Physicians Say Good Riddance to 'Worst Drug in History'

[somone]

http://www.medscape.com/viewarticle/736718

Physicians Say Good Riddance to 'Worst Drug in History'
Allison Gandey

February 2, 2011 — An estimated 10 million patients have used the pain reliever propoxyphene and were sent scrambling to doctors' offices when it was recently pulled from the market. Many physicians are still dealing with the aftermath of the product, first approved by the US Food and Drug Administration (FDA) in 1957. "Propoxyphene is the worst drug in history," Ulf Jonasson, doctor of public health, from the Nordic School in Gothenburg, Sweden, told Medscape Medical News. The researcher played a role in the decision to stop the pain reliever in the United Kingdom, Sweden, and later in the entire European Union. "No single drug has ever caused so many deaths," Dr. Jonasson said.

Propoxyphene was banned in the United Kingdom 5 years ago because of its risk for suicide. It was taken off the market in Europe in 2009 over concerns about fatal overdoses and now in the United States for arrhythmias. "I agree that propoxyphene is among the worst drugs in history," Eduardo Fraifeld, MD, president of the American Academy of Pain Medicine, said in an interview. "I'm surprised it stayed on the market so long. It's addictive, in my experience not very effective, and toxic." "I'd probably add Demerol to the list too," Dr. Fraifeld said. "It's toxic and sedating, and my personal opinion is it should not be used at all." Also known as pethidine, Demerol was the first synthetic opioid synthesized in 1932 as a possible antispasmodic agent. Its analgesic properties were recognized later. For much of the 20th century, pethidine has been the opioid of choice for many physicians treating acute and chronic severe pain. "The writing has been on the wall for both of these drugs," Dr. Fraifeld said...

Propoxyphene was first developed by Eli Lilly and later sold to Xanodyne Pharmaceuticals, which marketed the drug under the brand names Darvon and Darvocet. Since 1978, the FDA has received 2 requests to remove propoxyphene from the market. In January 2009, an advisory committee voted 14 to 12 against the continued marketing of propoxyphene products. At that time, the committee called for additional information about the drug's cardiac effects. In terms of benefit to risk ratio, "I would say, little 'b', big 'r' for this drug. And that's unsettling," committee member Ruth Day, PhD, from Duke University in Durham, North Carolina, who voted to remove propoxyphene, said at the time. The drug is a narcotic opioid. "It looks like it offers placebo benefits with opioid risks," added committee member Sean Hennessey, PhD, an epidemiologist from the University of Pennsylvania in Philadelphia. Later in 2009, the FDA decided to allow continued marketing of propoxyphene, but with a new boxed warning added to the drug label alerting of the risk for fatal overdose.

That came to an end in November 2010, when regulators disclosed new study results, combined with epidemiologic data, and medical examiner reports prompting the drug's market removal. New study results showed propoxyphene puts patients at risk for potentially serious or even fatal heart rhythm abnormalities. Gerald Dal Pan, MD, director of the Office of Surveillance and Epidemiology, said in November that regulators did not feel there was sufficient evidence earlier. "The new information on the effects of the electrical activity on the heart was the final piece to the puzzle," he said...

[provis99]

1. I'd say thalidomide was worse.

[tavalon]

5. Only in the context of pregnant women

It is still used as a cancer drug and has been successful. Of course, anyone in the childbearing years has to be on effective birth control and willing to abort if that fails.

[Nevernose]

15. Thalidomide is making a big comeback

As someone else noted, as a cancer treatment. Since older people are more likely to develop most cancers AND not be at risk for pregnancy or impregnation, there are a lot of optimists within the medical community for it.

[annabanana]

2. Jesus H Christ!. .That should have been pulled YEARS ago!

It's shameful that our system, such as it is, allows killers like this to run free.

[Jamastiene]

3. Bullshit.

Their view seems to be: to hell with all the pain sufferers who now have to take extremely addictive drugs that cost twice as much($$$ still under patent, Darvon/Davocet was available as a generic) and don't work even half as well.

For the few that had problems, many many many more were given relief from daily chronic pain with no problems.

I call bullshit. This was a $$$ move to force people to buy newer drugs that are still under patent to get more money. These newer drugs are extremely addictive and don't work nearly as well. They could have just added a warning and let the pain sufferers who could manage their pain with Darvocet have their relief. Instead, it's all about $$$... once again.

I call bullshit and Unrec. Period. My aunt, who suffers from the effects of chemical warfare testing from when she was a WAC in the US Army would say much much worse than I just did. I cleaned it up a bit, believe it or not. Hope they are fucking happy, the greedy fuckers.

[ret5hd]

4. What part of "It looks like it offers placebo benefits..." didn't you understand?

[Jamastiene]

7. What part of the other drugs ex-Darvocet users are forced to take

are way more expensive and don't work half as good don't YOU understand?

Your anecdotes mean nothing to someone suffering from chronic pain who was able to manage the pain with Darvocet, but cannot handle the extremely expensive, extremely addictive harder drugs.

If it was such a placebo, then why did they say it was so dangerous? And IF it was so dangerous, why didn't it kill more people?

[Ghost in the Machine]

8. Can't your aunt take oxycodone?

To me, they work better than the darvocets and they're only $1.10 for 120 of the generics with medicaid. I'm on pain management, too.

:hug: for your aunt, it sucks living in pain all the time.

Peace,

Ghost

[Jamastiene]

10. Unfortunately, she is allergic to it.

She is allergic to anything that is even close to codeine. She did take it right after they banned her Darvocet, because that is what the VA prescribed for her. I looked it up and it said no codeine was in it, but she had an allergic reaction that she is just now starting to recover from. The US Army didn't include that she was highly allergic to codeine and anything even remotely resembling codeine in her medical files at the VA. So, she's still trying to recover from taking it.

Now, they have sent something else (can't remember the name), but she is sticking to Tylenol and suffering. She doesn't want to go through the allergic reaction again like she just did, especially not so soon. So, she is not going to take the latest stuff. It clearly says it is a codeine synthetic in the description. She is not going to take anything else that even mentions codeine. I don't blame her. They seem to be pushing codeine based stuff a lot as a replacement, at least in her case. So, she is suffering with Tylenol.

Thank you for the :hug: and :hug: back to you. I will certainly let her know you sent the :hug: She needs all of those she can get lately.

edit: Correction on my part.
It was hydrocodone they gave her, not oxy. They haven't offered her oxycodone yet. She sure needs something.

[Ghost in the Machine]

11. I would say have her check into Tramadol if she can't take the oxycodone

but it is a synthetic codeine..

"Tramadol hydrochloride (Ultram, Tramal others below) is a centrally acting opioid analgesic, used in treating moderate to severe pain. The drug has a wide range of applications, including treatment for restless leg syndrome and fibromyalgia. It was developed by the pharmaceutical company Grünenthal GmbH in the late 1970s.

Tramadol possesses weak agonist actions at the μ-opioid receptor, releases serotonin, and inhibits the reuptake of norepinephrine.

Tramadol is a synthetic analog of the phenanthrene alkaloid codeine and, as such, is an opioid and also a prodrug (codeine is metabolized to morphine, tramadol is converted to O-desmethyltramadol)."

http://en.wikipedia.org/wiki/Tramadol


Oxycodone: http://en.wikipedia.org/wiki/Oxycodone

Hope she finds some help

Peace,

Ghost

[Horse with no Name]

28. Be careful of the Tramadol

I have seen some interesting research that might indicate it isn't such a good replacement.

[ChoralScholar]

41. Tramadol works well in these capacities,

as well as a "stay asleep" aid (like Ambien), and has a mild anti-depressive. I don't need the pain control, but I sure could use the other two.

[Horse with no Name]

25. Maybe they can try methadone

It has varying degrees of success with pain management--it isn't just for withdrawal. It is low cost. It is also much better than oxycontin.

If she is that allergic to the codeine family, chances are she will be in the same boat with oxycodone. I have the same problem and can't take any of it.

http://www.healthguidance.org/entry/11355/1/Methadone-Pain-Management.html

>>>snip

» Home » Conditions Disabilities » Chronic Pain »
Methadone Pain Management
By Mack LeMouse | Chronic Pain | Rating:

Methadone (also know as *deep breath in* symoron, dolphine, amidone, methadose, heptadon, phy, maethadose and others) is a synthetic – meaning processed – opioid. This is used as an analgesic, antiussive or as an ‘anti-addictive’ (the only one with an understandable name) for patients struggling to give up addictions to other opioids such as morphine and heroin which work on the same receptors. For this reason it has many of the same effects and can similarly be used for managing chronic pain and has a very long duration of action and low cost. Methadone can also be used alongside other drugs and for therapeutic effect for example cancelling out the euphoric effects of heroine.

Methadone pain management then is an excellent alternative to using dangerous more powerful drugs with worse side effects. However this doesn’t mean that methadone is not without its own short comings and in fact is highly addictive itself as well as carrying various side effects. You should therefore be careful when considering the pros and cons of methadone pain management. It is currently not available over the counter though like many prescription drugs it is often dealt illegally.

[csziggy]

35. Another thing to try would be a non-analgesic anti-inflammatory

I am not a pharmacist or doctor and don't know the exact way it works, but when my joints are very inflamed, Piroxicam (aka Feldene) works MUCH better to relieve my suffering than the Vicodin my doctor has prescribed for pain. It seems to do more to reduce the actual inflammation than anything else I have taken so removes the source of most of my pain. The Piroxicam does make me groggy but not as much as the Vicodin which I only take when absolutely desperate for sleep.

While your aunt may not have inflammation as the source of her pain maybe she could explore different routes for pain management that do not rely on pain killers but address the basic cause for pain.

[barbtries]

39. here's another suggestion for what it's worth:

Lodine. the name on the prescription is etodolac. i was just prescribed this for the first time after dental surgery last year. it's an older drug and worked like a charm on my mouth pain. no opioid effects either. i don't know if it would work for what ails the aunt though. but i swear i could feel the pain subside, like a wave going out and not coming back in.

with very severe pain and following a laminectomy and a laparotomy, i received demerol in the hospital, and loved it. after i got home during the days of severe and chronic back pain, percodan was my drug of choice, along with muscle relaxers and anti-inflammatories.

for about ten years now my diseased back has been stable, and for that i thank acupuncture. i'm currently taking no pain meds.

[underseasurveyor]

16. Not everything works the same for everyone.

Darvocet worked very well for me as a painkiller when I needed them. Never on a regular basis but after dental surgery for example, they were a life saver for me. I also like darvocet because they didn't knock me on my ass and make me feel all drugged and loopy. If I had to work I could still function.

Oxycodone doesn't work half as well at relieving my pain and they got me loopy and stupid and there was no way I could work if oxycodone were prescribed for me.

That's my personal experience and since pain killers are something that I use rarely anyway given a choice I'd tell my doc, give me darvocet because for me it works.

[krispos42]

18. Is her pain the sort of pain that could be controlled with marijuana? n/t

[MH1]

19. Not taking a side here, but you raise EXCELLENT points

nothing is necessarily 'as announced'.

I find it quite plausible that this action is taken for profit motive, rather than the stated goals.

[lumberjack_jeff]

27. Is it still available in Canada or Mexico? n/t

[DeSwiss]

6. Drug$ aren't about patient$.

- Especially in a totally corrupted country like the U.S.

K&R

[madokie]

9. Never liked the shit myself

[aquart]

12. "Heart rhythm abnormality." Like my mom.

Who took Darvon for years.

[Warren DeMontague]

13. Unfortunately, everything I've seen indicates that the "authorities" don't give a shit about pain.

It's all about control. They'd rather let 1,000 bone cancer patients die in agony than risk one person getting an unauthorized buzz.

[kickysnana]

14. +1

[SOS]

21. Exactly

My father was hit by a car in November.
He's 84 years old.
His primary doctor prescribed 10 5mg tablets of Percocet after his release from the hospital.
10 tablets!
He was hit by a car, was in the hospital for 40 days and is in constant pain.
And she prescribes 10 tablets! It's ludicrous.

Is she afraid he's going to become an addict at age 84?

(Luckily he has a neurologist who prescribed a larger number of tablets and he's got some relief now.)

[SmileyRose]

23. Depending on the state she may be legally limited to a 10 pill script.

Another reason the war on drugs is asinine.

[lumberjack_jeff]

26. +2 n/t

[tammywammy]

17. I have a bulging disk in my back and have had a script for darvocet for the last 12 years

I never took it except when in pain and that stuff was the best. It didn't make me loopy like vicodin, it would knock out the pain, I really liked it.

I never abused it, only took it when necessary. I'm worried about what my doctor will give me for my annual script when I see him next month. Darvocet allowed me to still work if I was having trouble.

[lonestarnot]

20. Big pharma has a pill to wake up, a pill to sleep, a pill for itch, a pill shitting, a pill for not

shitting, a pill for puking, a pill for not puking, no pills for stupid yet. Why not?

[Horse with no Name]

22. I have multiple drug allergies

and when I am given pain medication, it is usually limited to Darvocet.
Honestly, it isn't very effective for me, so most of the time, I choose not to take it.
For me, Tylenol or Motrin has about the same effect on pain. Luckily, I have a very high pain threshold and I do not have an addictive personality.
I won't miss the drug. However, I do hope that the docs are ready to step up and find something that is affordable and effective for the millions of chronic users of it.
You might be surprised how many people--especially elderly--have been given Darvocet DAILY for chronic pain and are now, hopelessly addicted/dependent to it.
That void needs to be addressed.
I also agree about Demerol. There isn't ONE therapeutic value of that drug other than addiction and dependence.
It knocks you out, but when you wake up, you still have pain and require more because IT DOES NOT AFFECT THE PAIN RECEPTORS. It is also bad when used in children because it accumulates in the brown fat and can cause toxicity.

[PBS Poll-435]

24. Acetaminophen is the worst drug in history

Responsible for more liver failure than even alcohol.

[Horse with no Name]

29. When used incorrectly

with alcohol or in higher than recommended dosages.

Personally, if you have ever taken care of kids with high fevers, it is invaluable. But too many take and give drugs indiscriminately or give or take the wrong dosage.

Acetaminophen works great BUT is deadly if you take too much. That part is correct.
The worst part is that it takes a couple of days to even recognize the overdose.:(

[PBS Poll-435]

31. For people that don't drink and take it regularly and correctly for

Arthritic pain (as directed) it can and does cause liver failure.

[Horse with no Name]

33. Honestly, I wouldn't ever recommend ANYTHING with acetaminophen be taken

chronically. People are different and their body metabolizes things differently, ie, a safe dose for one isn't necessarily going to be a safe dose for another.
You are correct in this aspect.

[etherealtruth]

30. Being mindful that Darvocet is the "perfect" blend of ....

acetaminophen and propoxyphene.

[REP]

40. NSAIDs are nephrotoxic

All NSAIDs are nephrotoxic, and chronic daily use at correct doses can led to proteinuria, hematuria and permanent renal impairment. Those with kidney disease or even just kidney problems can't take them at all without risk of pulmonary edema or even death.

[ohheckyeah]

32. I developed an allergy to Darvocet

and haven't been able to take it for years. When I had my back surgery the doctor gave me Talwin which worked pretty well.

[Lorien]

34. And posters in the health forum contend that homeopathic "remedies" are the

worst products in history. Funny; I expected many of them to show up here to defend propoxyphene since big pharma drugs are ALWAYS the answer.

Glad that it's finally GONE. Took damn long enough.

[Warren DeMontague]

37. No, homeopathy is just bullshit. It's water.

That doesn't mean natural and herbal remedies that use actual substances which may cause real physiological effects are bullshit, but that's not homeopathy.

Homeopathy? 100%, unmitigated, bullshit.



http://www.quackwatch.org/01QuackeryRelatedTopics/homeo.html

[earth mom]

36. Meanwhile DUers & the pharma giants smear natural medicine & cures...

while the pharma giants develop drugs that KILL people and don't give a damn as long as they continue to make billions. :puke:

[Divernan]

38. Big Pharma prefers to test new drugs on "virgin" users in 3rd world, remote areas.

Big Pharma can avoid a lot of those pesky side effects (which can delay or bar approval by the FDA) which occur when new drugs are tested on populations who have various health problems and/or are taking/have taken other drugs. It's simply a matter of going to remote and very poor areas where the populace has never had exposure to other drugs. And it's a win-win because impoverished, uneducated people are easily persuaded to volunteer, or to accept very minimal compensation for being guinea pigs, since they believe these drugs will be good for them. Also easy to "lose" participants who have adverse results, thereby pumping up the good numbers for the testing.

My personal practise is to take as few prescription drugs as possible, substituting a careful diet and regular exercise to avoid problems with high blood pressure or cholesterol. When I feel I HAVE to take a drug, I tell my doctor I want a drug which has been on the market for at least 10 years (also meaning it's available as a generic). I then research it myself on the web for medical journal articles and news stories relative to that drug.