Over-the-Counter Doesn't Mean Safe: NSAIDs Risk Heart Health Pop open your medicine cabinet and count how many NSAIDs (aspirin, ibuprofen, naproxen sodium) you have on hand. (Common brands include Bayer, Excedrin, Advil, Motrin and Aleve.) Or walk down the pain reliever aisle at your local drug retail store and see hundreds lining the shelves. We're all pretty used to these seemingly benign over-the-counter products and many people use them quite liberally.

The thing is, they're not benign. They're dangerous. Evidence shows that these widely used drugs, even in small amounts, can increase risk of heart attack and stroke.

FDA: NSAIDs Increase Risk of Heart Attack and Stroke

The Food and Drug Administration (FDA) made waves in the medical world in July of 2015, announcing that the existing label warnings on non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) will be strengthened. Here's a brief rundown of the information, directly from the FDA's safety announcement, to be included:

Over-the-Counter Doesn't Mean Safe: NSAIDs Risk Heart Health
  • "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."

Use Medication with Caution

In an article for the New York Times, Professor Bruce Lambert, director of the Center of Communication and Health at Northwestern University, explains that the evidence against these drugs "is now extremely solid." Lambert also stated, "I don't think we will ever see a study that says, 'Oops, NSAIDs were safe after all."

Most NSAIDs were developed in the 1950s and have been sold over-the-counter for years. Armed with this new information, it's likely that if NSAIDs came out today, they'd be prescription only. The most powerful lesson in all of this—is to always heed caution, take medications sparingly and opt for conservative, natural forms of treatment whenever possible.

Sources:

FDA Drug Safety Communication: FDA strengthens warning that non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) can cause heart attacks or strokes, FDA, accessed 2016

Experts Urge Sparing Use of Nonaspirin Painkillers, The New York Times, July 13, 2015