Nothing else had eased her knee pain. Celebrex made her sick to her stomach. Other medications just didn't work.

But after taking Vioxx for a few days, the knee pain disappeared.

"I didn't know one little pill could do that for you," the Richwood woman says.

Now, like millions of others who suffer from arthritis or other ailments that cause chronic pain, Gallanstein has to look for a new solution. Merck, the makers of Vioxx, voluntarily pulled the medication off the market after a study showed it doubled the risk of heart problems.

Now, a European agency is reviewing similar drugs, such as Celebrex, to see if they also cause heart problems. A study scheduled for publication next week in the New England Journal of Medicine also questions other drugs' safety.

Vioxx, Celebrex and Bextra are COX 2 inhibitors, a special class of medications that block the chemical that causes inflammation, and so prevent the pain associated with inflammation from arthritis and similar ailments, says Dr. Cathy Creger Rosenbaum, clinical safety and effectiveness officer for TriHealth.

Dr. Susan Louisa Montauk, a professor of clinical family medicine at the University of Cincinnati, says patients should talk to their physicians and pharmacists to find out what other medications or treatments might help keep their pain in check.

"The first question to ask is, do they really need a Cox 2 inhibitor," Montauk says.

For some patients, taking ibuprofen or naproxen might work just as well, she says, and other medications are available to ease the stomach upset these cause in some people.

Montauk and Rosenbaum say the Vioxx study didn't identify why the drug doubled the risk of heart damage. It's possible only a small subset of patients might be at increased risk, Montauk says, and once those patients are identified, Vioxx could be put back on the market.

E-mail pofarrell@enquirer.com