Researchers in Denmark are calling for tighter restrictions on the sale of popular painkillers like ibuprofen and diclofenac after linking it with a significantly increased risk of cardiac arrest, according to findings published in the European Heart Journal on Wednesday (Mar 15).
Ibuprofen could increase the likelihood of cardiac arrest by 31 per cent, and diclofenac raised the risk by 50 per cent, the researchers said.
The drugs are part of a group of painkillers known as non-steroidal anti-inflammatory drugs (NSAIDs), which are among the most commonly used drugs worldwide.
Professor Gunnar Gislason, who led the study, called for tighter controls on NSAIDs. He said: "Allowing these drugs to be purchased without a prescription, and without any advice or restrictions, sends a message to the public that they must be safe."
"STARK REMINDER THAT NSAIDs ARE NOT HARMLESS"
Prof Gislason's team studied data on all patients in Denmark who had a cardiac arrest outside of the hospital between 2001 and 2010.
Of the 28,947 patients, 3,376 had been treated with an NSAID up to 30 days beforehand. Ibuprofen and diclofenac were the most commonly used NSAIDs, making up 51 per cent and 22 per cent of total NSAID use respectively.
"The findings are a stark reminder that NSAIDs are not harmless," said Prof Gislason.
He explained that NSAIDs have numerous effects on the cardiovascular system which could explain the link with cardiac arrest. These include influencing platelet aggregation and causing blood clots; causing the arteries to constrict; increasing fluid retention; and raising blood pressure, he said.
Prof Gislason asserted that the current message being sent to the public about NSAIDs was wrong. "I don't think these drugs should be sold in supermarkets or petrol stations where there is no professional advice on how to use them," he said. "Over-the-counter NSAIDs should only be available at pharmacies, in limited quantities, and in low doses."
He said that people should not take more than 1,200mg of ibuprofen per day. Diclofenac is the riskiest NSAID and should be avoided by patients with cardiovascular disease as well as the general population, he added.
In Singapore, ibuprofen is classified as a General Sale List (GSL) medicine, provided it is sold in tablets or capsules containing not more than 200mg of the drug, or in syrup of 100mg/5ml, according to the website of the Health Sciences Authority. GSL products can be freely obtained from any retailer.