Good medicine Good medicine (February 11, 2005)

Advice on taking prescription pills

By Steven Carlson

Q: After Vioxx was pulled from the market, I went on Celebrex. Should I stop taking it? A: Talk with your physician about whether you should continue taking the drug or explore alternative medications. Vioxx, and now Celebrex, Bextra and naproxen (brand names are Aleve and Naprosyn), have been linked with an increased risk of heart attack and stroke, especially when they are used for long periods of time or in very high-risk circumstances, like immediately after heart surgery.

The studies that indicated that Vioxx had some risk were more conclusive. The jury is still out on Celebrex, Bextra and naproxen. For the vast majority of patients, these medications are tolerated and safe. Furthermore, they work. Studies are currently underway to clarify the risks of these medications. The Food and Drug Administration (FDA) is pooling all studies and will meet and review the findings later this month.

Generally, physicians are comfortable prescribing these drugs for patients with low cardiovascular risk, but there are other factors that only a doctor can fully assess. With any pain reliever, consumers should not exceed the recommended dose or take the product for longer than recommended, unless directed to do so by a physician.
Q: Is it safe to buy medicine over the Internet? A: If Mountain View residents are consistent with their fellow Americans, they each got about 12 prescriptions, on average, filled last year. Nationally, that's more than nearly 4 billion prescriptions a year. These medications carry a huge price tag, making the "bargain" prices from the Web very tempting.

But purchasing a medication from an illegal Web site can be risky business. You may receive a tainted or bogus product, the wrong product or incorrect dosage. Without going through a health care professional, you expose yourself to serious health risks. In a glossy ad or on a Web site, a drug may sound like what you want or need, but there's no safety check with Internet sales that a drug is for you or safe to use.

The American Medical Association and FDA agree, as do most physicians, that buying drugs online is a bad idea. Talk to your doctor before using any medications for the first time.
Q: What's the difference between generic drugs and brand-name prescription drugs? A: The most obvious difference is cost. Brand names are more expensive because the marketing campaigns that build name recognition are expensive. Some insurance companies will only pay for generic pharmaceuticals as a cost-saving measure. But the savings don't cost you health. Generic drugs have the same active ingredients as the brand-name versions, and they're all reviewed and approved by the FDA before going on the market.
Steven Carlson, M.D., practices internal medicine at Camino Medical Group's Sunnyvale Clinic and is the chair of the Group's Pharmacy and Therapeutic Committee.
E-mail Camino Medical Group representative Cynthia Greaves at greavec@caminomedical.org.

E-mail a friend a link to this story.