Friday, May 29, 2009


The controversy over painkillers for joint pains ( the NSAID or non-steroidal anti-inflammatory drugs ) and heart disease has been raging for quite awhile, I think since the early two thousands. The most popular episode was when MSD had to withdrawal VIOXX from the shelves when there were reports that VIOXX use maybe associated with an increase incidence of heart attacks and anginas. That cost MSD. Actually VIOXX and other similar drugs belong to a group of drugs called the Cox2 inhibitors, which were NSAID like without the gastric toxicity. Actaully the clinical papers linking Cox2 with heart disease were rather inconclusive, partly due to poor methodology and partly from some degree of manufacturer's cover-up of some relevant information and the incompetence of FDA at that time.
However, a recent paper in circulation, published in the May issue of Circulation, seem to suggest that Naproxen ( trade name, Simplex ) seem to be safe. Dr Ray of Vanderbuilt, Nashville, did a retrospective analysis on 48,000patients who were using painkillers and who also have heart disease, and found that some painkillers were associated with an increase incidence of heart disease, while naproxen was not. Five painkillers were studied. Of the NSAIDs, diclofenac ( locally voltaren and cataflam ) seem to come out worse and of the Cox2, Vioxx was worse then celebrax. One must bear in mind that this is a retrospective study with all its attendant bias.
Be that as it may, if I have joint pains and also heart disease, I will use naproxen, and if my stomach cannot tolerate it I will use celebrax. That to me will be reasonable, until I have more data. And that will be what I will advise my patients too.


Brate said...
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Brate said...

This is quite an astonishing result, especially for those taking medicine without the prescription of doctors. Many a times, the combination of two medicines can also cause some harmful effect on the health. Many people used to take inderal and paxil together. This sometimes has caused great heart problems. From the article you provided, I was quite shocked knowing that mere pain killer can be a carrier of so severe problems. Actually, because of the advancements in the technology in medicine, it has become quite necessary for us to consult a doctor. I have been doing so as I am having the facility for that. I can contact the doctor any time 365 days, because of the prevention plus plan( of Elite Health ( They certainly help me taking a complete health care. Such wellness programs also help maintain your health by a constant monitoring of your dietary habits also.