Are Vioxx, Celebrex, Bextra, and other Cox-2 inhibitor drugs worth the risks?
Preventing a stomach ulcer is not worth the added risk of having a heart attack, warns Dr. Byron Cryer, associate professor of internal medicine at UT Southwestern Medical Center. He is referring to the use of COX-2 inhibitors drugs marketed as Celebrex, Vioxx and Bextra, medications that were approved in the late 1990s for treating severe arthritis pain. Now, in certain cases, they have been associated with gastrointestinal ulcer complications. (Related article: Merck hid risks of death from Vioxx)
While Celebrex has been approved to remain in the U.S. market with a black-box warning, Vioxx and Bextra have been removed. They were hugely popular until last fall, when Vioxx was voluntarily pulled after clinical studies found long-term use significantly increased the incidence of heart attacks and strokes. (Related article: Vioxx side effects reconfirmed)
“While the COX-2 inhibitors are associated with a reduced rate of serious complications such as bleeding in the stomach and intestines, their gastrointestinal benefit is offset by side effects in other systems, specifically an increase in cardiovascular complications such as heart attacks and stroke,” says Dr. Cryer. He says alternatives include combining an older nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen (Advil, Motrin) or naproxen (Aleve) with medications that reduce acid secretion in the stomach, such as Aciphex, Nexium, Prevacid, Prilosec or Protonix.
The anti-inflammatory drugs etodolac (Lodine) and meloxicam (Mobic) are similar in gastrointestinal safety to COX-2 inhibitors and do not appear to have the same cardiovascular risks. Another option is acetaminophen (Tylenol) or narcotics-type pain medications. He suggests you consult your physician before changing your medication regimen. (Related article: Pain relief options after Vioxx and Bextra recall)
Vioxx recall lawsuits update
In the meantime, Merck, the manufacturer of Vioxx, continues its legal battle with Vioxx victims. Despite Merck's desperate attempts to deny Cheryl Rogers, the widow of Brad Rogers who died after taking Vioxx, the right to seek damages, the trial is likely to go ahead in the coming months (there are ongoing discussions to delay the trial by several months). Clay County Circuit Judge John Rochester, who is handling the case had asked Merck and plaintiff's attorney Jere Beasley to start settlement talks. Now you may recall that Merck has not only refused to accept responsibility for even one death from Vioxx, it has also refused to engage in any out-of-court settlements. Thus, Merck went into settlement talks only after being forced to do so by the judge. Merck's strategy appears to be to drag the trial and discourage other Vioxx victims from coming forward. (Related article: Vioxx lawsuit drama in Cheryl Rogers case)
In a related development, the second Vioxx lawsuit trial scheduled to begin in Angleton, Texas on May 31 has been posponed to July. In a case similar to Cheryl Rogers', Carol Ernst is accusing Merck that its drug caused the death of her husband Robert Ernst.