Harvard Men's Health Watch

Pain relievers: Bad for your heart?

People with heart disease should avoid prolonged use of certain anti-inflammatory drugs. Naproxen (Aleve) is safest.

The "stomach friendly" prescription pain relievers Vioxx (rofecoxib) and Bextra (valdecoxib) were removed from the market when evidence emerged that they raised the risk of heart attacks. But Vioxx and Bextra left behind a couple of over-the-counter cousins: ibuprofen (Advil, Motrin) and naproxen (Aleve). The ways these drugs work are quite different, but they are all members of the
family called nonsteroidal anti-inflammatory drugs (NSAIDs).

NSAIDs reduce pain, inflammation, and fever. To call them widely used is an understatement. Up to 40% of people 65 and older take an NSAID daily. But concern among cardiologists has grown with evidence that NSAIDs raise the risk of a second heart attack or death. So if you have heart disease, how should you manage pain?

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