Steven Nissen, MD, controversies in cardiology, control your cholesterol

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

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, 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

Listen to the Podcast:

The podcast of this program will be available the Monday after the broadcast date. The show can be streamed online from this site and podcasts can be downloaded for free for four weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.

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Air Date:February 4, 2017

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  1. Rick

    If you want to die young start taking pharmaceuticals when you are young. NSAID,s inhibit bone formation as well as cardiac problems and seeing that most are anti-inflammatory this alone inhibits your bodies healing processes as inflammation is the first step in the healing process!

  2. Karen

    Is there any research being done in regards to OsteoBiFlex or Glucosomine and arresting the degradation of joints and thus minimizing the pain of arthritis?

    Also, regarding sleep aids and the use of melatonin?

    • Glen

      I’ve been taking Osteo-Bioflex for years now and it is the only combination that works for me. I also take melatonin on a fairly regular basis two to three times a week. Is there any research regarding melatonin?

  3. Lynn
    Waxhaw, NC

    How about Trazadone? It’s a simple old prescription, but I wonder about long-term use.

    • Rain39

      I have used Trazadone a very old anti depressant seldom used for that purpose any more because of the heavy side effect profile of sleepiness. Think I have used it almost every night for 10 years. I get a great night’s sleep with absolutely no hangovers and remembered dreams for the first time after I started taking it. I only take the smallest dose that does the job. For me, that is 50 mg. No side effects but as an Rn with a graduate degree, I know they can be right around the corner.

  4. alan

    re: sleeping pills – i’ll just use melatonin 3mg for the two or three times a year I need a sleeping aid.

  5. Frank
    Port St. Lucie, FL

    Under “The Precision Trial,” you mentioned Advil brand of naproxen. I think you mean Aleve as I could not find any evidence the Advil brand sells any other pain reliever under that name except ibuprofen. I researched this as much as I could before writing you.


    • Terry Graedon

      You are correct. I slipped up. Thank you for the correction.

  6. Trisha

    I’m unable to access your podcasts. Are they unavailable now?

  7. Judith
    Greensboro nc

    Naproxen is Aleve, not Advil

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