In an article for the journal Rheumatology, published on-line Sept. 24, it was revealed that use of nonsteroidal anti-inflammatory drugs (NSAIDs) may increase a patient’s risk of a blood clot in a vein. These types of clots include deep vein thrombosis (DVT) and pulmonary embolisms (PE). The risk of a blood clot was increased 80 percent in NSAID users, the study authors found.
The analysis looked at six published studies, involving 21,401 patients who had suffered a venous thromboembolism (VTE), a blood clot in a vein. HealthDay reported on Sept. 24 that the association between the use of NSAIDs and and an increased risk of blood clots was clear. What was not clear was the association between individual types of NSAIDs and blood clots.
Nonsteroidal anti-inflammatory drugs are found in over the counter medications and also in prescribed formulations. They are used for the relief of pain and to lower fevers. The American Academy of Orthopaedic Surgeons lists aspirin, ibuprofen and naproxen as some of the most common NSAIDs. Brand names include Advil, Motrin, Aleve as well as the many aspirin products made by companies such as Bayer. Acetaminophen is not an NSAID but can be found in formulations that also include an NSAID.
Prescribed NSAIDs include COX-2 inhibitors. Vioxx and Bextra are no longer on the market due to their potential to increase a patient’s risk of heart attack or stroke, the Cleveland Clinic states.. Celebrex remains available by prescription but carries the same warning as as over the counter NSAIDs about the risk of stroke or heart attack. COX-2 drugs carry less risk of causing bleeding in the digestive tract than the other NSAIDs and may be better tolerated by some patients.
Health Day quotes Dr. Steven Carsons, chief of the division of rheumatology, allergy and immunology at Winthrop-University Hospital, as stating that aspirin continues to be an effective drug for the prevention of blood clots. He also stated that naproxen use appears to present no additional risks for clotting.
A deep vein thrombosis or pulmonary embolism can be life threatening, the Centers for Disease Control note. The greatest risk is for a blood clot to form in a blood vessel in the heart or brain, or to flow there from a clot elsewhere in the body. Such clots cause strokes or heat attacks when they block blood flow to parts of the brain or heart.
Acetaminophen is the active ingredient in a large number of medications with Tylenol being, perhaps, the most commonly recognized. Whether prescribed or purchased over the counter, it is often used to treat the same pain and fevers as NSAIDs. It is not a nonsteroidal anti-inflammatory drug. Its use carries the risk of liver damage. Patients should not take more than 4,000 mg of acetaminophen per day.
Patients should consult their physician for specific recommendations concerning pain relief or reducing fever. Both over the counter and prescription medications come with detailed instructions that the user should read and follow. Both NSAIDs and acetaminophen are found in a wide variety of formulations that may include other medications. The cumulative dose of a pain reliever from several medications may exceed the safe limit for that drug.