Americans are justifiably bewildered. On the one hand they are told to “take your medicine—it’s necessary to maintain good health.” On the other, they read that many of their medicines may cause the very problems they are trying to prevent. Some drugs may trigger troubles they never even imagined.
The asthma drug salmeterol (found in Advair and Serevent) is supposed to improve lung function for people with this serious breathing problem. But in recent years physicians have been warned not to use this drug as initial treatment for asthma. It may increase the risk of serious asthma attacks and asthma-related deaths.
Pain relievers like ibuprofen and diclofenac may raise blood pressure and increase the risk for heart attack or stroke. Some data even suggest that such nonsteroidal anti-inflammatory drugs are not very effective over the long term against osteoarthritis of the knee. NSAIDs might even accelerate joint degeneration.
After years of foot dragging, the FDA now warns that antidepressants might prompt suicidal thoughts in some vulnerable patients.
Heartburn drugs that suppress acid such as Aciphex, Nexium, Prevacid or Prilosec have become incredibly popular. But recent reports have linked long-term use of these drugs to an increased risk of hip fractures (Journal of the American Medical Association, Dec. 27, 2006) and pneumonia (Archives of Internal Medicine, May 14, 2007).
The most recent example of a confusing drug dilemma involves the diabetes medicine Avandia. On July 30, 2007, the FDA convened a panel of experts to make sense out of the murky data surrounding this popular medication. Diabetes doctors and drug experts determined that Avandia increases the risk of heart attacks. This medicine also carries a clear risk for heart failure.
One FDA safety officer, David Graham, MD, encouraged the agency to take the drug off the market. According to his calculations more than 200,000 people might have suffered heart attacks or strokes from this medicine. He estimated that for every month it remains on the market as many as 2,200 patients may suffer a serious cardiovascular complication.
Nevertheless, the assembled experts recommended that Avandia stay on the market. They encouraged the FDA to strengthen the warning on the label, however.
This mixed message leaves physicians and patients in a quandary. On the one hand, diabetes drugs are supposed to prevent the complications of diabetes. That means lowering the risk for heart problems. Taking a drug that might increase this risk seems counterintuitive.
Doctors may wonder why patients have become skeptical about new drug breakthroughs. The Vioxx and Avandia spectacles have made some people question whether they are guinea pigs in huge drug experiments.
New drugs are usually promoted aggressively. Sometimes older medications are safer solutions. There are many ways to treat arthritis, depression, diabetes, heartburn and high cholesterol. Surprisingly, even inexpensive home remedies are sometimes helpful. We discuss many alternate approaches in our book, Best Choices From The People’s Pharmacy. It is also available in public libraries and bookstores.
