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Q&A

What is Vioxx?

Vioxx is the brand name for a nonsteroidal, anti-inflammatory drug prescribed for arthritis, acute pain in adults and painful menstrual cycles.

What should I do if I am taking Vioxx?

Stop immediately, says Dr. David Wofsy, president of the American College of Rheumatology. "The nature of the complication here _ a heart attack _ is very serious," he said. "Though it happens in only a small fraction of people, it's not a risk anyone should take."

How long has Vioxx been available?

Since being introduced on the market in 1999, Vioxx has become a blockbuster drug for Merck & Co., with $2.5-billion in worldwide sales last year.

Why is Vioxx being pulled off the market now?

A clinical trial tracking Vioxx's effectiveness in preventing the recurrence of colon polyps has shown that Vioxx may cause an increased risk of heart attack and stroke if used long-term. Merck has stopped the clinical trial and voluntarily withdrawn Vioxx from the market worldwide.

Will I be able to buy Vioxx from Mexico or Canada?

No. Merck is removing the product from the market everywhere.

Can I get a refund for my prescription?

Merck will reimburse patients for unused Vioxx tablets. Information on how to obtain reimbursement will be posted on the Web (www.vioxx.com) in a few days, or patients can call toll-free 1-888-368-4699.

What are my options if I can't take Vioxx?

Discuss alternatives with your physician. Vioxx is related to over-the-counter drugs such as aspirin, ibuprofen and naproxen, but those drugs sometimes cause ulcers and stomach bleeding if taken long term.

What are the prescription drugs similar to Vioxx?

Prescription drugs in the same category as Vioxx are Celebrex and Bextra, both made by Pfizer.

Could there be dangerous side-effects with Celebrex or Bextra?

Pfizer has reiterated its confidence in the safety of its drugs. Dr. David Wofsy, president of the American College of Rheumatology and a rheumatologist on the faculty of the University of California San Francisco, said studies so far have not found any problems with long-term use of Celebrex, but no patients using them have been followed for 18 months, as was the case with Vioxx.

_ KRIS HUNDLEY, Times staff writer

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