Why shouldn’t you take OTC painkillers like Advil or Motrin? They up risk of heart disease, specially among diabetics

Are Type 2 diabetics at a greater risk of heart disease?

All patients of Type 2 diabetes are at increased risk for any form of cardiovascular disease, ranging from coronary artery disease to heart failure. This risk increases with the duration of diabetes and exponentially with poor glycaemic control.

How does taking common pain medications such as Advil or Motrin (ibuprofen) increase that risk further?

Diabetics are at a ten-time higher risk of suffering from a cardiac event than a non-diabetic individual. Patients of diabetes should be very cautious while consuming over-the-counter pain medications like Advil as these drugs are associated with a high risk of a coronary event. The increased risk for a heart disease in diabetics is further worsened if the patient consumes medications like Ibuprofen.

Why should people with Type 2 diabetes discuss the risks of using drugs like Ibuprofen with their doctors, especially if they’re older or their diabetes isn’t well managed?

Ibuprofen belongs to a class of drugs called NSAIDS which work by inhibiting an enzyme in our body (COX2). This enzyme inhibition results in synthesis of prostacyclin with no effect on synthesis of thromboxane, tilting the fine balance in the body towards a risk of thrombosis, leading to higher chances of myocardial infarction or heart attack. Apart from a heart risk, these NSAIDs are nephrotoxic and may worsen kidney function. As diabetics are also predisposed to chronic kidney disease, prolonged use of this medication might be extremely harmful.

Which age group should be more careful about taking these pills?

All diabetics, especially those with long-standing and poorly controlled diabetes, should consult their endocrinologist before starting these medications.

What can be the alternatives of these medicines? 

A commonly available alternative to NSAIDs is Paracetamol. Though not as effective in pain management, it lacks both the cardiotoxic and nephrotoxic side effects.

What can be the effect of these pills if taken on a regular basis by non-diabetics?

Long-term use of NSAIDs should be avoided in general by even non-diabetic patients because of the mentioned adverse effects. In addition to the effect on heart and kidney, NSAIDs can also lead to gastric ulcer formation. So, keeping in view multiple adverse effects of this class of drugs, their prolonged use should be avoided by both diabetic and non-diabetic individuals.