No pain killer is cardiac safe, said Padmashri and Dr B C Roy National Awardee Dr KK AggarwalPresident Heart Care Foundation of India.

They must be taken only when no other options are available and that too for a shorter period of time. Even paracetamol is not safe and can cause high blood pressure when taken more than 16 tablets in a week.

Any benefits of coxibs pain killers in causing fewer gastro side effects must now be balanced with the risk of adverse cardiovascular effects.

The short-acting NSAIDs ibuprofen and diclofenac increase cardiovascular risk at high doses, whereas the longer-acting naproxen does not.

Painkillers can interfere with anti platelet effects of low-dose aspirin taken for primary or secondary cardiovascular prevention. Ibuprofen negatively influences cardio protection when ingested concurrently. In contrast, concomitant administration of oral diclofenac, rofecoxib, and acetaminophen does not affect aspirin cardio protection.

In patients with chronic kidney disease even a single pain killer can precipitate acute kidney injury.


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