NEW DELHI: Painkillers can turn to be lethal, especially in case of those suffering with diabetes, hypertension, high cholesterol and kidney diseases. Painkillers and fever-reducing drugs, which are often easily available over the counter in India, increase the chance of a heart attack or stroke either of which can lead to death, the US drug regulator has warned.

Non-steroidal anti-inflammatory drugs (NSAIDS), a class of drugs that provides analgesic (pain-killing) and antipyretic (fever-reducing) effects, pose higher risk of heart attacks, which can occur as early as the first week of using these medicines and the risk increases with longer use or higher doses of such drugs, the US Food and Drug Administration (FDA) has said, basing its findings on a comprehensive review over last 10 years.

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In India, popular brands of pain killers and fever reducing medicines such as Brufen, Voveran and Meftal Forte are easily available and are often used with self-medication. Experts say though they these medicines are also popular among doctors, there is a need to be cautious while prescribing them.

"US FDA's reiteration of the warning after so many years is very crucial. They must have found more evidence against these medicines to raise an alarm of greater risk," says Dr Anoop Misra, a leading endocrinologist and chairman of Fortis C-DOC hospital for diabetes. According to Misra, though these medicines are very useful, they need to be avoided particularly among those exposed to high risk of heart attacks.

The American regulator has now raised an alarm asking patients and health care professionals to remain alert for heart-related side effects while using pain killers and fever reducing medicines.

"Patients taking NSAIDs should seek medical attention immediately if they experience symptoms such as chest pain, shortness of breath or breathing trouble, weakness in one part or side of the body, or slurred speech," it said.

It has also decided to update the existing warnings on drug labels to indicate that such medicines pose an "increased risk of heart failure".

The risk of heart attack and stroke with pain killers and fever reducing medicines was first described by the US FDA in 2005 when it issued boxed warning on drug labels. "Since then, FDA reviewed a variety of new safety information on prescription and OTC NSAIDs, including observational studies, a large combined analysis of clinical trials, and other scientific publications," said the American regulator, considered the world's strictest watchdog for medicines.

US FDA said though there is a greater likelihood of heart attack or stroke in patients with heart diseases or risk factors after taking NSAID, there are also studies showing that use of these medicines can increase the risk even in patients without any such disease.