Read the fine print the next time you pick up a bottle of ibuprofen or naproxen. You’ll see a warning about the risk for potentially deadly heart attacks and strokes. These drugs are known as nonsteroidal anti-inflammatories or NSAIDs.

The U.S. Food and Drug Administration (FDA)  requires NSAIDs to be labeled with a strong message about the risks they pose. Detailed risk information warns potential users that:

• The longer an individual uses NSAIDs, the greater the risk. However, heart attacks and strokes can occur within the first few weeks of use.
• The higher the dosage, the greater the danger.
• People with heart disease or risk factors like high blood pressure, face the greatest risk.
• Heart attack and stroke events can occur even in otherwise healthy people.

The warnings also apply to prescription NSAIDs, including diclofenac (Voltaren^®) and celecoxib (Celebrex^®). Your doctor might prescribe these for chronic pain from arthritis or other conditions.

The warnings do not apply to aspirin, even though it belongs to this class of drugs. If you take low-dose aspirin to prevent heart attacks or strokes, taking another NSAID might decrease the protection you get.

The warnings don’t mean you should never take these drugs. They are still effective treatments for pain, inflammation and fever. People with heart problems or high blood pressure should talk with their doctor before using them.

Read all drug labels carefully. Many multi-symptom cold medicines also contain NSAIDs, so make sure you don’t take a double dose unintentionally.

If you do take NSAIDs, seek immediate medical attention if you have symptoms of a heart problem or stroke. These include sudden chest pain, weakness on one side of the body, slurred speech or trouble breathing.

You can read more about the NSAID warning on the FDA website. 

Source: FDA Strengthens Warning That Non-Aspirin Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) Cause Heart Attacks or Strokes,  U.S. Food and Drug Administration, 2018.

Originally published 2/4/2016; Revised 2019, 2021