term recipe cannot be classified as "harmless."
The probability of dying from a heart attack in the first week is 5-7%. The risk increases with the duration of use and the dose of the medication.
According to scientists, doctors should inform their patients about this; in some cases, the risk may affect the decision to treat. According to scientists, the drug causes the greatest harm when used for more than 4-8 days per month.
For any chronic pain that lasts more than 7 days, you must seek medical advice. Self-medication is strictly prohibited, as it leads to unpredictable consequences.
