Doctors were bombarded with phone calls from worried patients after the announcement last week that drug manufacturer Merck had pulled its popular arthritis drug, Vioxx, from the market because of safety concerns.
Despite new evidence that taking Vioxx for 18 months or longer can increase the risk of stroke or heart attack, doctors said Friday that there is no need for people to fear for their health.
But a spot-check around the USA found that patients are concerned and are asking doctors what to do. Rheumatologist Matthew Ornstein of Mount Sinai Medical Center in New York City, who fielded patients' calls Thursday and Friday, says people should not panic, and the fact that no harmful effects were seen in the first 18 months of use suggests Vioxx is ''not a dramatically dangerous medicine.''
But Steven Abramson, director of rheumatology at New York University Medical Center, said the number of calls from patients indicates that the announcement is ''a major concern'' for people who take the medication and even for those who take drugs in the same class, such as Celebrex and Bextra. He said there is no evidence of problems with the other drugs.
Vioxx's withdrawal followed small studies that hinted at an association with heart problems, but it wasn't until results from a large, three-year study were announced last week that the company acted. Some doctors say they have been suspicious of Vioxx for a long time.
''Two and a half years ago, I took Vioxx off the shelves at Maimonides (Medical Center in New York City),'' says Warren Wexelman, a cardiologist and director of clinical therapeutics. ''I always felt the drug was flawed.''
Wexelman saw several bad reactions to the drug, such as fluid retention leading to swelling of legs, congestive heart failure and shortness of breath, in his patients. Two had to be hospitalized.
''I'm thrilled Merck finally did the right thing,'' he says.
Doctors say older drugs, such as ibuprofen, which is available over the counter or by prescription, can be effective, especially when taken with stomach-protecting medicines.
But some people don't want to switch. Internist Jim Jirjis of Vanderbilt Medical Center in Nashville says his office called all patients who were taking Vioxx to tell them that the drug was being withdrawn and to advise other treatments. One patient said, ''Quick, before it's off the shelves, write me a prescription for lots of them,'' Jirjis says. He refused.
Jerry Lynn, 70, of New York City says Vioxx has allowed him to play tennis twice a week. ''I'm very sorry they're taking it off the market.''
In Charleston, W. Va., Faye Ewing, 75, says Vioxx is the only thing that eased severe shoulder pain. Now, she says, ''I don't know what I'm going to do.''
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