One NSAID More Dangerous than All the Others?

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I see countless patients who by middle age or older become what I call an NSAID addict.  While these patients often believe they’re smartly using the stuff around them to keep active as they age, little do they know that using these drugs denotes a ticking time bomb of health risks. Now, a new study adds a bit more fuel to the idea that these are dangerous drugs.

NSAID Addicts

I see these patients in the office every day. Their addiction usually begins at the recommendations of a doctor, maybe their family physician or an orthopedic surgeon. They have middle-aged aches and pains that prevent them from doing what they want to do. Instead of going to a physician who will look at what’s wrong, diagnose, and treat these issues with precise regenerative medicine injections, they begin popping NSAID drugs, like Motrin or its prescription cousins. They get to a point that they have to pop a pill just to work out or be active. Little do they know that they are addicted to some of the most dangerous drugs we have.

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What Is Diclofenac?

Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID). In the U.S., diclofenac is only available by prescription (brands include Cambia, Voltaren, Zipsor, etc.), but in some countries it can be purchased over the counter. It is commonly prescribed for pain and inflammation in conditions such as arthritis and even migraines.

While we know all NSAIDs are dangerous, it seems diclofenac may be more dangerous than all the others.

Diclofenac a Serious Cardiovascular and GI Risk

The purpose of the new study (a cohort combining 252 studies) was to study any cardiovascular adverse events in low-risk subjects after taking the NSAID diclofenac and then compare these to adverse events in those taking other NSAIDs (ibuprofen and naproxen), acetaminophen, or nothing. The results? Compared to those who took nothing, there was a 50% increase in adverse events in those taking diclofenac. Compared to those taking acetaminophen or ibuprofen, the adverse events increase for diclofenac was 20%, and compared to naproxen, it was 30%. So what exactly were these cardiovascular adverse events? Findings included atrial fibrillation or flutter, ischemic strokes, heart failure, heart attacks, and even death due to a cardiac event.

Another disturbing finding was that diclofenac also was found to increase the risk of a gastrointestinal (GI) bleed—a dangerous side effect that has already been well established with NSAIDS and is required, along with the cardiovascular risks, by the FDA to be on the warning label; however, the GI bleed risk is significantly higher (two and a half times higher in fact) with diclofenac when compared to the NSAID ibuprofen.

A Review of More Reasons to Stay Away from NSAIDs

As if the risk of death from a heart attack or GI bleed isn’t troubling enough, there are many, many more reasons to stay away from NSAIDs. Whether it’s a prescription NSAID, such as Voltaren (diclofenac) or Celebrex (celecoxib) or even a seemingly more innocuous over-the-counter NSAID (don’t be fooled just because you can buy Advil [ibuprofen] right off the shelf—these are very dangerous drugs), the side effects apply. Let’s take a look at some of these:

Additionally, NSAIDs even in normal dosages can be risky, but many consumers exceed these minimum NSAID dosages without even knowing it. How? Either by taking too much (the label directs one pill, but the consumer takes two) or by taking two drugs for two separate conditions and not realizing both are actually NSAIDs. This unintentional overdosing significantly increases the risk of dangerous side effects and can even cause an accidental poisoning, so if you’re going to take the risk with NSAIDs, make sure you are well aware of the maximum dosages.

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What Can You Do?

Read my book Proactive! It contains everything you need to know to avoid being an NSAID addict! Click on the book cover below to learn these secrets:

Regenexx Proactive Book

The upshot? Don’t become and NSAID addict! Take care of your body, and don’t pop pills that increase your chances of kicking the bucket!

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile

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