Out of 1,000 people who take diclofenac and are low risk for cardiovascular disease, the study estimated, four extra people would develop a major health problem within a year, with one dying as a result (compared to people using no drug). Compared to taking no NSAID painkillers, taking diclofenac was linked to an increase in heart-related deaths; risk was found even at low dose across all ages and genders.
The researchers said that given the risks, doctors should be initiating treatment where indicated with other types of NSAIDs before considering diclofenac. But given the cardiovascular and gastrointestinal risks, there is little justification for starting a diclofenac treatment before testing other traditional NSAIDs, "the researchers concluded".
The latest research comes a year after a decade-long Danish study found ibuprofen, commonly sold as Nurofen and Advil, had been associated with a 31 per cent increased risk of cardiac arrest.
"It is time to acknowledge the potential health risk of diclofenac and reduce its use", they wrote.
Are you anxious the medication you take could be impacting your overall health negatively? The researchers' paper is titled, "Diclofenac use and cardiovascular risks: series of nationwide cohort studies".
Diclofenac is the most commonly used non-steroidal anti-inflammatory drug (NSAID) in low, middle, and high income countries, and it is prescribed to millions of people in the United Kingdom every year.
Diclofenac is used for treating pain and inflammation.
A study carried out by researchers in Denmark looked at nearly 1,400,000 patients who were started on diclofenac between 1996 and 2016, as well as patients who were initiated on other types of NSAIDs and patients who weren't initiated on any NSAIDs. For people at high risk of cardiovascular disease, that number would shoot up to 40, with half dying.
They found an increased rate of major adverse cardiovascular events within 30 days compared with starting other traditional NSAID or starting paracetamol.
Prescribed under brand names such as Voltaren, Cambia, Pennsaid, Solaraze, Flector, Zipsor, and Dyloject, the new study finds taking this painkiller can increase your risk of both heart attacks and strokes.
The researchers pointed out the absolute risk of heart attack, stroke or other cardiovascular disease still remained low for individual patients. On the other hand, paracetamol, another common painkiller, as well as ibuprofen, showed reduced risks of heart problems, compared with diclofenac. Among patients at moderate baseline risk, corresponding figures were seven, seven, eight and 14 additional events, respectively, and for those at high baseline risk, corresponding numbers were 16, 10, one and 39 additional events, respectively.
Although the study is observational, they say - which means that no conclusions can be drawn about causality - the large sample size and the quality of the research is sufficiently "strong evidence to guide clinical decision-making".