New reports on painkiller risks, based on reviews of dozens of studies including hundreds of thousands of patients, indicate most patients should try naproxen, an older anti-inflammatory drug.
Experts say it doesn't raise heart attack or stroke risk -- a major worry for older people -- and naproxen is inexpensive because generic versions have been around for years. Available over the counter, it's taken by millions of Americans.
The drawback is that like most painkillers, it can irritate the stomach, so doctors say some people may also need to take one of the newer acid reflux drugs.
"I do think we should start with naproxen in the vast majority of cases," said Dr. Steven Nissen, head of cardiology at the Cleveland Clinic and president of the American College of Cardiology. "It's about balancing the cardiovascular and gastrointestinal risk."
The new reports were published recently on the Web site of the Journal of the American Medical Association because of their public health implications ...
Along with the good news about naproxen, the two studies raise new concerns about a few painkillers, particularly diclofenac, which has been on the market since 1988. The commonly used anti- inflammatory drug, also sold as Voltaren and Cataflam, carries as high a risk of heart attack or stroke as Vioxx.
