Doctors are struggling to decide which pain relievers to prescribe now that they know that popular drugs like Vioxx and Celebrex

Celebrex: Lawyer: Monheit Law: Side Effects: Heart Attack: Cox-2 Celebrex Studies

"The pressures to prescribe are enormous," Dr. Matteson said. "You constantly have people at your door."... effectiveness of various procedures and drugs used to treat 10 of the most common health conditions, including stroke, arthritis, pneumonia, diabetes and ulcers. ... studies have linked Vioxx, Bextra and Celebrex - all of which are in the class of drugs known as COX-2 inhibitors - to increased heart risks under certain conditions. In late September, Vioxx was withdrawn from the market by its manufacturer, Merck. Pfizer, the maker of Bextra and Celebrex, continues to sell both drugs but has limited marketing.... Because responses to pain relievers varies among individuals, ... others doing similar studies decided that Vioxx, Celebrex and Bextra did not relieve arthritis-related pain any better than other drugs they had been tested against, like ibuprofen, which is also a nonsteroidal anti-inflammatory drug, or Nsaid.

... Vioxx showed the strongest evidence of reducing the incidence of stomach bleeding associated with older Nsaids. Stomach bleeding is a problem that is generally limited to older patients or those with a history of gastrointestinal problems. ... prescribing of COX-2 drugs by doctors ... Doctors working for the Veterans Affairs Department have been curtailing their use of COX-2 drugs since late 2001.... Kaiser Permanente, which also sharply limited its COX-2 prescriptions, saved money. Their actions may have also saved lives. A study conducted by an F.D.A. researcher that was released in September found that Kaiser patients relied on high doses of Vioxx, which can increase the risk of heart attacks, less than half as often as the general population.

... last month in a medical journal, Gastroenterology, found that the rate of stomach bleeding caused by etodolac was substantially lower than that caused by naproxen and comparable to that of Vioxx. ... Dr. David Campen, a medical director at Kaiser, said that his organization had not yet changed its prescribing guidelines for Celebrex, ... The Mayo system, ... has decided to reduce its use of the COX-2 drug even further. ... Previously, any patient over 60 qualified for Celebrex...
NY TIMES

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