KEY POINTS:
Health authorities say people using a drug linked to the death of two people in Australia should switch to a "safer alternative".
The Government's medicines watchdog, Medsafe, said yesterday that short-term users of Prexige "would be wise to stop taking it and take something else".
The drug is used short term for dental, menstrual and post-surgical pain. It is used long term by a small number of people with osteoarthritis.
It has been urgently ordered off the market in Australia after two people died and two others needed liver transplants after using it.
New Zealand authorities have stopped short of recalling the drug. They will probably make a decision today after talks with Australian health authorities and Prexige manufacturer Novartis.
Up to 60,000 people take the drug in Australia. In New Zealand, the number is much smaller as it is not a subsidised medicine.
Medsafe said about 2000 people used Prexige. Of those, about 700 were long-term users and the rest were taking it for less than 10 days.
The recommended dosage is also about half that of Australia.
But Medsafe spokesman Stewart Jessamine said safer alternatives were available for people taking Prexige short term for acute pain.
Even paracetamol taken regularly was a good alternative, he said.
The safer alternatives were also valid for long-term users, but patients should talk to their doctor.
Australia's Therapeutic Goods Administration took less than 24 hours to deregister Prexige and order a recall on Saturday after it reviewed eight cases of people with severe liver damage after using the drug.
Two of the eight died and two needed liver transplants.
The administration's principal medical adviser, Dr Rohan Hammett, said Australia was the first country to recall Prexige, which is a Cox 2 inhibitor - a non-steroidal anti-inflammatory drug.
Vioxx, also a Cox 2 inhibitor, was voluntarily recalled worldwide by its manufacturer Merck in 2004 because of adverse effects on patients.
A second drug from the same class, Bextra, was withdrawn a few months later because of concerns about an increased risk of serious skin reactions.
"Regulators around the world have been watching this class of drugs very closely since Vioxx and hence we've acted very quickly," Dr Hammet said.
Dr Jessamine said the Ministry of Health warned against using Cox 2 inhibitors in patients at high risk of heart attacks or strokes.
That was a different issue to the latest scare, he said, but advice on all Cox 2 inhibitors was to take the lowest dose over the shortest time possible.
Novartis New Zealand referred calls to its Australian division.
Novartis Pharmaceuticals Australia said it was "a pretty difficult time" for the company.
The parent company, Novartis AG, in Switzerland, had notified health authorities in the 50 countries where Prexige was sold.
More than seven million prescriptions have been issued since Prexige went on sale in 2005.
PAIN RELIEF
* 2000 Patients in NZ use Prexige, compared with 60,000 in Australia.
* 2 People in Australia who used the pain relief drug have died. The recommended dosage here is about half that in Australia.
