Word: naproxen
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...enough when prescription drugs like Vioxx and Celebrex turn out to have secondary effects that can kill you. But when a popular over-the-counter pill like Aleve (also known as naproxen) makes front-page news, linked to a 50% increased risk of heart attack, you've got to wonder what's going on. After all, most of us assume that any drugs sold over the counter--that is to say, without a doctor's prescription--must be pretty darn safe. And in general they are, when taken as directed--usually for just a few days--or in modest doses...
Aleve may yet get a clean bill of health. The National Institutes of Health issued its warning on naproxen based on a study of long-term use that hasn't been completely analyzed--and is contradicted by other findings. But the latest rash of drug scares serves as a timely reminder that even the safest FDA-approved medications can have side effects--some of them serious. (Don't think you're in the clear if you take herbals and other alternative remedies. Much less is known about their safety...
Vioxx is one in a new class of drugs called COX-2 inhibitors, which were designed to be safer for treating arthritis pain than over-the-counter remedies like aspirin, ibuprofen and naproxen. Concerns have been raised about another member of the group, Pfizer's Bextra. The safety of Celebrex, the most popular of the COX-2 drugs, will be reviewed in the coming months...
...first hint that there might be a problem with Vioxx surfaced in 2000, just a year after the drug won FDA approval. A study that compared Vioxx with naproxen (the active ingredient in Aleve) showed that Vioxx cut gastrointestinal problems in half but increased the risk of heart attack from 0.1% to 0.4%. Those results were ambiguous, though. Was Vioxx causing the heart attacks, or was naproxen protecting the heart? Few experts fault Merck for continuing to market Vioxx on the basis of that study alone...
...meantime, don't assume you necessarily have to switch to another COX-2 inhibitor. Aspirin, ibuprofen and naproxen work just as well as the prescription drugs, provided that you are not at increased risk for bleeding, peptic ulcer or other gastrointestinal problems. (See box for more details...