In 2004 , a late approve painkiller belonging to the wide used non - steroidal anti - inflammatory drug ( NSAID ) class waspulled from the marketafter investigators divulge that the drug hasten anunacceptably high numberof heart onrush and apoplexy - stimulate blood clots .

Ever since then , medical investigator have rest on high qui vive ; wondering if any other drugs in this course of instruction – which includes acetylsalicylic acid , ibuprofen ( Advil ) , and naproxen ( Aleve ) – should be abandoned due to their cardiovascular risks . Risks that   were overlooked or unapparent during condom studies that occurred years to decades ago .

Now , a team from Denmark has uncovered evidence that people who usediclofenac , one of the most commonly used NSAIDs and one often uncommitted without a prescription , ­­experience significantly more serious adverse events than those claim other NSAIDs orparacetamol(aka acetaminophen ) .

“ In our cogitation , we found that diclofenac instigator were at increased risk of major contrary cardiovascular events – both compared with no NSAID creation , initiation of paracetamol as an anodyne alternative to NSAIDs , as well as knowledgeability of other traditional NSAIDs , ” the authors wrote in theBritish Medical Journal .

“ While NSAID economic consumption previously was considered risk - neutral in short discussion periods and low doses , the risks were apparent even within 30 days and also for low STD of diclofenac . ”

The authors drew their data from countrywide aesculapian phonograph recording and ethical drug registry , choosing grownup patient who had not redeem a prescription medicine for an NSAID for at least one year ( in Denmark downcast - Cupid’s itch ibuprofen and aspirin are the only NSAIDs available over the return ) when they presented to a infirmary between 1996 and 2006 . The authors then compare the documented health issues that arose within 30 days in individual given a course of diclofenac ( 1.3 million people ) to those of 3.8 million people given ibuprofen , 291,490 given naproxen , 764,781 people given the non - NSAID pain reliever paracetamol , and 1.3 million people not prescribe any drug at all .

All subjects who were not withdraw diclofenac were couple bypropensity scoreto diclofenac substance abuser , mean that the radical were designed to mitigate   influence from factors like age and pre - existing diseases . None had experienced anterior cardiovascular issues .

An psychoanalysis of this monumental dataset revealed that diclofenac instigator had a 50 percent greater rate ofatrial fibrillationor fluttering , ischemic stroke , heart failure , heart attack , or pump - relate dying in the 30 days following their prescription filling compare with those who did not meet nonsteroidal anti-inflammatory . The diclofenac substance abuser ’ rates were 20 per centum higher than those of paracetamol or ibuprofen user and 30 pct higher than naproxen users .

Diclofenac initiators were also 2.5 time more likely to experience bleeding in the stomach and intestine , a known danger for many NSAIDS , than ibuprofen or paracetamol initiators , and 4.5 time more likely than non - initiators .

Because the study is observational , rather than a randomised control run , the authors note that no steadfast finale about causa and effect can be determined . Yet , they fence that their telling sample size and the consistency between their termination and those of like investigations together ply potent enough evidence that physicians and regulator should take heed .

“ discourse of pain and ignition with NSAIDs may be worthwhile for some affected role to improve quality of life despite potential side effects . consider its cardiovascular and gastrointestinal risks , however , there is petty justification to lead up diclofenac treatment before other traditional NSAIDs , ” they wrote . “ It is prison term to acknowledge the potential wellness risk of diclofenac and to reduce its use . ”