DECATUR - The manufacturer of Vioxx pulled the prescription drug from the market Thursday after a study showed some participants were twice as likely to have a stroke or heart attack.

The U.S. Food and Drug Administration approved Vioxx in 1999 as a painkiller for osteoarthritis, menstrual symptoms and acute pain, such as carpal tunnel. It was later approved to relieve symptoms of rheumatoid arthritis.

Merck & Co. Inc., the manufacturer, voluntarily withdrew the drug from the market worldwide, according to the FDA.

Dr. Anthony Amie, a Decatur obstetrician and gynecologist, said he used to prescribe Vioxx to some of his patients, but he stopped three months ago when he read studies about the increased risk for heart problems.

He said the risk is mainly for people who have diabetes, high cholesterol or high blood pressure.

"It doesn't mean if you've taken it, you're at risk," Amie said.

Regardless of how long patients have taken Vioxx, however, Amie said they should be examined by their physician, specifically asking for a kidney function test.

Or if a patient has felt any chest pain, they should request an electrocardiogram, or ECG, he said.

In the meantime, pharmacies are not filling Vioxx prescriptions.

Darrin Shasteen, a Rambo pharmacist, received a fax telling pharmacists Merck will reimburse patients for the cost of unused Vioxx.

"It's not going to be a huge impact on us," Shasteen said, because other alternatives are available.

Amie said most patients can easily switch from Vioxx to other nonsteroidal, anti-inflammatory drugs, such as Celebrex (celecoxib) or Bextra (valdecoxib).

People with a sulfa allergy should not switch to Celebrex, he said.

Bextra also contains sulfa, said Dr. Nehemiah Tan, a Decatur rheumatologist.

Tan said over-the-counter medications that include ibuprofen could work until the patient makes an appointment with their physician to determine the best alternative.

Amie said ibuprofen is just as good, but is usually taken four times a day rather than once a day like Vioxx.

Another draw to Vioxx, Amie said, was that it would not upset stomachs, whereas ibuprofen could irritate the gastrointestinal tract if taken too much.

Insurance companies could also play a role in which alternative fits the patients' needs. Shasteen said Medicaid only covered Vioxx for patients older than 65.

Bethany Carson can be reached at bcarson@;herald-review.com or 421-6968.