Safety Information for Patients Taking Vioxx, Celebrex, Bextra, Naprosyn, and other Drugs that May Elevate the Risk of Heart Attack

Recent data has shown that there may be an increased risk of heart attack associated with taking these drugs.

What you should do:

Celebrex, Bextra, Naprosyn and Vioxx are very helpful drugs that some persons need for arthritis, inflammation and the associated pain.

Each person should weigh their personal heart attack risk and act accordingly. Patients should not take more that the dosage recommended by their doctor. Patients who can discontinue the drugs or switch to other drugs, such as tylenol, should consider doing so.

Persons at very low risk of heart attack may not choose to worry at all and may choose to continue taking the medicines as directed, using no more than the recommended dose. Persons with significantly elevated risk of heart attack should consider discontinuing the drugs if they can do without them or find substitute medications, such as tylenol.

Remember that risks need to be weighed against benefits. We all know that driving our cars brings us a risk of a serious car accident, but we are willing to take that risk since we feel it's reasonable. Many persons continue to smoke cigarettes, or fail to use their seatbelts, or they choose risky sports or hobbies. The increased risks of heart attack or stroke associated with Vioxx, Celebrex, Bextra and Naprosyn may be resonable risks, especially in a person who really needs these medications and who has no other risk factors for heart attack or stroke.

Painkillers suspected of causing fatal heart disease may act by starting the process of hardening the arteries. The drugs, known as COX-2 inhibitors, are popular prescription painkillers. Tests on mice suggest COX-2 inhibitors might be especially dangerous to younger women, who are normally protected by biology from heart disease. A fatty acid made by the cyclooxygenase-2, or COX-2, enzyme protects female mice from hardening of the arteries. Shutting down COX-2 long term may actually kick-start the process of atherosclerosis.

A different study involving Alzheimer’s disease prevention was suspended after researchers said there were more heart attacks and strokes among patients taking naproxen, an over-the-counter pain reliever in use for 28 years and commonly known under the brand name Aleve.
The study, involving some 2,500 patients, was to test whether naproxen or Celebrex, both pain relievers, could reduce the risk of Alzheimer’s disease among healthy elderly patients who were at an increased risk of the disease.

Celebrex was found to have risks as well. The National Cancer Institute, which was conducting a separate cancer-prevention trial for Pfizer, said patients in the clinical trial taking 800 milligrams of Celebrex had a 3.4 times greater risk of cardiovascular events compared to a placebo. For patients in the trial taking 400 milligrams of Celebrex the risk was 2.5 times greater. The average duration of treatment in the trial was 33 months.In the 2,000 patient study, 15 individuals taking 400 mgs, 20 patients taking 800 mgs and 6 patients on placebo suffered either a cardiac-related death, heart attack or stroke.

Portions of this page adapted from news presented on msnbc, on 12/21/04