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Both drugs — with the exception of rosuvastatin, which is also prescribed for cardiovascular disease — were found to be safe and well-tolerated when approved because they block a natural protein and its conversion into new proteins.
But these drugs, while highly regarded by physicians, are not considered safe on an individual basis. They are taken as a group, which means the medication must be taken over a long period of time and cannot be taken with other medications that could be triggering side effects.
"There is no evidence that these two drugs are any safer [than] one another," said John Geer, a cardiologist at the University of Texas Health Science Center at Houston, who did not work on the review.
But other researchers say that the lack of evidence in favor these drugs is not surprising.
"If you don't know that one drug is safer than another drug, you cannot make such a decision," said Dr. Scott H. Stolzing, the chief of cardiology at U.S. Department Veterans Affairs, who was not involved in the review. "What we are trying to do is set standards prevent drug companies from giving patients something that is not proven effective so that people can make an informed decision."
The lack of evidence "doesn't really bother me that much," said Dr. James W. Collins Jr., chief of preventive cardiology at the Mayo Clinic, one of authors. "I Diclofenac sodium 50 mg gastro resistant tablets price suspect if anyone were to ask me, they would 'How can we make this stuff safe?' I have no answer."
The problem lies with how these drugs are approved by the FDA, according to Dr. Collins. He was not involved in the review but said two drugs are similar enough that it could make sense to look at the FDA's approval process.
But he said the lack of evidence in favor the two drugs as a group "raises some fundamental questions about how the FDA regulates drugs and why so much reliance has been placed on the drug company." In December 2009, Obama administration began negotiations with congressional Democrats and Republicans to rewrite Obamacare. After the failed push to pass a budget and raise the Tretinoin cream 0.1 45g price debt ceiling, they turned to the most difficult and politically sensitive task of overhauling their signature legislation: health care.
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