title: The effect of the withdrawal of rofecoxib on prescribing patterns of COX-2 inhibitors in Scotland.
abstract: BACKGROUND
  Concerns have been raised regarding the cardiovascular safety of the COX-2 inhibitors. In September 2004, rofecoxib was withdrawn from the market as a result of concerns regarding its cardiovascular safety.
  
  
  OBJECTIVE
  We set out to examine the effect of the withdrawal of rofecoxib on the prescription of other COX-2 inhibitors and nonselective nonsteroidal anti-inflammatory drugs (nsNSAIDs) in Scotland, using a national prescription database.
  
  
  RESULTS
  The withdrawal of rofecoxib led to an initial increase in the prescription of celecoxib as prescribers presumably switched to this alternative agent. However, this rise was short-lived, presumably as a result of concerns that the safety concerning rofecoxib may be a class effect. A parallel increase in the prescription of diclofenac and ibuprofen was also noted, suggesting that prescribers were prescribing these medications as alternatives to COX-2 inhibitors.
  
  
  CONCLUSIONS
  While prescribers and their patients may have initially interpreted safety concerns regarding rofecoxib to be drug specific, prescribers appear to have interpreted this effect to be class specific.
authors.affiliation: Department of Clinical Pharmacology, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, UK. david.j.williams@arh.grampian.scot.nhs.uk
authors.forename: D
authors.initials: D
authors.lastname: Williams
authors.forename: M
authors.initials: M
authors.lastname: Singh
authors.forename: C
authors.initials: C
authors.lastname: Hind
mesh_terms: D002318:Cardiovascular Diseases / Q000139:chemically induced*; D052246:Cyclooxygenase 2 Inhibitors / Q000009:adverse effects* / Q000600:supply & distribution; D017277:Drug Approval; D006801:Humans; D007783:Lactones / Q000009:adverse effects* / Q000600:supply & distribution; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012606:Scotland; D013450:Sulfones / Q000009:adverse effects* / Q000600:supply & distribution
chemical_list: D052246:Cyclooxygenase 2 Inhibitors; D007783:Lactones; D013450:Sulfones; C116926:rofecoxib