Advisory on Using Pain Medication
Reported March 23, 2005
(Ivanhoe Newswire) — Are you confused about what painkillers to take following recent arguing over the safety of COX-2 inhibitors? The American Heart Association’s new science advisory on the use of COX-2 inhibitors and other non-steroidal anti-inflammatory drugs suggests using the drug with the fewest known side effects.
The authors of the advisory explain that COX-2 inhibitors were developed with the idea of having a good pain reliever that wouldn’t upset the stomach. This sounded great until the long-term use of Vioxx (rofecoxib) was associated with increased heart attacks and strokes. Since the removal of Vioxx from the market, the FDA has conducted hearings into the safety of other COX-2 inhibitors.
The advice issued by the AHA includes:
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Potent drugs like the COX-2 inhibitors Celebrex (celecoxib) and Bextra (valdecoxib) should be held as a last defense and should be used short-term. Medications such as aspirin and acetaminophen (Tylenol) in recommended doses and duration have minimal toxicity, which makes them good first choices. If these don’t work, the AHA says to try a stronger NSAID like naproxen (Aleve).
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Because the adverse effects of COX-2 drugs are greatest in patients with, or at high risk for, cardiovascular disease, the statement suggests limiting the use of these drugs to those who have no appropriate alternatives. If necessary, use the lowest recommended dose for the shortest period.
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Consumers are warned that all over-the-counter drugs like aspirin and ibuprofen should be used in strict accordance with label directions, and if an OTC pain reliever is needed for more than 10 days, consult a doctor.
“In terms of drug use, one rule is always best, and it holds whether you are treating cancer or treating a headache: Always use the safest medicine first,” says Joel S. Bennett, M.D., a hematologist and a member of the writing group that drafted the advisory.
SOURCE: Circulation, published online March 21, 2005
