Finding a medication that works isn’t always easy. So when the Food and Drug Administration (FDA) determines that the drug’s risks outweigh its benefits and votes to pull the drug off the market, it can put some people in a bind.
Late last year, the FDA banned from the market drugs containing propoxyphene, such as Darvocet and Darvon, after studies linked the popular painkillers to heart rhythm abnormalities, some of which have been deadly. Propoxyphene was approved by the federal agency more than 50 years ago and had become one of the most prescribed medications for the treatment of mild to moderate pain. The drug is often used to treat the symptoms of arthritis and post-surgery pain.
While problems with propoxyphene began surfacing years ago with reports of accidental overdoses, data showing a link between the drug and heart toxicity was the straw that broke the camel’s back.
Those who did not experience problems with propoxyphene-containing medications are now at a loss. Patients are advised to talk with their doctors about how to safely wean off propoxyphene, and for alternative medications. But some are wary. Here are some comments made by readers of The Wall Street Journal Health Blog:
“My mother is 95. She has an allergy to morphine. Darvon and Darvocet were the only pain meds that the PA could prescribe. What does she take now?”
“I’ve been on Darvocet for one week now for a herniated disc/annular tear. I can’t take oxycodone because of severe vomiting. I figure I’ll just be careful and not over use it.”
“I have taken this painkiller off and on for 30 years. I cannot tolerate ANY other. I have severe reactions to anything morphine based or any synthetics that are similar to morphine, codeine, etc. What is the alternative?”
Unfortunately, the answer isn’t simple. Since responses to pain medications vary, doctors need to look at each patient’s case specifically to find the best alternative painkiller with the least bothersome side effects. Some doctors might suggest Tylenol with or without codeine, or a non-steroidal anti-inflammatory drug such as ibuprofen. But, as the readers above mentioned, codeine may cause GI problems and nausea, and ibuprofen can cause stomach bleeding.
Other mild-to-moderate pain medications include the prescription drugs tramadol and tapentadol. Some patients may need to be bumped up to a stronger pain killer, such as oxycodone or hydrocodone-containing drugs.
All drugs have their pros and cons. Patients should always talk to their doctors about any concerns they have about their medications, especially in situations where a medication has been removed from the market because of serious health issues.