American Heart Association advises on painkillers

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The American Heart Association (AHA) issued an advisory on the use of COX-2 inhibitors and other non-steroidal anti-inflammatory drugs (NSAIDS) to help healthcare providers and patients choose the pain relief drug with the fewest known risks.

Certain painkillers increase cardiovascular risks, the AHA said. Drugs like Celebrex (celecoxib) and Bextra (valdecoxib) should be "held in reserve, generally for short-term use," according to Dr. Joel S. Bennett, a member of the group that released the advisory.

The AHA's advisory affirmed recent cautions issued by the U.S. Food and Drug Administration (FDA). Merck's Vioxx was voluntarily pulled from the market in September 2004 when evidence that daily use of the drug increased the risk of blood clots. These findings have led to investigations by the FDA of other COX-2 inhibitors still on the market.

COX-2 inhibitors, such as Celebrex or Bextra, pose the greatest risk for patients with cardiovascular disease or those at risk of developing the disease, according to the advisory which is published in this month's Circulation: Journal of the American Heart Association. When these drugs are used, the advisory recommends the lowest dose for the shortest duration necessary.