In this show, we explore the stories behind some health headlines: the drawbacks of OTC sleeping pills and the best way to use them; whether arthritis drugs cause heart attacks; and how to afford a drug with a narrow therapeutic index.

When researchers discovered that the pain reliever Vioxx was associated with an increased risk of heart attacks, they began to worry that perhaps all medications in the same category of COX-2 inhibitors would pose hazards for the heart. In addition to rofecoxib (Vioxx), a similar medicine called valdecoxib (Bextra) was linked to cardiovascular problems and removed from the market. What about celecoxib (Celebrex)? People continued to take it, but was it causing trouble?

The Precision Trial:

A large study designed to answer that question was concluded recently. It found that celecoxib was no more dangerous than ibuprofen (Advil, Motrin) or naproxen (Aleve). That is not as reassuring as it might be; all of these drugs are now linked to a higher risk for heart attacks, strokes or cardiovascular death. We discuss the study and its implications with lead author Steve Nissen, MD. You’ll find the publication at the New England Journal of Medicine (Dec. 29, 2016).

Saving Money on Brand-Name Medicines:

When it comes to saving money on drugs, the best bet is to buy generic. Indeed, in many instances that is all you’ll be able to get. But what about medicines that have a very critical dose range? People taking such medications must make sure they are getting enough, as too low a dose puts them at risk. Too high a dose is also a problem. These drugs are classified as having a “narrow therapeutic window” or “narrow therapeutic index.”

Sometimes sticking with the brand name is the best way to make sure the dose does not vary too much. Dr. Tod Cooperman tells us which drugs these are and how people can access the brand name without taking out a second mortgage by using PharmacyChecker.com.

Are OTC Sleeping Pills a Good Way to Get to Sleep?

What do you do if you have trouble getting to sleep at night? Many of us reach for OTC sleeping pills like Nytol, Sominex or Tylenol PM. These products are labeled for short-term use, but a survey by Consumer Reports found that a lot of people take such OTC sleeping pills for a year or more. Could they contribute to confusion or forgetfulness? We talk with Lisa Gill of Consumer Reports Best Buy Drugs.

This Week’s Guests:

Steven Nissen, MD, is chairman of the Robert and Suzanne Tomsich Department of Cardiovascular Medicine at the Cleveland Clinic. He is the co-author, with Mark Gillinov, MD, of Heart 411: The Only Guide to Heart Health You’ll Ever Need. The photo is of Dr. Nissen.

Tod Cooperman, MD, is founder and president of ConsumerLab.com, an organization that tests the quality of supplements on the American market.

Lisa Gill is deputy content editor of Best Buy Drugs for Consumer Reports. The website is www.consumerreports.org/cro/health/prescription-drugs/best-buy-drugs/index.htm

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