Painkillers used in Kenya linked to cardiac arrest, study shows

Two painkillers commonly used in Kenya have been linked to increased risk of cardiac arrest, a study has shown.

Diclofenac and ibuprofen (Brufen) are readily available over the counter – without a doctor’s prescription – and can also be administered to children.

Cardiac arrest occurs when the heart suddenly stops pumping blood around the body.

The research published Wednesday in the European Heart Journal - Cardiovascular Pharmacotherapy (EHJ-CVP) warns that increased cardiovascular risk is a global concern because the drugs are widely used to relieve pain, reduce inflammation and bring down a high temperature.

The author of the study, Prof Gunnar Gislason, professor of cardiology at Copenhagen University Hospital Gentofte, Denmark, said: “Allowing these drugs to be purchased without a prescription, and without any advice or restrictions, sends a message to the public that they must be safe.”

The study shows the use of any painkiller classified as non-steroidal anti-inflammatory drugs (NSAID) was associated with a 31 per cent increased risk of cardiac arrest. Other NSAIDs include aspirin, naproxen, celecoxib and rofecoxib but these are fairly safer, the study shows.

It further says diclofenac, which costs Sh100 per tablet in Kenya (its generic costs Sh5 per tablet), is associated with a 50 per cent risk of cardiac arrest. On the other hand, ibuprofen’s risk of causing a cardiac arrest is 31 per cent. The drug costs about Sh10 a tablet and its generic Sh1.

'STARK REMINDER'

Prof Gislason said the findings from the 10-year study are a “stark reminder that NSAIDs are not harmless”.

He said: “Our study adds to the evidence about the adverse cardiovascular effects of NSAIDs and confirms that they should be taken seriously and used only after consulting a healthcare professional.

“They should probably be avoided in patients with cardiovascular disease or many cardiovascular risk factors.”

Kenyans are exposed to these cardiovascular risks due to sedentary lifestyles characterised by a lot of sitting, bulging waistlines and little physical exercise.

Prof Gislason said, as such, the medicines should only be available at pharmacies, in limited quantities and in low doses.

Painkillers work by, among other ways, constricting blood vessels such as arteries, influencing the clumping together of platelets in the blood, which causes blood clots, increases fluid retention and raises blood pressure.

Therefore, the researchers advise limiting ibuprofen to 1,200 milligrammes per day and avoiding diclofenac altogether.

A pharmacist in Kisumu told the Nation that Brufen, for instance, is administered three times a day. For children, this is about 200mg per tablet or about 600mg in a day.

The other safer painkiller option, the study shows, is Naproxen, said to be “probably the safest NSAID”. This is an active ingredient of a drug called Feldene, which is available in the country at Sh70 per capsule.