Many people with arthritis swore by Celebrex, Vioxx, and similar long-lasting prescription NSAIDs (nonsteroidal anti-inflammatory drugs) in the late 1990s through early 2000s. Then came a big pullback when research linked these pills to heart attacks and strokes. Vioxx was pulled from the market because of its greater risk. But many swore off Celebrex, too. Now Celebrex is regaining popularity and so is Mobic. We asked Kate Lapane, Ph.D, an epidemiologist at University of Massachusetts, and rheumatologist Dr. Allan Gibofsky at Hospital for Special Surgery in New York, what people need to know before starting.
1. Risk is relative. All NSAIDs, whether prescription or over-the-counter, carry some risk, but the dangers for any individual have to do with your current heart health. “We are now more attuned to NSAID risk and can better balance it with the risk of under-treating joint pain,” Gibofsky says.
2. Dosage is a key factor. When nonprescription NSAIDs such as ibuprofen, naproxen, and aspirin are no longer working, or when you find yourself taking them at higher than recommended doses, it may be time to switch to a prescription.
3. It’s a team effort. When you take NSAIDs in prescription form, there’s the benefit of having expert supervision. “Taking them under a physician’s care is safer than self-treating pain from a progressive condition,” Gibofsky says.
4. We know more today than we did then. Many ask: How do unsafe drugs get on the market? “Drug studies are designed to prove efficacy, and are often not able to detect safety issues,” Lapane explains. “These studies are not large enough to detect side effects — that takes hundreds of thousands of people and sometimes years of follow-up.” She says NSAIDs on the market today have stood the test of time, but it bears repeating that none are risk free.