7 ms·

I don't agree with the conclusions in this article at all. Also consider that Celebrex (same drug family) is still on the market. If these drugs were truly a gr

by Duff 14y ago

I don't agree with the conclusions in this article at all. Also consider that Celebrex (same drug family) is still on the market. If these drugs were truly a grim reaper, I don't think Celebrex would still be around. If anything, this should be seen as a reason to not allow the pervasive advertising of prescription drugs and aggressive peddling of drug swag - Vioxx was peddled in the most ostentatious way -- my doctor STILL has Vioxx clipboards and other junk in his office. I'm sure that this constant brand awareness and patient nagging helped drive sales (ie. encourage potentially unnecessary or inappropriate scripts). The other thing to consider is quality of life. I began suffering by a sudden onset of what was eventually diagnosed as a degenerated disc in my back -- at age 25. I went through some intensive physical therapy to try to avoid surgery (ultimately an unsuccessful effort), and Vioxx was the only thing that allowed me to function without narcotic pain relief (which I refused to take for more than a week at a time). It was that good at reducing chronic inflammation. If I were a 75 year old man with severe, debilitating arthritis having difficulty walking or living a decent life, I'd happily volunteer to take a drug like Vioxx to improve the quality of my remaining time here, even knowing that I was at a higher risk of a heart attack.

ajross 14y ago
Your argument seems to be one of simple personal disbelief, that one drug "in a family" can have effects that others don't? That doesn't seem to be borne out by history or logic... Even your own anecdote seems to argue against it: Vioxx worked for you pain, but Celebrex doesn't.
- Duff 14y ago
  I never tried Celebrex, as I had surgery in early 2004 that eliminated the need for any medication. I'm not a pharmacist, but the story regarding this drug is more nuanced. Doctors prescribed the two drugs differently, as folks with other drug sensitivities were not good celebrex candidates, and the risk factors associated with vioxx were not known. Vioxx was the more heavily marketed, "safe" choice.
liber8 14y ago
I've heard this from countless other people as well (including many doctors). Apparently, it was a fantastic pain drug for many people. Should Merck have disclosed the increased risk of heart attack and stroke? Absolutely. But, part of the problem is the incentives fostered by a bureaucracy like the FDA. If you know that your new wonderfully effective pain medication increases the risk of heart attacks from 4% to 6% (or whatever the numbers were), are you going to disclose that to the FDA, knowing it essentially spells doom for the billion dollars plus you spent on development?
- jeffdavis 14y ago
  "If you know that your new wonderfully effective pain medication increases the risk of heart attacks from 4% to 6% (or whatever the numbers were), are you going to disclose that to the FDA, knowing it essentially spells doom for the billion dollars plus you spent on development?" Did Merck not disclose something? http://en.wikipedia.org/wiki/Vioxx http://en.wikipedia.org/wiki/Vioxx seems to indicate they did disclose the increased risk over naproxen, but tried to explain it away without further investigation.
- jeremyarussell 14y ago
  Wouldn't it be nice if pharmacies could just publish all these finding and let people decide what to put in our own bodies. I know they argue that we aren't doctors and therefore shouldn't be forced to make those decisions, but with the aid of a doctor and true transparent facts I'm pretty sure I would have no problem going, okay this drug is twice as good at helping with my terrible pain, and the side effect is that I'm more likely to die of a heart attack. I'd go, well maybe I don't want to take that risk since I'm at risk already for a heart attack, or I could go oh I'm young and have no family history of heart failure, I should be alright the risk is worth the gain. I can't for the life of me figure out why we can't just do that. Anyone around care to enlighten me?
  - refurb 14y ago
    The majority of patients have ZERO ability to evaluate the risks and benefits with pharmaceutical intervention. The best example I can provide is patient compliance (do they take their drug as prescribed?). You'd be hard pressed to find a rate higher than 50% for any disease (other than the immediately life-threatening ones).
Alex3917 14y ago
Both tylenol and marijuana are in the same family of drugs (CB2 agonists), but tylenol kills hundreds of Americans per year whereas marijuana doesn't. The fact that they are vaguely in the same family doesn't mean they have comparable risk profiles.
- excuse-me 14y ago
  One of the most toxic pain killers (Acetaminophen/Paracetamol) is also one of the most common over the counter medicines!
  - sp332 14y ago
    Tylenol is usually fine if you stick to the recommended doses. Usually when someone has serious problems with it, they've been taking handfuls at a time (which will completely destroy your liver).
    - excuse-me 14y ago
      Anything is fine if you stick to the recommended dose! The problem with this drug is that 16-20 tablets can be a fatal dose - which isn't that many taken 2 at a time.
      - sp332 14y ago
        Even water is toxic if you ingest too much too quickly.
        excuse-me 14y ago
        IIRC Tylenol (ie Acetaminophen/Paracetamol) is the leading cause of deaths due to drugs. Both accidental, because the fatal dose is relatively low compared to the therapeutic dose and because deliberate overdoses are far more likely to be fatal than say sleeping tablets.
- deleted 14y ago
  [deleted]
sliverstorm 14y ago
Is an increased risk of heart attack preferable to narcotics? To my understanding, something simple like morphine has few side effects, beyond the obvious risk for addiction/abuse.
- Alex3917 14y ago
  Narcotics don't have negative health side effects, but there are still the issues of: - Do they actually work to relieve pain? - Are people able to function normally on them, or are they stuck in bed all day while unable to walk, with severe brain fog, profusely sweating, and nauseous. - Is it easy to accidentally OD even if you're taking the prescribed dose? (Which is the case with fentanyl patches... accidentally role over in bed or step into a hot shower without remembering to take it off first and there's a good chance you're dead.) Narcotics also aren't an anti-inflammatory so they're not actually fixing the problem at all, they're just covering up the pain, and often not even very well. That's why medical marijuana is so much better for back problems, because it's a strong anti-inflammatory, and also because the analgesic dose is much lower than the psychoactive dose so you can get relief from your pain without being left unable to function. Especially since you can now get high-CBD marijuana, which is basically non-psychoactive to begin with, but with even stronger anti-inflammatory properties than regular marijuana.
  - aiscott 14y ago
    From my personal experience with prescribed narcotics for things like wisdom tooth extraction, kidney stones, etc., is that they don't do much in terms of pain management. That is interesting about marijuana being anti-inflammatory...I did not know that.

by Duff 14y ago

ajross 14y ago

Your argument seems to be one of simple personal disbelief, that one drug "in a family" can have effects that others don't? That doesn't seem to be borne out by history or logic... Even your own anecdote seems to argue against it: Vioxx worked for you pain, but Celebrex doesn't.

Duff 14y ago
I never tried Celebrex, as I had surgery in early 2004 that eliminated the need for any medication. I'm not a pharmacist, but the story regarding this drug is more nuanced. Doctors prescribed the two drugs differently, as folks with other drug sensitivities were not good celebrex candidates, and the risk factors associated with vioxx were not known. Vioxx was the more heavily marketed, "safe" choice.

liber8 14y ago

I've heard this from countless other people as well (including many doctors). Apparently, it was a fantastic pain drug for many people. Should Merck have disclosed the increased risk of heart attack and stroke? Absolutely. But, part of the problem is the incentives fostered by a bureaucracy like the FDA. If you know that your new wonderfully effective pain medication increases the risk of heart attacks from 4% to 6% (or whatever the numbers were), are you going to disclose that to the FDA, knowing it essentially spells doom for the billion dollars plus you spent on development?

jeffdavis 14y ago
"If you know that your new wonderfully effective pain medication increases the risk of heart attacks from 4% to 6% (or whatever the numbers were), are you going to disclose that to the FDA, knowing it essentially spells doom for the billion dollars plus you spent on development?" Did Merck not disclose something? http://en.wikipedia.org/wiki/Vioxx http://en.wikipedia.org/wiki/Vioxx seems to indicate they did disclose the increased risk over naproxen, but tried to explain it away without further investigation.
jeremyarussell 14y ago
Wouldn't it be nice if pharmacies could just publish all these finding and let people decide what to put in our own bodies. I know they argue that we aren't doctors and therefore shouldn't be forced to make those decisions, but with the aid of a doctor and true transparent facts I'm pretty sure I would have no problem going, okay this drug is twice as good at helping with my terrible pain, and the side effect is that I'm more likely to die of a heart attack. I'd go, well maybe I don't want to take that risk since I'm at risk already for a heart attack, or I could go oh I'm young and have no family history of heart failure, I should be alright the risk is worth the gain. I can't for the life of me figure out why we can't just do that. Anyone around care to enlighten me?
- refurb 14y ago
  The majority of patients have ZERO ability to evaluate the risks and benefits with pharmaceutical intervention. The best example I can provide is patient compliance (do they take their drug as prescribed?). You'd be hard pressed to find a rate higher than 50% for any disease (other than the immediately life-threatening ones).

Alex3917 14y ago

Both tylenol and marijuana are in the same family of drugs (CB2 agonists), but tylenol kills hundreds of Americans per year whereas marijuana doesn't. The fact that they are vaguely in the same family doesn't mean they have comparable risk profiles.

excuse-me 14y ago
One of the most toxic pain killers (Acetaminophen/Paracetamol) is also one of the most common over the counter medicines!
- sp332 14y ago
  Tylenol is usually fine if you stick to the recommended doses. Usually when someone has serious problems with it, they've been taking handfuls at a time (which will completely destroy your liver).
  - excuse-me 14y ago
    Anything is fine if you stick to the recommended dose! The problem with this drug is that 16-20 tablets can be a fatal dose - which isn't that many taken 2 at a time.
    - sp332 14y ago
      Even water is toxic if you ingest too much too quickly.
      - excuse-me 14y ago
        IIRC Tylenol (ie Acetaminophen/Paracetamol) is the leading cause of deaths due to drugs. Both accidental, because the fatal dose is relatively low compared to the therapeutic dose and because deliberate overdoses are far more likely to be fatal than say sleeping tablets.
deleted 14y ago
[deleted]

sliverstorm 14y ago

Is an increased risk of heart attack preferable to narcotics? To my understanding, something simple like morphine has few side effects, beyond the obvious risk for addiction/abuse.

Alex3917 14y ago
Narcotics don't have negative health side effects, but there are still the issues of: - Do they actually work to relieve pain? - Are people able to function normally on them, or are they stuck in bed all day while unable to walk, with severe brain fog, profusely sweating, and nauseous. - Is it easy to accidentally OD even if you're taking the prescribed dose? (Which is the case with fentanyl patches... accidentally role over in bed or step into a hot shower without remembering to take it off first and there's a good chance you're dead.) Narcotics also aren't an anti-inflammatory so they're not actually fixing the problem at all, they're just covering up the pain, and often not even very well. That's why medical marijuana is so much better for back problems, because it's a strong anti-inflammatory, and also because the analgesic dose is much lower than the psychoactive dose so you can get relief from your pain without being left unable to function. Especially since you can now get high-CBD marijuana, which is basically non-psychoactive to begin with, but with even stronger anti-inflammatory properties than regular marijuana.
- aiscott 14y ago
  From my personal experience with prescribed narcotics for things like wisdom tooth extraction, kidney stones, etc., is that they don't do much in terms of pain management. That is interesting about marijuana being anti-inflammatory...I did not know that.