Does taking nonsteroidal anti-inflammatory drugs (NSAIDs) increase the risk of heart attack or stroke?

Answer From Rekha Mankad, M.D.

Yes. Nonsteroidal anti-inflammatory drugs (NSAIDs) — medications commonly used to treat pain and inflammation — can increase the risk of a heart attack and stroke. This increase in risk affects people who already have heart disease and those who don’t. However, the risk is greater in those who have heart disease.

You can buy NSAIDs without a prescription. And some NSAIDs are available only by prescription. Examples of NSAIDs include ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve, Anaprox DS, others), diclofenac sodium and celecoxib (Celebrex).

If you need to take an NSAID, take the smallest dose for as short a time as possible. This limits the risk of heart attack or stroke. NSAIDs are generally safe for most people to take once in a while. But be aware that serious side effects can occur as early as the first weeks of daily NSAID use. The risk can increase the longer it’s taken.

To help ease muscle or joint pain, consider other therapies — such as hot or cold packs or physical therapy — before taking NSAIDs. Your health care provider might suggest other medications, such as acetaminophen (Tylenol, others) for general pain relief. If you have COVID-19, there’s no evidence to suggest avoiding ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs).

Aspirin doesn’t appear to be associated with a higher risk of heart attack or stroke. If you take aspirin to help prevent a heart attack, talk with your health care provider before taking NSAIDs. Some NSAIDs interact with aspirin and affect its ability to prevent a heart attack.

If you develop signs or symptoms of a heart attack or stroke — such as chest pain, shortness of breath, weakness in one part of the body or side of the body, or sudden slurred speech — get medical attention right away.

 

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