Are your aches and pains going to give you a heart attack?
The U.S. Food and Drug Administration said in July it was strengthening an existing warning label that non-aspirin, non-steroidal anti-inflammatory drugs (NSAIDs) increase the chance of a heart attack or stroke. The agency said it would require updates to the labels of prescription and over-the-counter (OTC) non-aspirin NSAIDs.
But what does that mean for the millions of people who take the widely used painkillers for occasional aches and pains, and to treat chronic medical conditions such as arthritis especially considering heart disease and stroke remain the top two causes of death in the world.
The new warnings from the FDA point out:
- Heart attack and stroke risk increase even with short-term use, and the risk may begin within a few weeks of starting to take an NSAID.
- Estimates of increased relative risk range from 10 percent to 50 percent or more, depending on the drugs and the doses taken for a longer period of time.
- The risk is greatest for people who already have heart disease, though even people without heart disease may be at risk. There are nearly 2.7 million people living with heart disease in the UK.
- One type of NSAID was not deemed to safer than another. Previous studies have suggested that naproxen may be safer than other types of NSAIDs, but the new evidence reviewed by the expert panel was determined to simply not be strong enough to support claims of naproxen’s safety.
“Even the occasional user is taking a risk,” says Edith Egnankou, Pharm.D, a U.S. Pharmacotherapist and owner of Friendship Pharmacy. The new warning, she says, “applies to people with or without a history of heart disease so the underlying message is no NSAID whether it’s a prescription or a lower does over-the-counter (OTC) is completely safe.”
She also advises consumers to read labels to make sure they are not taking several medications that contain NSAIDs. Higher doses carry a high risk.
Dr. Peter Wilson, a professor of medicine and public health at Emory University in Atlanta was a member of the expert panel convened by the F.D.A last year to sift through new evidence on the drugs, including a meta-analysis of a number of randomized trials and observational studies coordinated by researchers at the University of Oxford.
The consensus from the data is that people over 65 with a history of heart disease should be especially careful. The thought is these are good for short-term relief probably for your younger person with no history of cardiovascular trouble.
Even younger people are looking for alternatives to NSAIDs because of unwanted side effects. “I could take ibuprofen until the cows come home,” said Christopher Moniz, a 28-year old lobster fisherman in Bridgewater, Maine who describes his carpel tunnel syndrome as severe, “but it’s not worth tearing up my stomach so I tried a natural product with turmeric” he said. “I’m on the boat for a week at a time and I swear by it, works for me.”
“It’s a risk-benefit decision,” said Myles Altorelli, MD, a chiropractor in New Preston, CT.
“For many arthritis patients, NSAIDs reduce joint pain and swelling rather effectively and help them to enjoy a reasonable quality of life,” he said.
Dr. Altorelli emphasized that for people who are in the habit of taking drugs for mild pain the new warning might have them searching for a more natural alternative. Despite the studies, he admits his own previously held skepticism of the efficacy of Turmeric until his own mother found relief from her arthritis.
“Anecdotally I do see patients having great success with Turmeric,” Dr. Altorelli said.
Turmeric is a powerful herb in the ginger family that contains curcumin as its active ingredient. Used for thousands of years as a natural pain reliever, today it’s scientifically recognized for it’s anti-inflammatory properties and is widely used for the treatment of disorders associated with inflammation.
Over a thousand studies have shown all the dramatic benefits that this health promoting herb offers, especially for the treatment of arthritis. In one study, Turmeric extract was found to be safe and equally effective as a non-steroidal anti-inflammatory drug for the treatment of osteoarthritis of the knee (1).
There are other heath benefits as well. Chronic inflammation is known to be a contributor to many common Western diseases. Curcumin can inhibit many molecules known to play a major role in inflammation. It is an antioxidant and has been linked to improved brain function and a lower risk of brain disease.
Curcumin has beneficial effects on several factors known to play a role in heart disease; it may prevent cancer and has been found to be as effective as an anti-depressant. It’s also highly effective in reducing nerve pain, burning feet and the excruciating pain associated with shingles.
Turmeric is also safe for long-term use and although it’s recommended to discontinue use two weeks prior to surgery as it may act a blood thinner, it certainly won’t increase your risk for a heart attack or a stroke.
- Kuptniratsaikul V, Dajpratham P, Taechaarpornkul W, et al. Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: a multicenter study. Clin Interv Aging. 2014 Mar 20;9:451-8.
|GENERIC NAME||BRAND NAME(s)|
|diclofenac||Cambia, Cataflam, Dyloject, Flector, Pennsaid, Solaraze, Voltaren, Voltaren-XR, Zipsor, Zorvolex, Arthrotec (combination with misoprostol)|
|diflunisal||No brand name currently marketed|
|etodolac||No brand name currently marketed|
|ibuprofen*||Advil, Caldolor, Children’s Advil, Children’s Elixsure IB, Children’s Motrin, Ibu-Tab, Ibuprohm, Motrin IB, Motrin Migraine Pain, Profen, Tab-Profen, Duexis (combination with famotidine), Reprexain (combination with hydrocodone), Vicoprofen (combination with hydrocodone)|
|ketoprofen||No brand name currently marketed|
|nabumetone||No brand name currently marketed|
|naproxen*||Aleve, Anaprox, Anaprox DS, EC-Naprosyn, Naprelan, Naprosyn, Treximet (combination with sumatriptan), Vimovo (combination with esomeprazole)|
|tolmetin||No brand name currently marketed|
*There are many over-the-counter (OTC) products that contain this medicine.
Written by Keith Nalepka
Keith Nalepka is the CEO of Herbal Health Care Group, the makers of Noxicare – the only natural topical pain relief cream that contains Turmeric.