Does taking nonsteroidal anti-inflammatory drugs (NSAIDs) increase the risk of heart attack or stroke?
Yes. Nonsteroidal anti-inflammatory drugs (NSAIDs) can increase the risk of heart attack and stroke. These medicines most often treat pain, swelling and irritation, called inflammation, and fever.
The increase in risk affects people who have heart disease and those who don't. But the risk is greater in those who have heart disease. So it's best for people with heart disease not to use NSAIDs if possible.
You can buy many NSAIDs without a prescription. You can get some NSAIDs only by prescription. Examples of NSAIDs include ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve, Anaprox DS, others), diclofenac sodium and celecoxib (Celebrex, Elyxyb).
If you need to take an NSAID, take the smallest dose for as short a time as you can. This helps cut the risk of heart attack or stroke. Depending on where your pain is, an NSAID gel that you put on the skin might be a safer choice.
Most people can take NSAIDs safely once in a while. But serious side effects can happen 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, try hot or cold packs or physical therapy before taking NSAIDs. Your healthcare professional might suggest other medicines, such as acetaminophen (Tylenol, others), for pain relief.
Aspirin doesn't appear to be linked to a higher risk of heart attack or stroke. If you take aspirin to help prevent a heart attack, talk with your healthcare professional before you also take NSAIDs. Some NSAIDs get in the way of aspirin working to prevent a heart attack.
If you get symptoms of a heart attack or stroke, get medical help right away. These symptoms include chest pain, shortness of breath, weakness in one part of the body or one side of the body, or sudden slurred speech.
Show References
- Solomon DH. NSAIDs: Adverse cardiovascular effects. https://www.uptodate.com/contents/search. Accessed April 18, 2024.
- NSAIDs and the risk of heart problems and stroke. Arthritis Foundation. https://www.arthritis.org/health-wellness/treatment/treatment-plan/disease-management/nsaids-risk-of-heart-problems-and-stroke. Accessed April 18, 2024.
- Minhas D, et al. Recommendations for the use of nonsteroidal anti-inflammatory drugs and cardiovascular disease risk. Decades later, any new lessons learned? Rheumatic Disease Clinics of North America. 2023; doi:10.1016/j.rdc.2022.08.006.
- Information about taking ibuprofen and aspirin together. U.S. Food and Drug Administration. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/information-about-taking-ibuprofen-and-aspirin-together. Accessed April 18, 2024.
- Schjerning AM, et al. Cardiovascular effects and safety of (non-aspirin) NSAIDs. Nature. 2020; doi:10.1038/s41569-020-0366-z.
- Warning signs of a heart attack. American Heart Association. https://www.heart.org/en/health-topics/heart-attack/warning-signs-of-a-heart-attack. Accessed April 22, 2024.
- Stroke signs and symptoms. Centers for Disease Control and Prevention. https://www.cdc.gov/stroke/signs_symptoms.htm. Accessed April 22, 2024.
Original article: https://www.mayoclinic.org/diseases-conditions/heart-attack/expert-answers/nsaids-heart-attack-stroke/faq-20147557