Jeremy Laurance, "Ibuprofen 'doubles the risk of a heart attack'", New
Zealand Herald, June 2, 2006,
Link:
http://www.nzherald.co.nz/category/s...ectID=10384696

The common painkiller Ibuprofen, sold over the counter in supermarkets
and pharmacies, doubles the risk of a heart attack in patients who take
it at high doses over a long period, a study has found.

The drug is one of the most widely used remedies for headaches, period
pains and discomfort caused by inflammation.

It is used by millions of arthritis sufferers on a daily basis to
relieve painful joints.

But researchers warned people yesterday not to remove the drug from
household medicine cabinets.

There was no danger for occasional users and the benefits of the drug
for patients who depend on it to lead normal lives were still likely to
outweigh its risks, they said.

The study is the largest and most definitive of its kind into the
effect of non-steroidal anti-inflammatory drugs (NSAIDs) on the heart,
involving 138 trials covering 140,000 patients.

It follows concern over a separate group of anti-inflammatories - known
as the Cox-2 inhibitors - which led to the withdrawal of Vioxx in 2004
after it was linked with an increased rate of heart attacks.

Vioxx , made by Merck, is now the subject of a series of multimillion
dollar lawsuits from patients who suffered heart attacks which they
claim were caused by the drug.

Now confirmation that drugs such as Ibuprofen, which the Cox-2
inhibitors were designed to replace, also carry an increased risk of
heart attack puts the risks of Vioxx in a different light.

The Coxib drugs have fewer side effects on the gut than the NSAIDs such
as Ibuprofen, which are prone to cause gastrointestinal bleeding, and
some researchers are questioning whether Vioxx should have been
withdrawn.

Scientists from the Clinical Trial Service Unit at the University of
Oxford, with colleagues from the University of Rome, carried out the
study published in the British Medical Journal.

They combined results from all trials of the two classes of drug in
order to provide the most reliable estimate of the increased risk.

Two drugs from among the NSAIDs - ibuprofen and the prescription-only
diclofenac - increased the risk of a heart attack by almost as much as
the Coxib drugs, but a third drug, naproxen, did not.

The researchers say most of the patients in the trials did not have
pre-existing heart disease and the increased risk was modest, amounting
to three extra heart attacks in every 1,000 people taking Ibuprofen or
diclofenac every year.

The two drugs had a lesser effect on the stroke rate.

Overall they increased the risk of any vascular event - heart attack or
stroke - by 40 per cent.

Colin Baigent, of the Medical Research Council, who directed the
research, said: "That is a relatively low risk for someone who can't
get out of bed in the morning because their body is racked with pain.
What we have demonstrated is that both the NSAIDs and the Coxibs have
the same kind of risks but it is for doctors to discuss those risks
with their patients."

He added: "For those on smaller doses the supposition must be that the
risks are lower. The advice has always been to take the lowest dose for
the shortest time necessary to control symptoms. People who are popping
these for the odd headache, the risks to them are minimal."

Dr Baigent said the scare over Vioxx had been overdone.

"There was a worry at the time that this particular drug was to blame
[for the increase in heart attacks] and it was withdrawn. Probably all
these drugs are associated with some hazard but they control pain very
effectively. We have to decide which drug is best for each patient.
This debate has been ill informed and a bit hysterical."

A spokeswoman for Arthritis Care said 9 million people in the UK
suffered from arthritis and "millions" were taking high doses of pain
killers on a regular basis.

"This is a patient choice issue. All drugs have side effects but
patients taking large doses are in a lot of pain. They have to weigh up
the possibility of an enjoyable life against something else."

Reckitt Benckiser, which makes Nurofen - a non-prescription
ibuprofen-based pain reliever, stressed the BMJ study did not look at
their drug, only at higher dose prescription drugs.

Zephanie Jordan, at Reckitt Benckiser, said: "Ibuprofen is a highly
effective pain medicine that has been used safely in more than 50
countries worldwide and by millions of people.

"There is a considerable body of scientific evidence illustrating the
safety and efficacy of ibuprofen when used at low doses and for short
term use."

- INDEPENDENT, HERALD ONLINE STAFF

On 2 Jun 2006 05:34:53 -0700, "Roman Bystrianyk"
<rbystrianyk@gmail.com> wrote:


Kearney PM, Baigent C, Godwin J, Halls H, Emberson JR, Patrono C
Do selective cyclo-oxygenase-2 inhibitors and traditional
non-steroidal anti-inflammatory drugs increase the risk of
atherothrombosis? Meta-analysis of randomised trials
BMJ 2006;332:1302-1308 (3 June), doi:10.1136/bmj.332.7553.1302
<http://bmj.bmjjournals.com/cgi/content/full/332/7553/1302>

According to the study the risk ratio was however 1.51 (95 %
confidence interval: 0.96 to 2.37), not 2. Additionally, from the
confidence interval we see that the result slightly missed statistical
significance. The dose associated with this risk was 3 * 800
mg ibuprofen/d.

In another recent study

Hernandez-Diaz S, Varas-Lorenzo C, Garcia Rodriguez LA. Non-steroidal
antiinflammatory drugs and the risk of acute myocardial infarction.
Basic Clin Pharmacol Toxicol. 2006 Mar;98(3):266-74.
PMID: 16611201 [PubMed - in process]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&li st_uids=16611201>

ibuprofen's risk ratio was only 1.07 (95% CI: 1.02-1.12), but as seen
from the confidence interval, this result was statistically
signifanct. The associated dose is not mentioned in the abstract, but
it's possible that smaller doses were included in this study than in
the BMJ study.





--
Matti Narkia

Matti Narkia wrote:
: On 2 Jun 2006 05:34:53 -0700, "Roman Bystrianyk"
: <rbystrianyk@gmail.com> wrote:
:
:: Jeremy Laurance, "Ibuprofen 'doubles the risk of a heart attack'",
:: New Zealand Herald, June 2, 2006,
:: Link:
:: http://www.nzherald.co.nz/category/s...ectID=10384696
::
:: The common painkiller Ibuprofen, sold over the counter in
:: supermarkets and pharmacies, doubles the risk of a heart attack in
:: patients who take it at high doses over a long period, a study has
:: found.
::
: This news report apparently refers to the study
:
: Kearney PM, Baigent C, Godwin J, Halls H, Emberson JR, Patrono C
: Do selective cyclo-oxygenase-2 inhibitors and traditional
: non-steroidal anti-inflammatory drugs increase the risk of
: atherothrombosis? Meta-analysis of randomised trials
: BMJ 2006;332:1302-1308 (3 June), doi:10.1136/bmj.332.7553.1302
: <http://bmj.bmjjournals.com/cgi/content/full/332/7553/1302>
:
: According to the study the risk ratio was however 1.51 (95 %
: confidence interval: 0.96 to 2.37), not 2. Additionally, from the
: confidence interval we see that the result slightly missed statistical
: significance. The dose associated with this risk was 3 * 800
: mg ibuprofen/d.

From the full study: "When we considered all the randomised trial data,
selective COX 2 inhibitors were associated with a highly significant
1.4-fold increased risk of serious vascular events, largely due to a twofold
increased risk of myocardial infarction."

--
Juhana

On Fri, 2 Jun 2006 22:54:05 +0300, "Juhana Harju"
<shantigiriorama@gmail.com> wrote:

Yes, for _selective_ COX-2 inhibitors. Ibuprofen is _not_ a COX-2
inhibitor, it is a _non-slective_ traditional non-steroidal
anti-inflammatory drug. Read the study again.




--
Matti Narkia

On Sat, 03 Jun 2006 00:37:35 +0300, Matti Narkia <mna@mbnet.fi> wrote:

It seems that I accidentally left out the word _selective_, which
should've been before COX-2. Late hours ...

Selective COX-2 inhibitors include Bextra, Celebrex, and Vioxx
(<http://www.fda.gov/cder/drug/infopage/cox2/>, Ibubrofen is not one
of them.



--
Matti Narkia

On Fri, 2 Jun 2006 22:54:05 +0300, "Juhana Harju"
<shantigiriorama@gmail.com> wrote:

More appropriate quote, also from the body of the article, is

"Comparisons of traditional NSAID versus placebo

We combined direct estimates of treatment effect (from trials
involving a comparison of an NSAID versus placebo) with indirect
information (from a comparison of trials of a selective COX 2
inhibitor versus placebo and a selective COX 2 inhibitor versus
NSAID) (see statistical appendix on bmj.com). The summary rate
ratio for vascular events, in comparison with placebo, was 0.92
(95% confidence interval 0.67 to 1.26) for naproxen, 1.51 (0.96 to
2.37) for ibuprofen, and 1.63 (1.12 to 2.37) for diclofenac."

as ibuprofen is a tradtional NSAID, not a selective COX-2 inhibitor.


--
Matti Narkia

Matti Narkia wrote:
: On Fri, 2 Jun 2006 22:54:05 +0300, "Juhana Harju"
: <shantigiriorama@gmail.com> wrote:
:
:: Matti Narkia wrote:
::: On 2 Jun 2006 05:34:53 -0700, "Roman Bystrianyk"
::: <rbystrianyk@gmail.com> wrote:
:::
:::: Jeremy Laurance, "Ibuprofen 'doubles the risk of a heart attack'",
:::: New Zealand Herald, June 2, 2006,
:::: Link:
:::: http://www.nzherald.co.nz/category/s...ectID=10384696
::::
:::: The common painkiller Ibuprofen, sold over the counter in
:::: supermarkets and pharmacies, doubles the risk of a heart attack in
:::: patients who take it at high doses over a long period, a study has
:::: found.
::::
::: This news report apparently refers to the study
:::
::: Kearney PM, Baigent C, Godwin J, Halls H, Emberson JR, Patrono C
::: Do selective cyclo-oxygenase-2 inhibitors and traditional
::: non-steroidal anti-inflammatory drugs increase the risk of
::: atherothrombosis? Meta-analysis of randomised trials
::: BMJ 2006;332:1302-1308 (3 June), doi:10.1136/bmj.332.7553.1302
::: <http://bmj.bmjjournals.com/cgi/content/full/332/7553/1302>
:::
::: According to the study the risk ratio was however 1.51 (95 %
::: confidence interval: 0.96 to 2.37), not 2. Additionally, from the
::: confidence interval we see that the result slightly missed
::: statistical significance. The dose associated with this risk was 3
::: * 800
::: mg ibuprofen/d.
::
:: From the full study: "When we considered all the randomised trial
:: data, selective COX 2 inhibitors were associated with a highly
:: significant
:: 1.4-fold increased risk of serious vascular events, largely due to a
:: twofold increased risk of myocardial infarction."
:
: Yes, for _selective_ COX-2 inhibitors. Ibuprofen is _not_ a COX-2
: inhibitor, it is a _non-slective_ traditional non-steroidal
: anti-inflammatory drug. Read the study again.

That is correct. I realized my hasty interpretation after posting.

--
Juhana

Bottom line.. Want to live in pain all your life or accept a small
chance of dying. No-brainer for me.

Bud wrote:
Until you factor in the alternatives to ibuprofen.

Prayerfully in Christ's amazing love,

Andrew
http://tinyurl.com/oq5k3

On Sat, 03 Jun 2006 12:38:19 -0400, Bud <bud@romance.org> wrote:

Or one could use naproxen, which according to this latest study does
not seem to be associated with an increased risk of cardiovascular
event, or indomethacin, which so far also doesn't seem to be
associated with an increased risk for these events.


--
Matti Narkia

In article <dav382dpr0e9u2sr32sgk7aep0v84m8mlh@4ax.com>,
Matti Narkia <mna@mbnet.fi> wrote:

Does naproxen have a common name? Is it a prescribed drug?

Bill who is ignorant.

--
S Jersey USA Zone 5 Shade
This article is posted under fair use rules in accordance with
Title 17 U.S.C. Section 107, and is strictly for the educational
and informative purposes. This material is distributed without profit.

I do take Naproxen and my comment was for NSAIDS in general. That said,
Naproxen is the generic name. Some trade names are Aleve, Naprosyn,
Anaprox, Naprelan and it can be purchased OTC and online where it's
generally cheaper than prescribed forms. HTH.

p.s. Ignorance is o.k. Stoopid ain't .;-)

On Sat, 03 Jun 2006 17:33:13 -0400, William Wagner
<not-to-here-williamwag@gmail.com> wrote:

See

<http://www.drugs.com/naproxen.html>
<http://www.rxlist.com/cgi/generic/naprosyn.htm>
<http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a681029.html>
<http://www.medicinenet.com/naproxen/article.htm>
<http://en.wikipedia.org/wiki/Naproxen>

I also found this

<http://www.fda.gov/bbs/topics/news/2004/NEW01148.html>

It seems that FDA has been worried about naproxen, too.



--
Matti Narkia

"Matti Narkia" <mna@mbnet.fi> wrote in message
news:dav382dpr0e9u2sr32sgk7aep0v84m8mlh@4ax.com...
Hhhhhm, I took 3-500mg of Naprosyn per day for with no problems for over 5
years to be able to go to work with arthritis problems. Some people could
not take that for 5 weeks without their stomach being torn up and bleeding.
Now, Indomethacin was taken for about 2 years but had to be stopped due
to my ankles being swollen from fluid which went away in a week after
stopping the medicine.
It is a true statement that people are different and our reactions to
different medicines are different. That is why doctors make the big bucks
to find out what works best for us while doing the least amount of harm.

Harv

In article <1149251693.337354.232810@j55g2000cwa.googlegroups .com>,
Roman Bystrianyk <rbystrianyk@gmail.com> wrote:
Good advice. The dosages that showed problems were 800 mg, three
times per day. That's a LOT. For comparision, a normal ibuprofen
(non-extra-strength) is 200 mg. So unless you're taking four of
those, three times per day, for a long time, the results don't apply
to you.

Now, I realize that, say, arthritis sufferers may indeed be taking
that much, but people who just pop a couple of ibuprofen for a
headache or sore muscles once in a while need not fear.

For those not up on such things, naproxen is sold under brand names
like Aleve and Naprosyn.

-- David Wright :: alphabeta at prodigy.net
These are my opinions only, but they're almost always correct.
"If you can't say something nice, then sit next to me."
-- Alice Roosevelt Longworth