Next Drug Out? Now that Vioxx is history, what drugs might be pulled next? Readers of www.worstpills.org, sponsored by the advocacy group Public Citizen; www.webmd.com, a consumer healthcare site; and www.CoreyNahman.com, a pharmaceutical news site, have some ideas. Long before the recall, all three sites had posted concerns about a higher risk of heart attack with Vioxx and advised users to consult their doctors. In fact, as visitors to www.worstpills.org were told, Public Citizen had sought additional package warnings or bans for all 15 drugs withdrawn from the market since 1992, including the diabetes drug Rezulin, found toxic to the liver in some patients, and the antihistamine Seldane, tied to heart rhythem abnormalities.

Criticisms were posted months or years before drugs were pulled.

The Candidates Worstpills.org cites products including weight loss drug Meridia, which has been linked to cardiovascular events; cholesterol-lowering Crestor, tied to more kidney problems than its competitors; and arthritis drug Arava, which has caused unexplained deaths in some users. It's also raised concerns about possible heart risks posed by Bextra and Celebrex, competitors to Vioxx.

"For each of these drugs that has us concerned, there's an alternative drug that seems to be safer, based on published studies in well-regarded medical journals," says Sidney Wolfe, head of Public Citizen's Health Research Group.

The makers of these drugs say they pose no unusual risks and don't need to be withdrawn.

Meanwhile Former Vioxx users can send unused pills back to Merck (see www.vioxx.com/rofecoxib/vioxx/consumer/patient_instructions.jsp for details) for reimbursement of their insurance co-pay or cash outlay, based on drugstore receipt. No receipt? Most pharmacies will print out a duplicate for you. Target will reimburse you immediately if you bring back pills and a receipt from any pharmacy, not just Target's.

-- Francesca Lunzer Kritz