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FDA causes unnecessary scare about common painkillers

The U.S. Food and Drug Administration (FDA) has caused an unnecessary scare about some pain relievers by adding a warning to drugs that are safe, says Curt Furberg, M.D., Ph.D., from Wake Forest University School of Medicine. At the same time, he says the agency has failed to recognize the harm of a pain reliever that should be taken off the market.

"The FDA is adding 'black box' warnings to all prescription and over-the-counter pain relievers ?even to naproxen ?which the evidence shows is safe," said Furberg, who serves on the FDA Drug Safety and Risk Management Advisory Committee. "This is based on the false assumption that all nonsteroidal anti-inflammatory drugs increase the risk of heart attacks. In fact, there are major differences between these agents."

In a commentary published by Trials (http://www.trialsjournal.com/content/8/1/13), an online journal of BioMed Central, Furberg says the FDA has failed to recognize current scientific evidence when it made decisions on the safety of nonsteroidal anti-inflammatory drugs (NSAIDs) that are often used to treat the pain or inflammation from arthritis.

The most commonly used NSAIDs are ibuprofen (Advil®), naproxen (Aleve®), and diclofenac (Voltaren®). There are more than a dozen others, including drugs such as celecoxib (Celebrex®) that are in a special class known as selective COX-2 inhibitors because of the hormone they target. The other NSAIDs are known as "non-selective."

Furberg said while the evidence for the non-selective NSAIDs is somewhat limited, an analysis combining several small studies found that high doses (500 mg twice daily) of Aleve were not associated with an increased risk of heart attacks compared to a placebo, or an inactive pill.

On the other hand, high doses of Advil (800 mg three times a day) and Voltaren (75 mg twice daily) were associated with rates of heart attack that were 51 percent
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Source:Wake Forest University Baptist Medical Center


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