Diclofenac Painkiller Linked to Increased Cardiovascular & Gastrointestinal Risks, Study Finds
A large-scale observational study analyzing data from over 6.3 million middle-aged adults in Denmark has revealed potential cardiovascular and gastrointestinal risks associated with the painkiller diclofenac. The research,spanning two decades (1996-2016),indicated that initiating diclofenac treatment was linked to a higher incidence of irregular heartbeat,stroke,heart failure,and heart attack compared to those taking paracetamol,ibuprofen,or naproxen.It was also associated with an increased risk of cardiac death and upper intestinal bleeding.
Due to ethical concerns, direct randomized controlled trials comparing diclofenac’s cardiovascular risks to other NSAIDs are currently considered unfeasible. this study, led by Dr. Schmidt and colleagues, provides ample evidence based on real-world patient data.
While the absolute risk of these events remains low for individual patients, the findings suggest that, considering its potential risks, diclofenac should not be the first-line NSAID choice. Dr. Schmidt stated that while NSAIDs can improve quality of life for some, “there is little justification to initiate diclofenac treatment before other traditional NSAIDs” given its cardiovascular and gastrointestinal profile.
the Medicines and Healthcare Products Regulatory Agency (MHRA) already advises against diclofenac use in individuals with pre-existing serious heart conditions. Those with a history of heart failure, heart disease, or stroke should discontinue use entirely. Individuals who smoke, or have high blood pressure, high cholesterol, or diabetes are advised to consult with a healthcare professional before using the drug.
the MHRA maintains that diclofenac remains a safe and effective pain reliever for patients not considered “at-risk.” previous research, including a 2013 Oxford University study, estimated that approximately three out of 1,000 people with moderate heart disease risk taking 150mg of diclofenac daily for a year could experience an avoidable heart attack, with one possibly being fatal. A subsequent review by European health officials corroborated these findings and reinforced the recommendation against diclofenac use in patients with heart conditions or a history of heart attack or stroke.
Diclofenac functions by blocking cyclo-oxygenase, an enzyme responsible for producing chemicals that cause pain, swelling, and inflammation, providing relief for conditions like toothache and period pain.