Un estudio muestra los problemas relacionados con el consumo de algunos antiinflamatorios que se pueden comprar en la farmacia sin receta
En España y en muchos otros países es posible comprar fármacos como el ibuprofeno sin receta. Los ciudadanos toman estos medicamentos para todo tipo de dolores sin mayores restricciones. Sin embargo, las autoridades médicas y sanitarias desde hace tiempo se advierte que no son inocuos. Un estudio publicado esta semana en la revista European Heart Journal ha concluido que incrementa un 31% el riesgo de paro cardiaco. El mismo análisis indicaba que otros fármacos del mismo tipo, antiinflamatorios no esteroideos (AINE), presentan un riesgo incluso superior.
Según los autores del trabajo, liderado desde el Hospital Universitario Gentofte de Copenhage, el naproxeno es el AINE más seguro, y se podrían tomar hasta 500 miligramos al día. El diclofenaco es el más peligroso y, dicen los investigadores, se debería evitar su consumo ya que hay otros fármacos con efectos similares más seguros.
“Permitir comprar estos fármacos sin prescripción y sin ningún consejo o restricción manda un mensaje al público de que tienen que ser seguros”, afirma en una nota de la Sociedad Europea de Cardiología Gunnar Gislason, coautor del estudio. “Otros estudios anteriores han mostrado que los AINE están relacionados con un mayor riesgo cardiovascular, algo que preocupa porque su uso está muy extendido”, añade.
Para realizar esta trabajo, los científicos recogieron todos los paros cardiacos registrados en Dinamarca entre 2001 y 2010. Además, recogieron toda la información sobre prescripciones de estos medicamentos desde 1995. En el tiempo estudiado, 28.947 habían tenido un paro cardiaco fuera del hospital en el país. De ellos, 3.376 habían tomado AINEs hasta 30 días antes del ingreso. El ibuprofeno y el diclofenaco fueron los dos medicamentos más utilizados, cubriendo respectivamente el 51% y el 22% del uso total. Respecto al incremento del riesgo de paro cardiaco, el ibuprofeno fue responsable de un 31% y el diclofenaco del 50%.
Entre las explicaciones posibles, los autores plantean que los efectos se pueden deber a la agregación de plaquetas que provocan coágulos, hacen que las arterias se estrechan, se incrementa la retención de líquidos y sube la presión sanguínea. “No creo que estos fármacos se debieran vender en supermercados o gasolineras donde no hay consejo profesional sobre cómo usarlos. Los AINE solo deberían estar disponibles en farmacias, en cantidades limitadas y dosis bajas”, ha planteado Gislason.
En España, la Agencia Española de Medicamentos y Productos Sanitarios (AEMPS) emitió una recomendación para limitar el consumo de ibuprofeno. No debería tomar más de 2.400 miligramos al día a pacientes con enfermedad cardiovascular grave: insuficiencia cardiaca, cardiopatía isquémica, enfermedad arterial periférica o cerebrovascular. La recomendación llegó tras la revisión europea (del Comité para la Evaluación de Riesgos en Farmacovigilancia) elaborada respecto al riesgo cardiovascular de este medicamento así como del dexibuprofeno, sobre el que también se deben tomar precauciones.
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