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If you're one of the more than 29 million Americans who regularly use painkillers like ibuprofen and naproxen — including over-the-counter brands like Advil, Motrin and Aleve — the government has new words of warning for you: Using these drugs increases your risk of heart attack and stroke.
Studies reviewed by a Food and Drug Administration advisory panel last year found mounting evidence that NSAIDs, or nonsteroidal anti-inflammatory drugs, increase the risk of heart attack, stroke and heart failure whether or not a person has heart disease. Those with a history of heart problems are at the highest risk. "No matter who you are, your risk increases," said Bruce Lambert, director of the Center for Communication and Health at Northwestern University, who specializes in drug-safety communication.
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A new warning on prescription and over-the-counter NSAIDs will point out that the increased risk can occur even within the first few weeks of taking the drug and might rise with high doses taken for an extended period of time. The new warning does not apply to either aspirin or acetaminophen.
So what does this mean for the millions of people who use these painkillers for everything from a temporary headache to chronic pain from arthritis? Here are answers to some frequently asked questions.
Should I stop taking NSAIDs for pain relief?
If you're using them to relieve crippling pain that impairs your quality of life, don't stop without talking to your doctor, says Sanjay Kaul, a cardiologist at Cedars-Sinai Medical Center in Los Angeles and a member of the FDA advisory panel. These are situations where patients and physicians have to consider the trade-offs in benefits and risks.
But he urges his patients "not to use these medications for minor aches and pains, headaches or fever." Try Tylenol (acetaminophen), aspirin or a heating pad first. "Restrict NSAID use to more severe cases of pain," he says. And if you do take them, stick to the lowest effective dose for the shortest time possible.
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