NEWS Ibuprofen causes A-Fib

[Alexandra]

You see I have to say that this sort of thing makes me angry. All drugs have side effects but to say that no one should take a particlar drug becuase of an increased risk of a particular side effect is a nonsense. It's scaremongering. Better to say Ibruprofen can cause AF not causes AF.

Writing thread titles is a sort of advertising. In the very brief space allowed one has to attract attention and give an idea of the subject matter. I felt very strongly that I wanted to warn fell runners, many of whom admit to and even recommend taking NSAIDs regularly, that they are dangerous.

Years ago, walking a GR in France, I took Diclofenac for about a fortnight so as to be able to continue despite two painful injuries. I knew I was taking a risk and decided it was worth it. Previously, I had taken all sorts of pain killers for migraines. Ever since I have had quite severe digestive problems and have completely given up taking pain killers including aspirin (paracetamol has never worked for me.) I found that my recovery rate from migraines was no worse without pain killers than with. I do attribute my digestive problems to NSAIDs; I am less sure whether they contributed to my A-Fib. I would not wish either condition on anyone. Given another chance I would NOT have taken Diclofenac in France, nor assorted strong pain killers for migraines. It makes my blood run cold to read about some runners' taking these drugs for quite trivial reasons.

I know that sometimes people have to make terrible choices, between agony and taking drugs they know are harming them. I just want people not in that dire position to realise that more and more serious side effects of NSAIDs are being discovered every day and that taking them eg to speed recovery after a race may cost more than most people would want to pay.

[martmason]

Does ketobrufen have the same effect as I,m also on (prescribed by my gp) that now.

[Alexandra]

Are gels and creams equally bad or is it just NSAIDs taken internally that have the risk factor?

This is acecdote, not evidence, but after I gave up all NSAIDs I did try Ibuprofen gel and it upset my (very delicate) stomach. It is only supposed to have a local effect, but after all people have been poisoned through their skins. I have taken to using GLUCOSAMINE GEL from Healthspan instead. It has been claimed to be equally effective. I really don't know if it is snake oil or not, but I find it pleasant and soothing, use it daily, keep meaning to give it up and then buy more. 2 tubes cost £9.95 but if you use the voucher code car-ujy and spend £15+ you can get £2 off.

[Mike T]

Does ketobrufen have the same effect as I,m also on (prescribed by my gp) that now.

All NSAIDs have similar side effects, but some are worse than others. It is felt that ibuprofen is the weakest, and that diclofenac is one of the strongest. I am not familiar with ketobrufen, but it certainly sounds like an NSAID.

[Mike T]

This is acecdote, not evidence, but after I gave up all NSAIDs I did try Ibuprofen gel and it upset my (very delicate) stomach. It is only supposed to have a local effect, but after all people have been poisoned through their skins. I have taken to using GLUCOSAMINE GEL from Healthspan instead. It has been claimed to be equally effective. I really don't know if it is snake oil or not, but I find it pleasant and soothing, use it daily, keep meaning to give it up and then buy more. 2 tubes cost £9.95 but if you use the voucher code car-ujy and spend £15+ you can get £2 off.

Independent studies show that glucosamine taken by mouth is no more effective than placebo, but of course some people obtain benefit from placebos. Studies of glucosamine taken by mouth funded by the manufacturers show some benefit. Make of this what you will. I would be surprised if a gel was any better than placebo, but I have not looked at the literature on this. NSAID gels probably work by systemic absorption rather than by any local effect - apart from the rubbing of course, which helps relieve some aches/pains. As the amount absorbed through the skin is generally small, the risk of side effects is lower, but still present.

[Flopsy]

Years ago, walking a GR in France, I took Diclofenac for about a fortnight so as to be able to continue despite two painful injuries. I knew I was taking a risk and decided it was worth it. Previously, I had taken all sorts of pain killers for migraines. Ever since I have had quite severe digestive problems and have completely given up taking pain killers including aspirin (paracetamol has never worked for me.) I found that my recovery rate from migraines was no worse without pain killers than with. I do attribute my digestive problems to NSAIDs; I am less sure whether they contributed to my A-Fib. I would not wish either condition on anyone. Given another chance I would NOT have taken Diclofenac in France, nor assorted strong pain killers for migraines. It makes my blood run cold to read about some runners' taking these drugs for quite trivial reasons.

Saying NSAID's are 'dangerous' is a bit excessive isn't it. They have the potential to cause harmful side effects but they are not dangerous.

It sounds to me like you misused diclofenic. Self prescibing for several weeks to keep going through injury. That's not what I would would call using sensibly. Did you ALWAYS have the tablets either after or during a meal? That is an absolute essential. If not then you ignored manufacturers and medical guidelines.

Your stomach problems are not proved to be linked to NSAID's. I note that you said you have previously used asprin but do not consider them to be 'dangerous'. Are you are aware how bad asprin are for your stomach? My dad was a pharmacist and refused to let us ever have them. They can cause ulceration.

But this is by the by as your post was to warn us of the diclofenic causing heart trouble. Well yes the manufacturers agree and state on their literature that there is a 'small increased risk' of heart problems, as there is with many tablets. But that is no reason for everyone to stop using them. Use them sensibly yes, even doctors advise that, but not to stop using them.

Just asking you to express proportionality here Alexandra (and Mike).

[Mike T]

Good to hear Notlob as I may need the procedure in the future. BB are out for me though as my resting heart rate is too low

BB - beta blockers - and running do not go well together. They have all sorts of effects on heart/lungs/glycogen release and would seriously limit exercise capacity in most people.

[Alexandra]

Saying NSAID's are 'dangerous' is a bit excessive isn't it. They have the potential to cause harmful side effects but they are not dangerous.

It sounds to me like you misused diclofenic. Self prescibing for several weeks to keep going through injury. That's not what I would would call using sensibly. Did you ALWAYS have the tablets either after or during a meal? That is an absolute essential. If not then you ignored manufacturers and medical guidelines.

Your stomach problems are not proved to be linked to NSAID's. I note that you said you have previously used asprin but do not consider them to be 'dangerous'. Are you are aware how bad asprin are for your stomach? My dad was a pharmacist and refused to let us ever have them. They can cause ulceration.

But this is by the by as your post was to warn us of the diclofenic causing heart trouble. Well yes the manufacturers agree and state on their literature that there is a 'small increased risk' of heart problems, as there is with many tablets. But that is no reason for everyone to stop using them. Use them sensibly yes, even doctors advise that, but not to stop using them.

Just asking you to express proportionality here Alexandra (and Mike).

I do agree with your Dad that aspirin is also "dangerous" - I certainly didn't say it wasn't. I don't know that it is any MORE likely than Ibuprofen etc. to cause ulceration. I always took NSAIDs with meals, but that didn't save my insides from damage. I think there are several kinds of risk to consider here:

1) A small risk of something really bad.
2) A big risk of something not so bad.
3) A big risk of something really bad.
4) A small risk of something not so bad.
5) Multiple risks.

Each individual has to weigh these factors up for him/herself, and set them against the proposed benefit. It is clear that NSAIDs carry multiple risks. IMO the outcomes risked, including but not limited to, damage to the digestive system, arrhythmias and Alzheimers, are pretty bad. Mike will be better able than me to say how high the risk of each of these bad outcomes is. I think in the case of damage to the digestive system the risk is very high. Probably no-one yet knows how high the risk of Alzheimer's is.

Of course agonising pain or disability may well make any risk seem worthwhile and people have to choose for themselves. I want it to be a choice made with open eyes.

[Mike T]

For those who would like to see the numbers of people who come to harm: http://www.medicine.ox.ac.uk/bandoli...nsae/nsae.html

[Alexandra]

For those who would like to see the numbers who come to harm: http://www.medicine.ox.ac.uk/bandoli...nsae/nsae.html

Alas, the link doesn't work for me.