Calls for ibuprofen sale restrictions after study finds cardiac arrest risk

There have been fresh calls for restrictions on the sale of the painkiller ibuprofen after another study found it heightens the risk of cardiac arrest.

Taking the over-the-counter drug was associated with a 31% increased risk, researchers in Denmark found.

Other medicines from the same group of painkillers, known as non-steroidal anti-inflammatory drugs (NSAIDs), presented an even higher risk, according to the findings published on Wednesday in the European Heart Journal.

Diclofenac, available over the counter in the UK until 2015 and still taken on prescription, raised the risk by 50%.

Prof Gunnar Gislason of the University of Copenhagen, who led the study, called for tighter controls on the sale of ibuprofen and other NSAIDs. He 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 findings are a stark reminder that NSAIDs are not harmless. Diclofenac and ibuprofen, both commonly used drugs, were associated with significantly increased risk of cardiac arrest.”

The findings are the latest to raise alarm about the use of NSAIDs. Last September a study in British Medical Journal found they were linked to an increased risk of heart failure. Previous studies have linked the drugs to abnormal heart rhythm – which can cause heart failure – and an increased risk of heart attack and stroke if taken regularly.

Gislason urged people with heart problems to avoid ibuprofen and other NSAIDs. “NSAIDs should be used with caution and for a valid indication. They should probably be avoided in patients with cardiovascular disease or many cardiovascular risk factors,” he said.

“I don’t think these drugs should be sold in supermarkets or petrol stations where there is no professional advice on how to use them.”

Gislason suggested they should only be taken after consulting a doctor. “Over-the-counter NSAIDs should only be available at pharmacies, in limited quantities and in low doses,” he said.

He added: “The current message being sent to the public about NSAIDs is wrong. If you can buy these drugs in a convenience store then you probably think: ‘They must be safe for me.’

“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.”

The Danish investigators studied data on almost 29,000 patients who suffered an out-of-hospital cardiac arrest recorded in Denmark between 2001 and 2010. They found that use of any NSAID raised the likelihood of cardiac arrest by 31%.

The researchers speculated that the results could be explained by the effect of the drugs on the cardiovascular system, as they influence platelet aggregation and the formation of blood clots. They may also cause arteries to constrict, increase fluid retention and raise blood pressure.

Gislason said people should not take more than 1,200mg of ibuprofen in one day.

The Proprietary Association of Great Britain, the trade body representing manufacturers of over-the-counter medicines said the study had “several limitations,” and insisted that NSAIDs are safe.

John Smith, its chief executive, said: “Information about daily dosage was only based on estimates rather than accurate data and didn’t account for over-the-counter use. Prescribed NSAIDs would normally contain a higher dosage than those medicines available over-the-counter and would typically be used for longer durations.”

He added: “NSAIDs available over-the-counter, such as ibuprofen, are an effective and appropriately safe way to provide short-term pain relief if used in accordance with the clear on-pack instructions and the patient information leaflet inside. NHS Choices recommends NSAIDs to help relieve pain, reduce inflammation, and bring down a temperature.

“It is important for people with a history of heart disease or other long term condition to speak to a pharmacist before taking any over the counter medicine to check for any potential drug interactions or health concerns.”

Calls for ibuprofen sale restrictions after study finds cardiac arrest risk

Polish abortion law protesters march against proposed restrictions

Polish women have gathered in cities across the country to protest against a proposal to ban abortions in cases where foetuses are badly damaged or have no chance of survival after birth.

Many wore black, a symbol of mourning for the feared loss of reproductive rights, as they took to the streets of Warsaw, Gdańsk, Łódź, Wroclaw, Poznań and other cities and towns across the predominantly Roman Catholic nation of 38 million.

“Girls just want to have fundamental rights,” one banner proclaimed.

The protests on Monday follow a similar round of street demonstrations in early October, a reaction to a proposal for an even more restrictive law which would have banned abortion in all cases, including rape, and imposed prison sentences of up to five years on women and doctors involved in terminating pregnancies.

Massive so-called “black protests” forced lawmakers to abandon that proposal.

The women, joined by many men, have returned to the streets in response to a new proposal by Jarosław Kaczyński, the head of the ruling Law and Justice party. Earlier this month, he said his party wants to ensure that even pregnancies involving a child “certain to die, very deformed, still end up in a birth, so that the child can be baptised, buried, have a name”.

In the weeks since the first round of protests, the grassroots movement advocating abortion rights has increased its demands. Those who turned out on Monday also called for better sex education and easier access to birth control while also demanding that the influential Roman Catholic church end its “interference” in political life and public education.

Clashes broke out between abortion rights supporters and anti-abortion activists outside a metro station in central Warsaw where demands were laid out in a petition that a steady stream of people lined up to sign.

“We want to live in a secular society,” said Agata Rybka, a 24-year-old student of biotechnology at Warsaw University who had volunteered to oversee the petition signing. “Right now religious issues dominate public discourse and we don’t like it.”

Poland already has one of the most restrictive abortion laws in Europe, with terminations only allowed in cases of rape, when the foetus is irreparably damaged and when the woman’s life or health is in peril.

The new proposal would not amount to a total ban, and would still allow abortion in cases of rape or if the woman’s life or health is in danger.

Dorota Szumilak, a 44-year-old financial analyst, signed the petition, explaining that she did so because she saw in the abortion ban proposal an attempt to restrict women’s rights more broadly. A Lutheran, she said she feels discriminated against in a society where the Catholic church runs religion classes in the schools and is now supporting further restrictions on abortion.

“The role of the church is now too strong,” she said.

She was with a friend, Malgorzata Brendel, 53, who said the attempts to tighten the abortion law had prompted her to become one of a growing number of Poles who are now formally leaving the Catholic church.

Polish abortion law protesters march against proposed restrictions