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Life Without Vioxx

What's A Patient To Do?

October 1, 2004
The abrupt withdrawal of Vioxx leaves many patients wondering what to do for pain relief. Vioxx was touted as being easy on the stomach, unlike many other pain remedies that can cause gastric distress, ulcers and bleeding.

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Merck withdrew the drug after tests found a risk of heart attacks and strokes in patients who had taken it for 18 months.

For many patients, the simplest -- and cheapest -- solution is to go back to over-the-counter drugs like ibuprofen and naproxen, better known as Advil and Aleve. While they may cause digestive distress in some patients, there are medications -- like Pepcid -- that can help reduce the discomfort.

As always, diet and exercise are the cheapest and least potentially harmful ways to reduce the pain of osteoathritis and other maladies aggravated by being sedentary and overweight.

By the way, patients don't have to worry about going off Vioxx suddenly. Unlike many drugs, there is no need to taper off.

Vioxx was one of a class of drugs known as COX-2 inhibitors. Thus, the most obvious alternative for many patients who had good results with Vioxx is to switch to another COX-2 drug, like Pfizer's Celebrex and Bestra.

Like Vioxx, Celebrex and Bextra are easy on the stomach. But do they also present a risk of vascular problems? Some researchers say there's no indication of that. But the European Agency for the Eavluation of Medicinal Products recommends against any COX-2 drug for patients predisposed to cardiovascular ailments.

The truth is there haven't been any rigorous long-term studies yet, so no one can say for sure.

What about those who've been taking Vioxx for a year or two? Most researchers think the risk of heart attack and stroke go away when the drug is discontinued. But, again, there have been no rigorous studies so no one really knows.

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