A study published in the British Medical Journal has found that non-steroidal anti-inflammatory drugs like ibuprofen can cause irregular heartbeat (atrial fibrillation).
Between 1999 and 2008, over 32,000 patients with a diagnosis of irregular heartbeat were matched with 325,918 people of the same age group and gender.
The people most at risk of irregular heartbeat were those who had just started taking the drug.
Nine percent of cases and 7 percent of controls were current users of anti-inflammatory medication. When compared to people who didn’t use any of these medications, first time users had a 40 percent increase in irregular heartbeat.
The study authors concluded that "Use of non-aspirin NSAIDs was associated with an increased risk of atrial fibrillation or flutter. Compared with non-users, the association was strongest for new users, with a 40-70% increase in relative risk (lowest for non-selective NSAIDs and highest for COX 2 inhibitors). Our study thus adds evidence that atrial fibrillation or flutter needs to be added to the cardiovascular risks to be considered when prescribing NSAIDs."
Professor Jerry Gurwitz from Massachusetts Medical School suggested that doctors should think carefully about whether or not to prescribe anti-inflammatory painkillers to older patients with a history of high blood pressure or heart failure, as people in these groups were more likely to be affected by irregular heartbeat. Far from being a trivial complaint, it is associated with an increased long term risk of stroke, heart failure and even death. Two million Americans and four million Europeans have an irregular heartbeat.
Ibuprofen has also been implicated in causing meningitis in adults and children. A patient information sheet for infant ibuprofen for babies over six months of age listed meningitis as a serious side effect of the drug and instructed parents to stop using the medication and see a doctor immediately.
The journal Medicine (Baltimore) reported that ibuprofen is the most frequent cause of drug induced aseptic meningitis: "Ibuprofen is a common nonsteroidal anti-inflammatory drug that is the most frequent cause of aseptic meningitis induced by drugs. The incidence of this type of aseptic meningitis is increasing, mainly among patients with underlying autoimmune connective tissue disorder, but also among healthy people. Whatever the clinical presentation, physicians must consider the possibility of ibuprofen-related meningitis or meningoencephalitis in patients taking ibuprofen, especially if they are suffering from an autoimmune connective tissue disorder."
Patients taking ibuprofen could seek advice from their doctor about other forms of medication or consult a qualified alternative medicine practitioner if they are worried, and parents giving anti-inflammatories to their children for pain relief could consider using a different form of painkiller.
Non-steroidal anti-inflammatory drug use and risk of atrial fibrillation or flutter: population based case-control study, BMJ, 4th July 2011 - http://www.bmj.com/content/343/bmj.d3450
NSAIDs and atrial fibrillation, BMJ, 4th July 2011 - http://www.bmj.com/content/343/bmj.d2495
Ibuprofen linked to irregular heart rhythm, The Telegraph, 9th July 2011 - http://www.telegraph.co.uk/health/healthnews/8615998/Ibuprofen-linked-to-irregular-heart-rhythm.html
Patient Information Sheet for Infant Ibuprofen - http://www.boots.com/wcsstore/cmsassets/Boots/Content/Products/Pain%20Supports%20-%20CAT:%20A00000552/10097822.P/boots%20ibuprofen%206%20months.pdf
Characteristics of meningitis caused by Ibuprofen: report of 2 cases with recurrent episodes and review of the literature, Medicine (Baltimore). 2006 Jul;85(4):214-20 - http://www.ncbi.nlm.nih.gov/pubmed/16862046
Reviewed July 11, 2011
by Michele Blacksberg R.N.
Edited by Alison Stanton
Joanna is a freelance health writer for The Mother magazine and Suite 101 with a column on infertility, http://infertility.suite101.com/. She is author of the book, 'Breast Milk: A Natural Immunisation,' and co-author of an educational resource on disabled parenting, in addition to running a charity for people damaged by vaccines or medical mistakes.