Narcotic painkillers, a class of drugs that includes Oxycontin, as well as the now-recalled medications Darvon and Darvocet, may increase the risk of heart attacks and bone fractures in elderly arthritis patients, a new study has found. According to a report in The New York Times, over the past several years, the use of narcotic painkillers like Oxycontin, Darvon and Darvocet in the elderly has increased based on assumptions that they were safer than other types of drugs, such as NSAIDS.
The study, which appears in The Archives of Internal Medicine, appears to be the first large-scale study to compare the safety of different types of painkillers given to the elderly, the Times said. It was conducted by researchers at Brigham and Womens Hospital in Boston and financed by federal Agency for Healthcare Quality and Research.
The study focused on 12,840 Medicare patients in Pennsylvania and New Jersey treated between January 1999 and December 2005. According to The Wall Street Journal, it found that those treated with narcotic painkillers (also known as opiods) faced an 87 percent increased risk of death during the study, compared to NSAIDs like ibuprofen.
The narcotic drugs were linked to a 68 percent increase in overall “safety events”â€”ranging from intestinal bleeding to stroke and heart attack to fracturesâ€”when compared with the older painkillers. Newer pain drugs didn’t show any increase in these overall safety events, the Journal said.
The narcotics were also linked to a risk of fractures that was 4.5 times that in patients taking the NSAID drugs. According to a CNN report, the researches found that in a given year, about 1 in 10 older people who take a narcotic painkiller will break a bone, compared with about 1 in 50 people taking COX-2 inhibitors, a more targeted form of NSAID.
The study also found that people who took opioids were more than twice as likely to have a heart attack compared to those who took NSAIDs. Most surprising, according to CNN, the risk of heart attack seen with narcotic painkillers was higher than that seen COX-2 inhibitors, even Vioxx and Bextra. COX-2 inhibitors have long been the subject of heart safety concerns, and both Vioxx and Bextra were pulled from the market because of their association with heart problems.
Recently, the US Food & Drug Administration (FDA) asked drug makers to stop sales of one narcotic painkiller, proproxyphene, because of its association with serious and possibly fatal heart rhythm problems. Propoxyphene is the active ingredient in both Darvon and Darvocet, which were recalled by Xanodynde Pharmaceuticals last month.
Since 1978, the consumer group Public Citizen has petitioned the FDA twice to start Darvon and Darvocet recall from the market (both are propoxyphene-based products). Public Citizen asserts that propoxyphene has been linked to many thousands of US deaths since 1981, a large proportion of which were likely caused by cardiac toxicity, including the interruption of electrical conduction in the heart.