In the wake of Merck & Co Inc's voluntary decision to pull its arthritis and acute pain medication VIOXX (rofecoxib) off the market, the company has taken swift action to communicate with patients, pharmacists, and pharmacy operators. Merck has posted information on and, established a VIOXX hot line (888-368-4699), and initiated a major advertising campaign including full-page advertisements in national newspapers, according to Merck spokeswoman Anita Larsen.

"The VIOXX Web site is constantly being updated, and the VIOXX hot line has operators ready to answer health care professionals' and patients' questions. Feedback is very important to us," Larsen said.

The National Association of Chain Drug Stores (NACDS) commended Merck for its quick voluntary action. "Merck did a good job of avoiding the confusion that sometimes happens with a major withdrawal," said Edward J. Staffa, RPh, NACDS vice president of pharmacy practice & communications.

"They [Merck] made it as practical as possible for pharmacy and pharmacy operators to react to the withdrawal," he added. Furthermore, Staffa said that the company's clear information on how patients could receive a refund directly from Merck was very useful.

As for NACDS members and pharmacy operators, Staffa said, "I have spoken to some of them, and they were satisfied with Merck's response."

Following Merck's announcement, "Walgreens immediately pulled and quarantined VIOXX. It's our standard procedure when a drug is recalled. We referred patients to Merck regarding their questions and advised patients to speak with their physicians to see what alternative medications they could take," said Carol Hively, corporate spokeswoman for Walgreens.

The Pennington Apothecary, based in Pennington, NJ, has fielded many calls. "Many patients have called, especially patients who just started taking VIOXX, about what to do with their supply. We advised them to go to the Merck Web site," said owner Chris M. Castagna, RPh.

If patients could not reach their physician immediately regarding alternative medications, "we have recommended OTC products such as ibuprofen, as long as they don't have gastrointestinal problems," Castagna added. As of press time, the pharmacy was waiting for instructions from its supplier, McKesson Corp, about the return policy.

Merck's decision to withdraw VIOXX is based on new, 3-year clinical data from a prospective, randomized, placebo-controlled clinical trial, the APPROVe (Adenomatous Polyp Prevention on VIOXX) trial.