Questions raised for consumers
The withdrawal of Vioxx from the market leaves about 2 million patients worldwide faced with immediate concerns: Should they stop taking the drug right away, switch to a similar drug, or go back to older drugs such as ibuprofen?
Dr. John Klippel, president of the Arthritis Foundation, said the first step should be a consultation with the health care professional who prescribed the drug. Other drugs may be an option, but he said many people could get relief from changes in diet and increased exercise.
"This is an opportunity to evaluate their entire treatment for pain," he said.
Some people may be able to switch to ibuprofen or naproxen, drugs that are roughly one-sixth the cost and that work well for many. For those who have stomach irritation or bleeding as a result of these drugs, Celebrex and Bextra, two drugs similar to Vioxx, are an option.
But for some patients, who are allergic to sulfa drugs, Celebrex and Bextra are off-limits. So Dr. Elinor Mody, a rheumatologist at Brigham and Women's Hospital, said she will "do what we did in the old days" before Vioxx and Celebrex. She'll prescribe ibuprofen or naproxen along with a drug that protects the stomach, or use Tylenol or a low-level narcotic.
The doctors disagree on whether patients should stop taking Vioxx immediately, but most say patients should switch to another remedy as soon as possible. Last night, the drug's manufacturer,
-- ALICE DEMBNER
