Ibuprofen melts aspirin's heart
Double prescription could sap
painkiller's cardiovascular benefit.
14 February 2003
HELEN PEARSON
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| Aspirin and ibuprofen are
two of the most commonly consumed non-prescription
drugs. |
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The over-the-counter painkiller ibuprofen may slash the
beneficial effects of aspirin on the heart, warns a new report.
The study followed more than 7,000 cardiovascular patients in
Tayside, UK, who took aspirin to ward off a heart attack. Those
who also popped ibuprofen frequently were twice as likely to die
during the eight-year study than those taking aspirin alone1.
Aspirin and ibuprofen are two of the most commonly consumed
non-prescription drugs.
"It would seem prudent not to take the two drugs together,"
advises study leader Tom MacDonald of Ninewells Hospital and
Medical School in Dundee. He suggests that some patients should
use an alternative painkiller such as paracetamol.
The American Heart Association recommends a regular dose of
aspirin for the roughly 3 million US patients who have had a
heart attack or stroke. An unknown number of these also take
ibuprofen for unrelated pain conditions such as arthritis.
"People should at least be alerted," agrees president of the
American Heart Association, Robert Bonow. He would also like to
see follow-up studies to find the patient groups most at risk.
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People should at least be alerted
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Robert Bonow
American Heart Association
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Ibuprofen is believed to block aspirin from thinning the
blood. Aspirin normally binds to an enzyme called cyclooxygenase
in blood platelets, which stops them clumping together into
vessel-clogging clots.
The study is thought to be most pertinent to people who take
the two drugs long term — in most cases a single ibuprofen pill
is probably harmless. And so far other painkillers in the same
class as ibuprofen, called NSAIDS, have not been found to have
the blocking effect.
But in some cases, even one dose of ibuprofen might
counteract aspirin's effects, speculates pharmacologist Garret
FitzGerald of the University of Pennsylvania in Philadelphia —
for example, when air passengers swallow aspirin to avert deep
vein thrombosis.
In a preliminary study in 2001, FitzGerald showed that taking
ibuprofen at night can block the anti-clotting effects of an
aspirin swallowed the next morning2.
"The caution index for doctors has been raised appreciably," he
says. |
