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Risk of cardiovascular adverse events
New Zealand. Medsafe has announced that all nonsteroidal anti-inflammatory drugs (NSAIDs) increase the risk of a cardiovascular adverse event.
NSAIDs reduce inflammation by inhibiting the production of cyclo-oxygenase (COX)-1 and 2, and are generally indicated to reduce pain, decrease fever and decrease inflammation.
Since the Medicines Adverse Reactions Committee (MARC) previously discussed the cardiovascular safety of diclofenac and ibuprofen, several new studies on the cardiovascular safety of NSAIDs have been published.
The MARC reviewed the cardiovascular safety of NSAIDs including two clinical trials and two meta-analyses. MARC concluded that it is currently not possible to differentiate or rank NSAIDs by their individual cardiovascular risk profiles.
NSAIDs should be avoided in patients with established cardiovascular disease, and patients should be informed of the risk of NSAIDs. If required, NSAIDs should be used at the lowest effective dose for the shortest duration possible.
Reference : Prescriber Update, Vol. 40, No.2, Medsafe, June 2019 (medsafe.govt.nz/)
(See WHO Pharmaceuticals Newsletter No.4, 2015: Small increased cardiovascular risk with daily doses at or above 2,400mg in Ireland)
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