The common painkiller ibuprofen may boost heart attack risk by blocking the lifesaving effects of aspirin//, a new study shows.
“The public health impact of this is monstrous," Michael Farkouh, director of clinical trials at Mount Sinai Heart, a premier New York cardiovascular centre has said.
“Ibuprofen is relatively safe except when we give it with aspirin to people at high risk of heart attack," Farkouh says. "But when given with aspirin, we do we see an excess of heart attacks."
This is a controversial conclusion. The study itself had not been designed to look at ibuprofen safety, nor has it proved that ibuprofen is harmful to people at high risk of heart disease.
But it does provide a clear warning sign that ibuprofen is risky for people who need the blood-clot-reducing effect of daily low-dose aspirin.
Those taking aspirin in the ibuprofen arm of the study had a ninefold excess of heart attacks.
But another expert Steve Nissen, chairman of cardiovascular medicine at The Cleveland Clinic and past president of the American College of Cardiology, urges caution. He notes that the findings are based on only eight heart attacks among thousands of high-risk patients taking ibuprofen and aspirin.
Still Dr.Farkouh says the numbers may be small but the potential risks are great. And it would not be the first time that relatively small numbers of heart attacks caused a major change in how doctors look at pain drugs.
“The whole Vioxx thing was based on 64 heart events among 21,000 patients studied," Farkouh recalls. "Here we are talking about potentially a higher magnitude of impact. The interaction of ibuprofen with aspirin is a bigger public health concern than Vioxx was."
Rofecoxib, a nonsteroidal anti-inflammatory drug, was marketed under the brand name Vioxx by Merck for treatment of osteoarthritis, and related acute pain conditions.
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