Harvard Heart Letter

Pain relief balancing act

For people with heart disease, naproxen may be the best choice for easing pain.

Choices abound for easing the nagging pain of arthritis, a sore shoulder, bad back, or other ongoing problems. For this sort of long-term pain relief, most people reach for an over-the-counter painkiller like aspirin, acetaminophen (Tylenol, generic), ibuprofen (Motrin, generic), or naproxen (Aleve, generic). Some rely on prescription drugs such as celecoxib (Celebrex). A study supports the idea that one of these — naproxen — is easiest on the heart.

Key points

  • Pain relievers in the class known as nonsteroidal anti-inflammatory drugs (NSAIDs) have different effects on the heart, blood vessels, blood, and digestive system.

  • Among over-the-counter NSAIDs, naproxen appears to have a beneficial — or no — effect on the heart, while ibuprofen may increase the risk of a heart attack or stroke, possibly by interfering with the action of aspirin.

  • If you take both aspirin and ibuprofen, take the aspirin first each day and wait 30 minutes or so before taking ibuprofen.

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