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How Safe Are Other Pain Relievers?

Posting Date: 04/04/2005

Millions of people have taken Vioxx, Celebrex and Bextra for pain. These new COX-2 inhibitor drugs were prescribed for a variety of conditions, including arthritis, muscle strains and bad backs.

Then evidence about heart attacks and strokes led to the removal of Vioxx. Scary headlines also undermined sales of Celebrex and Bextra.

With all the bad news, many physicians started looking for alternatives. Some are prescribing older NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen, naproxen or diclofenac.

Others are turning to newer drugs, such as Mobic, for patients in pain. This anti-inflammatory medication has avoided controversy largely because it was not advertised as heavily as Vioxx or Celebrex. But some scientists have begun to question whether Mobic or even some NSAIDs are much safer than the drugs they are replacing.

Mobic also affects the COX-2 enzyme. Australian drug regulators have classified it as a COX-2 inhibitor and warn against its use by patients with cardiovascular risk factors.

American patients are puzzled. One reader wrote:

?I?ve read that Mobic is a COX-2 inhibitor. I am confused since my doctor told me it isn?t.

?I'm trying to figure out what my risk would be with this drug if it were a COX-2 inhibitor. I'm 43 and not overweight, run 40 miles a week and don't smoke or drink. My cholesterol and blood pressure are low, and I have no personal or family history of heart disease. Should I be concerned about using Mobic or any other COX-2 inhibitor??

Most doctors would conclude this patient?s risk is extremely low. But even some people without obvious heart problems may be vulnerable.

One reader shared her tragic story:

?I have read recent reports about the drug Mobic and its possible link to heart attacks. I have been so frustrated trying to find out why my 39-year-old husband suddenly collapsed and died from a fatal heart arrhythmia.