Heart attack survivors must evaluate every aspect of their lives, most especially the medications they take, and popular over-the-counter pain relievers like ibuprofen are no exception. But, is it safe to take ibuprofen after a heart attack? You may be surprised by the answer.
Ibuprofen is in a class of medications referred to as NSAIDs, nonsteroidal anti-inflammatory drugs, and is an ingredient in several OTC drugs, most notably pain relievers under the brand names of Advil and Motrin. Check the label to find out if your medication contains ibuprofen if you’re unsure.
In 2005, the Food and Drug Administration issued a warning regarding NSAIDs that said the drugs “might” increase the chance of a heart attack or stroke; a decade later the FDA upgraded the warning to “will,” according to CBS Denver.
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According to FDA
, its 2015 guidelines on NSAID labels are as follows:
- The risk of heart attack or stroke can occur as early as the first weeks of using an NSAID. The risk may increase with longer use of the NSAID.
- The risk appears greater at higher doses.
- It was previously thought that all NSAIDs may have a similar risk. Newer information makes it less clear that the risk for heart attack or stroke is similar for all NSAIDs; however, this newer information is not sufficient for us to determine that the risk of any particular NSAID is definitely higher or lower than that of any other particular NSAID.
- NSAIDs can increase the risk of heart attack or stroke in patients with or without heart disease or risk factors for heart disease. A large number of studies support this finding, with varying estimates of how much the risk is increased, depending on the drugs and the doses studied.
- In general, patients with heart disease or risk factors for it have a greater likelihood of heart attack or stroke following NSAID use than patients without these risk factors because they have a higher risk at baseline.
- Patients treated with NSAIDs following a first heart attack were more likely to die in the first year after the heart attack compared to patients who were not treated with NSAIDs after their first heart attack.
- There is an increased risk of heart failure with NSAID use.
Given that the warnings are alarming, Harvard Medical School issued some recommendations
for using NSAIDs, such as ibuprofen, safely. Harvard advised that an occasional dose for pain is probably safe, but long-term usage could be dangerous; however, the medical school stressed that people with a heart condition should avoid ibuprofen altogether. For everyone else, proceed with caution, in the following steps:
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The British Heart Association, also cautions against taking ibuprofen
- It’s important to take the lowest effective dose, and limit the length of time you take the drug.
- Never take more than one type of NSAID at a time. There appears to be risk associated with all types of NSAIDs.
- Try alternatives to NSAIDs such as acetaminophen. It relieves pain but does not appear to increase heart attack or stroke risk. However, acetaminophen can cause liver damage if the daily limit of 4,000 milligrams is exceeded, or if you drink more than three alcoholic drinks every day.
- If nothing else works and you need to take an NSAID for arthritis or other chronic pain, try taking weeklong “holidays” from them and taking acetaminophen instead.
- If you experience chest pain, shortness of breath, or sudden weakness or difficulty speaking while taking an NSAID, seek medical help immediately.
with aspirin after a heart attack. Because aspirin is given to heart attack patients to reduce clotting, combining the two drugs could increase the risks of bleeding and subsequent heart attacks.
“The side effects include an increased risk of gastric bleeding and kidney problems. Part of treatment following a heart attack is the prescription of anti-clotting medication which reduces the risk of another heart attack,” said BHA Senior Cardiac Nurse Maureen Talbot.
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