Newswise — Is your pain medication safe?

With recent news associating certain pain medications with increased heart attack risks, it's a good time to discuss pain medication options with your doctor.

The May issue of Mayo Clinic Health Letter provides an overview of recent news.

A pain reliever called rofecoxib (Vioxx) was taken off the market in September 2004 when a large study associated the COX-2 inhibitor with a small increase in the risk of heart attack and stroke.

Since then, there's been evidence to suggest that there also may be some degree of increase in cardiovascular risk with other COX-2 inhibitors.

So far, research has left many questions unanswered. Researchers don't know if the cardiovascular risk occurs only in people with previous heart disease or across a broad group; at certain dose or any dose; or with short- or long-term use.

Until the risks are more fully understood, it's probably best to talk to your physician about using COX-2 inhibitors only if you don't have any effective alternatives for pain relief. Other options could include:

Acetaminophen (Tylenol, others): It decreases pain, but doesn't reduce inflammation. An overdose can cause liver damage.

Aspirin: Aspirin makes your blood less able to clot -- a benefit since many heart attacks and strokes are caused by blood clots. Key risks are stomach ulcers and bleeding.

Traditional nonsteroidal anti-inflammatory drugs (NSAIDs): Ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and ketoprofen (Orudis, Oruvail) are some of the more commonly used drugs in this category. (COX-2 inhibitors are also NSAIDs.)

Traditional NSAIDs increase the risk of stomach bleeding and ulcers. Another recent study suggested increased cardiovascular risk with naproxen. Questions have also been raised about the cardiovascular safety of other traditional NSAIDs.

What to do? Work with your doctor to make a pain medication choice that's right for you. With any medication, it's best to take the lowest effective dose for the least amount of time possible.

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