Ask the doctor; With Vioxx gone, what can I do for my aches and pains that won't harm my heart?

Harvard Heart Letter, December, 2004

Q The news that Vioxx was pulled from the market rattled me, since I had been taking it for my arthritis for almost two years. I have heard both that it is okay for people like me with heart disease to take one of the other Vioxx-like drugs and that it isn't okay. What do you recommend?

A Although the sudden decision to withdraw Vioxx came as a surprise, it wasn't entirely unexpected. Concerns about the cardiovascular safety of this medication were raised soon after it was approved for sale in the United States.

As I write this in early October 2004, hard and fast guidelines for replacing Vioxx haven't yet been published. What I and many of my colleagues are telling our patients with heart disease is to first try one of the older, more established...