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Docs Ponder Replacements for Vicodin, Percocet
(Source: Creative Commons)
The Gazette
July 03, 2009
A proposed ban on a group of popular prescription painkillers could create headaches for doctors and patients.
A Food and Drug Administration panel voted Tuesday to pull from the market drugs that contain a combination of narcotics and acetaminophen, including Vicodin and Percocet. The panel’s advice comes amid concerns about liver damage associated with taking acetaminophen in high doses.
Colorado Springs physicians said on Wednesday that if the ban goes through, it would take a very effective treatment out of their tool boxes. There are other options, but those could pose their own set of problems.
“It would have some impact,” said Dr. William N. Timmins, a family medicine doctor who also specializes in hospice and palliative care. “It would not be devastating, but it would not be negligible.”
He and other doctors plan to keep prescribing the drugs until there’s an official decision from the FDA.
Combo drugs such as Vicodin or Percocet are considered the second rung on the ladder of pain management, a step above basic pain relievers such as acetaminophen alone and a step below sole narcotics. Such drugs were prescribed 200 million times last year, according to FDA data.
Without them, doctors would be faced with creating a combo of their own, or picking one kind of drug over another. Those decisions could mean choosing between a weaker narcotic or a stronger one, which could increase the risk of addiction; or sending patients home with two prescriptions instead of one.
“Obviously it’s going to change the pain management with these combos. They’re very popular; we use them a lot,” said Dr. Dennis Schneider, chief medical officer with Colorado Springs Health Partners, a 95-physician practice in the Pikes Peak region.
Doctors say the drugs are safe when used correctly. But some people have inadvertently taken excessive amounts of over-the-counter Tylenol in addition to their acetaminophen-containing prescriptions. Others abuse the painkillers.
Physicians say the ban would likely lead to new drug offerings long-term.
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