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I Took Vioxx—Now What?

What to take for pain relief - Now that Vioxx is not an option.

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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