Millions of Americans who took the painkillers Vioxx and Celebrex could have taken older -- and less expensive -- painkillers like ibuprofen instead.

The drugs, part of a group of drugs known as COX-2 inhibitors that have recently come into question due to their negative effects on the heart, were primarily marketed as being less likely, in theory, to cause stomach complications like bleeding than other, older, nonsteroidal anti-inflammatory drugs, or NSAIDs.

However, patients who were at little risk for the stomach complications accounted for some two-thirds of the growth in Vioxx and Celebrex use from 1999 (the year the drugs came onto the market) to 2002. The finding has raised questions as to why so many patients at low risk for stomach complications were prescribed Vioxx and Celebrex.

According to researchers, Vioxx and Celebrex represented only one-third of NSAID prescriptions in 1999, yet by 2001 they made up nearly two-thirds. They say consumers' assumptions that "newer" drugs are automatically "better" may have influenced the growth in part and point out that new drugs have only been proven to be better than placebo and not necessarily other drugs on the market.

Marketing efforts also influenced the extreme growth of Vioxx and Celebrex. Merck, the drug company that makes Vioxx, spent some $161 million on direct-to-consumer ads in 2000 -- more than was spent on any other drug in 2000. Vioxx was pulled from the market in September 2004 -- when 2 million people in the United States were taking it -- after studies showed an increased risk of heart attack and stroke in patients taking the drug.

Other studies have also found an increased risk of heart attack and stroke among those taking Celebrex and another COX-2 inhibitor, Bextra, both of which are made by Pfizer.

Archives of Internal Medicine January 24, 2005;165(2):171-7

USA Today January 24, 2005

Dr. Mercola's Comments:

It's not at all surprising to read that doctors were overprescribing Vioxx and Celebrex by the MILLIONS, even to patients who probably never needed to switch to them. What's interesting is how it happened. Low-risk patients accounted for TWO-THIRDS of the growth of Vioxx and Celebrex from 1999 to 2002. Researchers blame much of the growth of these "Twin Towers" of the COX-2 product line to human nature. Simply put, patients AND doctors tended to believe "newer" drugs were "better" than older, more proven NSAIDs. However, the above study demonstrates that both drugs have been proven only to be better than a placebo. Where did patients and doctors get that notion that "newer" was better? A torrent of marketing dollars -- to the tune of $161 million -- Merck spent on direct-to-consumer ads for Vioxx in 2000 ALONE. But that's a drop in the bucket considering the many billions these toxic drugs have generated in earnings for Merck and Pfizer. You probably also recall I posted warnings about Vioxx back in 1999 -- long before it was launched. At the time, I knew this drug was a prescription for disaster and specifically recall conversations with Merck drug reps who laughed at me about my concerns. I doubt they are doing that today. Of course, there are far healthier and safer ways to treat your pain: Begin to normalize your daily ratio of omega-3 and omega-6 fats by taking a high-quality fish or cod liver oil. Reduce (with the idea of soon eliminating) sugars and grains from your diet. Optimize your diet according to your body's unique metabolic type. And, for those of you still looking for alternatives to Vioxx, Bextra and Celebrex, check out my past article Seven Ways to Protect Your Heart With Anti-Inflammatory Alternatives. Related Articles: Vioxx -- The Beginning of the End for Conventional Medicine; Feds Ignore Vioxx Warnings Whistle Blower is My New Hero In Light of Vioxx, Bextra Getting A Closer Look No More Celebrex Ads: FDA Orders Them Off the Air More Evidence of Doctors Over-Prescribing Drugs Should Drugs be Advertised on Television?