Continuing to consider the Vioxx withdrawal


Category : Medical Rants, Pharma

Another good NY Times piece on Vioxx – One Lesson From Vioxx: Approach New Drugs With Caution

Some words of wisdom:

If nothing else, the removal of the painkiller Vioxx from the market last week served as a reminder that new drugs sometimes turn out to have unforeseen side effects after a few years of widespread use, and it makes sense to use them with caution.

“When we weigh the risks and benefits of medication, the word new has to be added to the risk side,” said Dr. Susan Louisa Montauk, of the University of Cincinnati College of Medicine. “That does not mean that one should never use a new drug, but it does make it a risk because major concerns can come up as long as 8 to 10 years down the line.”

This is not a new concern. All who have practiced medicine for more than 10 years have learned this lesson. My previous posts on this topic have stressed this point!

Dr. Jerry Avorn, the author of “Power Medicines: The Benefits, Risks and Costs of Prescription Drugs,” said he thought that when older drugs were available, “there better be a damn good reason to take the new drug.”

He recommended that patients ask their doctors, “Does this drug have any important advantage over existing drugs that would make it worth my taking it?”

Jerry Avorn speaks wisely. Physicians should also ask themselves this question. Sometimes newer drugs have advantages. The introduction of PPIs (Prilosec, Prevacid) greatly advanced treatment of gastroesophageal reflux. Newer antibiotics are sometimes necessary because of resistance problems.

We should not reflexly either reject nor accept new drugs. We should look at the data objectively and make conservative decisions. When in doubt, stick with the tried and true.

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Vioxx medblog roundup
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