The debate over the safety of common painkillers such as ibuprofen has been reignited with a new study showing it can increase the risk of potentially fatal cardiac arrest.
Researchers in Denmark found that taking ibuprofen was associated with a 31 percent increased risk of cardiac arrest. Other medicines from the same family of painkillers, known as non-steroidal anti-inflammatory drugs (NSAIDs), posed similar dangers.
In Australia, ibuprofen is found in common, over-the-counter painkillers, including Nurofen and Advil.
"The findings are a stark reminder that NSAIDs are not harmless," said study leader Professor Gunnar Gislason, from the University of Copenhagen.
"Diclofenac and ibuprofen, both commonly used drugs, were associated with significantly increased risk of cardiac arrest."
Over-the-counter NSAIDs should only be available at pharmacies, in limited quantities and in low doses.Professor Gunnar Gislason
He warned NSAIDs should be used with caution and "should probably be avoided" in patients with cardiovascular disease or many cardiovascular risk factors.
"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.
"Over-the-counter NSAIDs should only be available at pharmacies, in limited quantities and in low doses."
The research isn't the first major study to draw a link between cardiac arrest and common painkillers.
In late 2016 The Guardianreported on UK research drawn from data for almost 10 million NSAIDs users from the UK, the Netherlands, Italy and Germany found 92,163 hospital admissions for heart failure were identified among the group.
In 2013 researchers found that diclofenac was the most commonly used NSAID in 15 countries studied, despite being associated with more cardiovascular complications than other NSAIDs.
The Therapeutic Goods Administration conducted two reviews of over the counter (otc) NSAIDS in recent years, one in 2014 focussing on cardiac advise and another in late 2016 on advice to pregnant women.
The 2014 review found OTC NSAIDS are safe when used according to the recommended doses for short durations, as instructed on the label.
"However, inappropriate use or overuse of these medicines can pose a significant health risk," the TGA said at the time.
The TGA also warned doctors to avoid using prescription NSAIDs in patients who previously had heart problems including myocardial infarction, angina, cardiac failure, hypovolemia, significant peripheral vascular disease or pre-existing significant renal/liver dysfunction.
"Use these medicines with caution in patients with risks factors for cardiovascular disease, undertaking individual assessment of each patient to ensure the benefits outweigh the risks," the TGA said.