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Took Vioxx—Now What?
By Kelly Griffin
October 2004
More than a million Americans have relied on Vioxx for relief of chronic
pain. Now, they are left with two aching questions: Has Vioxx damaged
my heart? And, what should I take now?
The good news,
says cardiologist Eric Topol , M.D., of the Cleveland Clinic, is that
as long as you stop taking the drug immediately, there’s no
reason to worry about long-term damage. Vioxx raises heart-attack
and stroke risk by making it easier
for blood clots to form, and also by raising blood pressure. There
is no evidence it causes any permanent damage to the cardiovascular
system. Once you stop taking Vioxx, it should be out of your system
within a few days.
People who take one of the remaining COX-2 inhibitors, Celebrex or
Bextra, may wonder whether their drug poses the same risk as Vioxx.
While there is no conclusive evidence of the same level of risk with these drugs, one study has pointed to the possibility of a slight increased cardiac risk with Celebrex, Cardiologist and pharmacologist Garret FitzGerald, M.D., of the University of Pennsylvania called for further safety tests in an article released October 6 by the New England Journal of Medicine. Nevertheless, he says, the current evidence of risk is much more convincing for Vioxx than for either Celebrex or Bextra.
Adds FitzGerald of the remaining COX-2 inhibitors: "I think these drugs are very useful, particularly for people who have had gastric ulcerations. The question really is: In people who are at high cardiovascular risk, should there be a warning to consider avoiding members of this class? We really need to get guidance from the FDA on this particular issue."
Does that mean Vioxx users should switch to one of these COX-2 inhibitors?
Not necessarily, says rheumatologist John Clough, M.D., of the Cleveland
Clinic. Most people can get effective pain relief with cheap, over-the-counter
pain relievers such as Motrin (ibuprofen), Aleve (naproxen) and other
nonsteroidal anti-inflammatory drugs (NSAIDs). Of these, naproxen has
the added benefit of actually protecting the heart.
“The only reason a person would need a selective COX-2 inhibitor,” says
Clough, “would be if they have a recent history of peptic ulcer
or some other disorder of the gastrointestinal tract that the standard
NSAIDs might aggravate.”
Consult with your doctor to decide which painkiller is right for you.
If you have Vioxx on hand, don’t use it up. Merck & Company,
the drug’s manufacturer, will refund the price of unused Vioxx
in its original pharmacy packaging. For information about the refund,
or more information about the drug, visit the
Merck's website or
call 888-368-4699.
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