Harvard Heart Letter

Trying times for painkiller choices

Vioxx, Bextra, and Celebrex can increase the risk for heart attack and other cardiovascular problems. So can the old standbys, like ibuprofen and acetaminophen.

The ruckus over the safety of three blockbuster painkillers "" Vioxx, Celebrex, and Bextra "" is shining the spotlight on how drugs are tested and marketed. Just as important, it is exposing our all-too-comfortable relationship with painkillers.

The sudden removal of Vioxx from the market in 2004 because of possible cardiovascular side effects "" after an estimated 20 million Americans had taken the drug "" sparked calls for drug approval reform, not to mention thousands of lawsuits. A few months later, Bextra was yanked due to life-threatening skin reactions and possible cardiovascular effects. But the problems aren't limited to the new kids on the block. We're learning that the old standbys, like ibuprofen (Advil, Motrin, others) and acetaminophen (Tylenol), aren't entirely blameless when it comes to heart trouble.

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