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The HMO's pharmacies will stop dispensing the painkiller. Heart attack risks are cited.

By Debora Vrana, Times Staff Writer

Oakland-based Kaiser Permanente has ordered its pharmacies to stop dispensing Bextra, a painkiller that some tests have shown increased the risk of heart attack, a spokeswoman said Saturday.

It is the first case of doctors deciding to ban use of a drug that has been approved by the U.S. Food and Drug Administration, said Beverly Hayon, a spokeswoman for Kaiser.

"This is an issue of patient safety," she said.

Bextra, made by Pfizer Inc., is often prescribed in arthritis cases and is in the same class of drugs as other Pfizer painkillers such as Celebrex, which studies have also shown to increase the chances of heart attacks and strokes.

It is also in the same group of drugs as Vioxx, the drug that Merck & Co. pulled from the market in the fall after its studies showed increased risk of heart attacks.

A ban by Kaiser, the nation's largest not-for-profit managed-care provider, with more than 9 million patients, could prompt other doctors and HMOs to avoid the drug.

That would further hurt sales of Bextra, which have already declined since Pfizer said last year that the drug increased the risks of heart attacks and strokes for those who have had coronary bypass surgery. Last year, Pfizer reported that Bextra had sales of $1.26 billion.

A Pfizer representative could not be reached for comment Saturday.

Kaiser Permanente's new policy cited "significant concerns about the safety of the drug" Bextra and was adopted by top medical experts at Kaiser last week.

Under the new policy, "Kaiser's pharmacies in California will cease filling prescriptions for Bextra, and prescribers will be contacted with suggested alternatives."

Kaiser will continue prescribing Celebrex at low doses, Hayon said.

Kaiser said its Bextra ban would take effect on Feb. 1 for new prescriptions and March 1 for refill prescriptions.

Bextra has been available at Kaiser's pharmacy on Sunset Boulevard in Hollywood, but it had not been recommended for members, pharmacist Tien Winarko said.

Source: Los Angeles Times (www.latimes.com)