In short Article

Cardiovascular risks of diclofenac


Side-effects of the use of NSAIDs, such as an increased risk of serious morbidity like gastric haemorrhage and cardiovascular diseases, have been known for years. Recent Danish research shows that the risk of a first cardiovascular disease associated with short-term use is greater for diclofenac than for other NSAIDs, even within 30 days of use! This means that there is concern about just a few weeks of self-treatment of back pain with diclofenac bought at the chemist’s. This was already known to be the case for people with existing cardiovascular diseases, but it is now known to be true for people without cardiovascular disease as well. So why not stop selling NSAIDs like diclofenac over the counter, and making these drugs only available on prescription for short-term use?

  • A large-scale Danish cohort study has found that the risk of a first cardiovascular disease is statistically significantly greater for 30 days of using diclofenac than for 30 days of using other NSAIDs or paracetamol.
  • The study provides an argument for even greater vigilance in prescribing and dispensing NSAIDs, especially diclofenac.
  • The Danish findings suggest that if patients without cardiovascular disorders or stomach complaints need short-term NSAID treatment, naproxen or ibuprofen should be preferred over diclofenac.
  • The strong association between diclofenac and first-time cardiovascular disease arising within 30 days would be a major argument to stop selling this drug over the counter.

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The literature refers to the Dutch text

Authors

  • mw drs M.A.E. Nieuwhof