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Patients Should Ask Doctor About Which Drugs Are Best ; People Need to Inform Physician of History and Other Medications

Posted on: Saturday, 9 April 2005, 03:00 CDT

Taking Bextra or Celebrex? It's probably time to talk to your physician -- again.

"It's important that patients who have a history of cardiovascular or gastrointestinal disease be extremely cautious with these drugs," said Victor A. Yanchick, professor and dean of the school of pharmacy at Virginia Commonwealth University.

After the prescription pain-reliever Vioxx was taken off the market last year because of fears that it increased risk of heart attacks and strokes, worried patients taking it or similar drugs such as Bextra and Celebrex were advised to talk to their doctors about what they should do.

Yesterday's action by the federal Food and Drug Administration to take Bextra off the market and to require stronger warnings for the prescription drug Celebrex and related over-the-counter pain- relievers means it may be time to re-evaluate again.

Yanchick said it's important for people who continue to take the drugs, often used for arthritis pain, to take them as prescribed by a doctor who knows the patient's medical history.

"If you are supposed to take one tablet once a day ... don't exceed the recommended dosage," said Yanchick.

Patients should get all their prescriptions filled at a single pharmacy so their progress can also be monitored by a pharmacist for potential problems, he said.

Doctors at one local rheumatology practice have a recorded message advising patients what steps to take.

The patient education page on the American College of Rheumatology's Web site has suggestions for what patients should ask or tell their doctors, including:

*Make sure the doctor knows your entire medical history, including history of ulcers or other stomach problems, heart disease, high blood pressure and stroke, and medication allergies.

*Tell your doctor about all medications you are taking, including medicines prescribed by other doctors, over-the-counter medicines and other supplements.

*Talk about any side effects or problems you think you have had with your current or previous nonsteroidal anti-inflammatory drugs (NSAIDs).

*Talk about the differences in risks and benefits of taking a traditional NSAIDs, such as ibuprofen and naproxen, versus a cox-2 selective NSAID, such as Celebrex.

*If you use a traditional NSAID, ask whether you should also take a medicine to protect the stomach.

*If you are taking (or will be taking) low-dose aspirin, ask if aspirin use will affect the choice of an NSAID.

*If you and your physician decide that a cox-2 NSAID is the best choice, take the lowest dose that gives pain relief and consider taking it for limited periods.

Source: Richmond Times - Dispatch

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