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New Warnings on Anti-Inflammatories

7 October 2014 No Comment

I just read an article on the Medical Observer website which said that the Therapeutic Goods Administrator (TGA) “will ramp up warnings on NSAID packages after a safety review found over-the-counter diclofenac was associated with liver damage and that NSAIDs in general were linked to adverse cardiovascular effects”.

The TGA has now suggested that these medications come with the following warning: “Warning: In rare cases, diclofenac has been associated with serious liver injury”.

A couple of choice quotes from the article:

  • Doctors have also been warned to avoid using prescription NSAIDs in patients with previous myocardial infarction, angina, cardiac failure, hypovolaemia, significant peripheral vascular disease and pre-existing significant renal/liver dysfunction.
  • High blood pressure, heart failure and stroke were also found to be associated with OTC versions of naproxen, ibuprofen and diclofenac.
  • While use of OTC NSAIDs at the recommended dose and for short durations was safe, incorrect use and overuse were found to pose “a significant health hazard”, the TGA review said.
  • It was “critical” that traditional NSAIDs were used with caution in patients with CV risk factors, according to the review, and blood pressure, renal function and body weight should be assessed before and after treatment with non-selective NSAIDs and COX-2 inhibitors to detect early cardiorenal side effects, it said.

The specific medications involved include

  • diclofenac,
  • naproxen,
  • ibuprofen,
  • celecoxib,
  • indomethacin,
  • meloxicam and
  • piroxicam


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