GPs 'ignore heart attack and stroke risk' of painkiller used by millions
Research shows that taking the painkiller diclofenac increases the risk of heart attacks and strokes by 63 per centScientists are calling for the drug to be banned as safer alternatives availableUK's drugs watchdog said European safety review of diclofenac is underwayPatients told not to stop taking pill but do speak to your GP

Fiona Macrae


01:08 GMT, 13 February 2013



11:30 GMT, 13 February 2013

Diclofenac is widely prescribed for common ailments, including back pain and arthritis

Diclofenac is widely prescribed for common ailments, including back pain and arthritis

Doctors are writing millions of prescriptions a year for a painkiller that is known to raise the risk of heart attacks and strokes, a study has warned.

Diclofenac is given by GPs to ease the pain of arthritis, backache, gout and other common conditions.

A review of existing research showed the drug is one of the riskiest of its type, raising the danger of heart attacks and strokes – including fatal incidents – by up to 63 per cent.

This risk is almost identical to
that of the painkiller Vioxx (rofecoxib), which was withdrawn from
worldwide sales in 2004 because of cardiovascular risk.

The study’s authors are calling for diclofenac to be banned or severely restricted in use.

they accused family doctors, who issued almost five million
prescriptions for the drug in England in 2011, of being complacent about
the dangers and of not warning patients of the risks.

In a review of studies on painkillers
known as nonsteroidal anti-inflammatory drugs (NSAID), which also
include ibuprofen, co-author Patricia McGettigan, of Barts and the
London School of Medicine and Dentistry found diclofenac had the highest

Despite this, it was the most used – meaning it was prescribed more often than safer alternatives such as the painkiller naproxen.

Dr McGettigan said that the dangers of diclofenac have been well-documented, so GPs are either not keeping up with the latest research or simply ignoring the warnings.

The researcher said: 'This drug improves symptoms but patients are not stuck for alternatives.

'There are strong arguments to revoke its marketing authorisations globally.'

She added that a healthy young person’s
odds of having a heart attack or stroke is so low that taking diclofenac
will add little to their risk.

However, the effect could be significant in elderly people with underlying health problems.

Diclofenac is also available over-the-counter in a lower dose Voltarol tablets and cream.

Diclofenac is prescribed by the GP

Diclofenac was prescribed almost five millions times by GPs in 2011

The gel is not thought to have any cardiac side-effects but the pills may, if taken in large numbers, said Dr McGettigan.

Dr McGettigan, who makes her argument
in the journal PLoS Medicine, urged patients not to panic and stressed
that no one should come off their tablets without first speaking to
their GP.

Talbot, of the British Heart Foundation, said that anyone taking
diclofenac and other NSAIDs should be made aware of the risks as well as
the benefits.

Dr McGettigan said there were strong arguments for banning diclofenac

Concern: Dr McGettigan said there were strong arguments for banning diclofenac

The charity Arthritis Research UK said
there are few other effective options for those with painful, long-term
conditions such as arthritis and it recommends that people take the
lowest dose of the most appropriate of the painkillers for the shortest
amount of time.

A spokesman added that painkilling gels and creams are a safer alternative to pills.

Britain’s drugs watchdog, the Medicines and Healthcare Regulatory products Agency, said that a European review of the safety of diclofenac is already underway.

A spokesman added: ‘Diclofenac is an extremely important NSAID used for the treatment of arthritis and other painful conditions.

‘For most patients the risks of side-effects are outweighed by the benefits these drugs bring in managing pain.

‘If people have any concerns about any NSAID they are taking, then they should speak to their doctor.’

Novartis, which makes Voltatol, the low- dose form of the drug, said patient safety is its top priority and if fully supports the European review of diclofenac's safety.

A spokesman added that the company is confident that the information available to date shows the benefits outweigh the risks.