Results from the data analyses indicated that participants who started to take diclofenac during the trial period were at an increased risk of all major cardiovascular events, including atrial fibrillation, ischeamic stroke, heart failure, myocardial infarction, and cardiac death, irrespective of age and sex. But given the cardiovascular and gastrointestinal risks, there is little justification for starting a diclofenac treatment before testing other traditional NSAIDs, "the researchers concluded".
A study published in the British Journal of Clinical Pharmacology focusing on 57,000 people residing in Taiwan also found that taking painkillers such as ibuprofen and naproxen could be linked to having an irregular heartbeat.
But its cardiovascular risks compared with those of other traditional NSAIDs have never been examined in large randomized controlled trials, and current concerns about these risks make such trials unethical to conduct.
The study included more than 6.3 million adults with an average age of 46-49 in Denmark with at least one year of continuous prescription records from 1996 to 2016.
"Treatment of pain and inflammation with NSAIDs may be worthwhile for some patients to improve quality of life despite potential side effects", the team wrote in a statement regarding the study.
Both men and women were at higher risk for heart problems, as were those taking low doses of the drug.
Writing in The BMJ, he says diclofenac should only be available with a prescription, like in the United Kingdom - and only them when also accompanied with an appropriate warning on the front of the pack.
For those at moderate risk at the start, they found 7 extra cardiovascular events with diclofenac compared with ibuprofen or naproxen; 8 extra events compared with paracetamol; and 14 extra events compared with no NSAIDs.
Experts have analyzed the cardiovascular risks that come together with diclofenac compared to other non-steroidal anti-inflammatory drugs (NSAIDs). On the other hand, paracetamol, another common painkiller, as well as ibuprofen, showed reduced risks of heart problems, compared with diclofenac.
The study also relies on observational data, so it can't directly prove that diclofenac is causing problems.
The Medicines and Healthcare Products Regulatory Agency (MHRA) said in June 2013 that the drug should not be used by people with serious underlying heart conditions-people who had suffered heart failure, heart disease or a stroke were advised to stop using it completely.
'It is time to acknowledge the potential health risk of diclofenac and to reduce its use.