In the last several months, all of the COX-2 inhibitors have been linked with heart disease. Vioxx is off the market; the FDA is evaluating Bextra and Celebrex. Now naproxen, a non-selective nonsteroidal anti-inflammatory drug, has been linked with heart disease. There is concern that the other NSAIDs, including ibuprofen (advil) may also increase the risk of heart disease.
I believe these medications are relatively safe for short-term use. Those at low risk for heart disease can continue to use these medications long-term under the supervision of a physician.
For those who are at high risk for heart disease and need long-term pain management, the choices now include aspirin, tylenol, and opioids. Aspirin is just as effective as the NSAIDs for pain management, and has the same risk of GI bleeding. Aspirin is well known to reduce the risk of heart attacks. I expect the use of aspirin to increase significantly in the upcoming year. Many patients find tylenol ineffective. Unfortunately, the Feds have cracked down on the prescription of opioids.
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