Diclofenac and ibuprofen, two painkillers British researchers have concluded can increase the risk of heart diseases, should not cause alarm as the benefits on proper dispensation outweighs the "long-term” risks, health officials have said.

The two drugs are common in the country. They are mainly dispensed to patients with migraines and many other diseases such as arthritis and gout (painful joints due to age). They are also used as common pain relievers for various ailments such as toothache.

However, British researchers, last week, published in the British Medical Journal findings of studies on the effect of painkillers that ibuprofen and diclofenac, among other such drugs can be equally dangerous in terms of heart attack risk as Vioxx, which was withdrawn from the market for similar reasons in 2004. 

Vioxx, which was not used in Rwanda, is a type of non-steroidal anti-inflammatory drug which goes by the generic name rofecoxib and is a relative of more familiar drugs such as ibuprofen and naproxen.

The Ministry of Health, however, argues that precautions are made before a drug is marketed in the country. Besides, pharmacists are also expected to regulate prescription since they already know that the drugs have side effects. 

"When a medicine’s benefits outweigh its known risks, it is considered safe enough to be used. What the researchers pointed out in this article is the "long-term high-doses of the mentioned painkillers” which is not recommended. These medicines are safe when used at recommended doses and their long-term use is not recommended,” Patrick Mwesigye, the Coordinator of the Pharmacy Task Force in the Ministry of Health, said.

Mwesigye added that there are always other alternatives but the ministry does not recommend them.  

He further called upon the population to avoid taking medicine in high doses, or those which are not recommended by physicians and pharmacists. He also advised patients to avoid chronic/abuse of medicines in general.  

Mwesigye said the findings should help people understand that these medicines should be taken with precaution and follow instructions to avoid high doses because when they are abused, their risks can outweigh their benefits. 

"Before using any medicine, they should think through the benefits and the risks in order to make the best choice for them but above all, all users should seek advice from the pharmacists and physicians while getting medication,” he added. 

Merck, the company that used to make Vioxx, voluntarily withdrew the drug from the market after reports showed that patients taking it had higher rates of cardiovascular events.

High demand 

According to Lambert Ingabire, a Pharmacist at King Faisal Hospital, the demand for ibuprofen or diclofenac is high in Rwanda. 

He also said that these drugs are non-steroidal, anti-inflammatory and analgesic.  

These pain relievers are used by a number of patients such as those suffering from cramps, teeth ache, and muscle aches among other pains. 

Although he could not confirm that long-term high-dose use of ibuprofen or diclofenac is dangerous in terms of heart attack risk, he said painkillers could have some side effects such as somnolence and  constipation. 

Alternatives for this medication include piroxicam, Ketoprofen, Indocid and aspirin according to the Pharmacist. 

He also adds that high dose use of this medication would mean consumption of over 200mg a day.