This July, the FDA announced that there will be changes to the labels of almost every medication in the non-steroidal anti-inflammatory drug (NSAID) class – a warning that those drugs could cause heart attacks and fatal strokes even in young people with no known cardiovascular risk factors. The heart attacks could be triggered after just weeks of taking the pills.
Peter Wilson of Emory University, who served on the expert panel that advised the FDA on the decision, said, “There is great concern that people think these drugs are benign, and they are probably not. The thought is these are good for short-term relief, probably for your younger person with no history of cardiovascular trouble.”
Details of risk still unknown
Except for aspirin, the FDA has required NSAIDs to carry warning labels about the risk of heart attacks and strokes since 2005. Since then, there’s been new research that has shown that the risk was higher than previously thought. The results were terrifying – the research has shown that the risk increases within the first few weeks of taking the drugs, even in people with no previous risk for heart disease.
Higher doses of the drugs create higher risks, and some prescription-strength doses potentially carry five times the risk of over-the-counter doses. People who take non-aspirin NSAIDs following a heart attack are considerably more likely to die over the course of the following year than people who don’t take those drugs.
According to the research, different drugs appear to carry different degrees of cardiovascular risk. Alas, researchers are still not sure which drugs are more dangerous. This means that for the time being, all of them must be considered equally dangerous.
Wilson offered a rough rule of thumb for estimating the risk based on drug dosage. Over-the-counter NSAIDs appear to increase stroke and heart attack risk by around 10 %, while low-dose prescription NSAIDs seem to increase it by about 20 %. High-dose prescription NSAIDs can increase the risk of a stroke and a heart attack by about 50 %.
There are no safe painkillers
Stroke and heart attack are not the only serious risks from NSAIDs. All of them, including aspirin, carry a serious risk of causing potentially fatal stomach bleeding, often without a warning. This is caused by the drugs’ function to block the action of the inflammatory chemicals that are known as prostaglandins. Prostaglandins provide many important functions in the body, one of them being the protection of the lining of the stomach from being corroded by digestive acids.
Prostaglandins also play a crucial role in female fertility. That’s why NSAIDs can interfere with conception and lengthen or delay labor. If a person takes them during pregnancy, the NSAIDs can cause infants to experience delayed respiratory and circulatory development, which can lead to permanent health problems.
NSAIDs are also known to cause kidney damage.
Taking other painkillers is also not without risk. Narcotic painkillers in the opioid family are very addictive and kill far more people each year than any street drug.
Let’s take Acetaminophen–the active ingredient in Tylenol–as an example. It is the leading cause of acute liver failure. Furthermore, studies suggest that it actually blunts people’s moral and emotional reasoning. According to one study, people who had taken Tylenol described the emotional content of various images as more neutral and less emotionally intense when compared to people who had taken a placebo, and they weren’t even aware that their reactions had changed. Another study found that people who take Tylenol experience less emotional pain from rejection, while a third study suggested that the drug dulls the sense of indignation that leads to moral judgment.
Bruce Lambert of Northwestern University, who is a drug safety communication specialist, commented on the FDA’s new NSAID rules, and said, “One of the underlying messages for this warning has to be there are no completely safe pain relievers, period.”