The MHRA have conducted a full review of the cardiovascular safety of NSAIDs and concluded that the availbale data does not support a change to current practice.
The current advice can be found in the full review. In summary:
- Use Paracetamol based analgesia as first line where ever possible
- prescribing of NSAIDs should be based on overall safety profiles (including cardiovascular and gastrointestinal safety) as set out in product information, and risk factors for individual patients
- all patients should take lowest effective dose of NSAIDs or COX-2 inhibitors for the shortest time necessary to control symptoms
Particular to COX-2 Inhibitors:
- patients with established ischaemic heart disease (IHD), cerebrovascular disease should not take coxibs: celecoxib (Celebrex), etoricoxib (Arcoxia), and parecoxib (Dynastat)
- for patients with risk factors for cardiovascular events, individual risk assessment is appropriate before a selective COX-2 inhibitor is prescribed
Action: Ensure that you are using Paracetamol based analgesia as first line and that appropriate risk assessments are carried out on patients prescribed NSAIDs.