Ibuprofen can be taken every day
Ibuprofen: Less dangerous than feared
Years ago studies had shown that pain relievers from the group of non-steroidal anti-inflammatory drugs (NSAIDs) increase the risk of stroke, heart attack and the like. In addition to ibuprofen, NSAIDs also include acetylsalicylic acid, diclofenac, naproxen and the group of selective COX-2 inhibitors (coxibs). The latter also includes the active ingredient rofecoxib, which was withdrawn from the market in 2004 due to an increased number of deaths.
As a result, the European Medicines Agency (EMA) investigated a possible cardiovascular risk from diclofenac and assessed it as questionable in this regard in 2013. In the meantime, the experts from the EMA's Pharmacovigilance Risk Assessment Committee (PRAC) have evaluated the risk of ibuprofen use.
1200 milligrams are not dangerous
For doses up to 1200 milligrams per day, as they are approved for self-medication, the researchers could not determine an increase in the risk of cardiovascular incidents. However, that changed from a daily dose of 2400 milligrams - the recommended maximum daily dose under medical supervision. The subjects who took such a high dose had a slightly higher rate of heart attack, stroke, or other cardiovascular disease. The risk at this dose was similar to that of taking diclofenac or the so-called coxibs.
Adapt therapy recommendation
Overall, the Committee believes that the benefits of ibuprofen still outweigh the risks. However, he calls for the recommendations on high-dose therapy to be updated. Long-term therapy, especially in high doses, must always be carefully considered, especially for people with other risk factors for the heart and circulation. These include smoking, high blood pressure, high cholesterol, and diabetes. Patients who have already suffered a stroke or heart attack or who suffer from other cardiovascular problems should no longer receive daily doses of 2400 milligrams at all, writes the PRAC.
Does ibuprofen reduce the effects of ASA?
The painkillers naproxen and acetylsalicylic acid (ASA) are considered less of a concern with regard to cardiovascular health - but they involve other risks, especially internal bleeding. ASA is even widely used to prevent heart attacks and strokes. These active ingredients are designed to prevent platelets from clumping together and blood clots from forming. The PRAC has investigated whether ibuprofen reduces the effects of low-dose acetylsalicylic acid. The result: Occasional use does not affect the benefits of ASA. How long-term use of ibuprofen affects the effects of ASA, however, remains unclear.
How NASR work
Non-steroidal anti-inflammatory drugs (NSAIDs) reduce the production of prostaglandins. This hormone transmits pain signals. When injured, the body releases more of it. It also plays an important role in inflammatory reactions and fever. Its inhibition has an analgesic, anti-inflammatory, anti-rheumatic and antipyretic effect.
Press release of the European Medicines Agency - Science, Medicines, Health from April 13th, 2015
Coxib and traditional NSAID Trialists' (CNT) Collaboration: Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyzes of individual participant data from randomized trials. The Lancet (2013). doi: 10.1016 / S0140-6736 (13) 60900-9
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