In the Houston Chronicle, People's Pharmacy columnists Joe Graedon and Teresa Graedon remember a drug scandal from 1970 that mirrors today's Avandia troubles almost exactly. Orinase, a popular diabetes drug was found to be increasing the very heart trouble it was designed (and marketed) to prevent.

Orinase's active ingredient is tolbutamide, a substance that stimulates the pancreas to produce insulin. According to the Graedons, the heart damage being caused by Orinase-takers was first revealed by the University Group Diabetes Program in 1970 following an extensive analysis of diabetes care in the US. Like the Avandia controversy, experts also debated the results of the University Group's conclusions on Orinase, yet it was more or less eventually accepted as fact that drugs belonging to the class sulfonylureas, including tolbutamide, do indeed increase the likelihood of heart problems. I say "more or less" because many authorities still hedge their bets. Example? The health site Drugs.com copies info on Orinase provided by Thomson Healthcare/Micromedix. According to that source, sulfonylureas, have been "reported, but not proven in all studies, to increase the risk of death from heart and blood vessel disease." [My emphasis.] This, thirty-seven years after the release of the study demonstrating such risk!

Orinase is still prescribed in certain situations. Is Avandia destined to end up sidelined, yet still on the market, like Orinase? Seems to be headed that way. In the meantime, the unfortunate reality is that new drugs will continue to be rushed to market and serious side effects discovered (or made public) only after they have been prescribed to thousands of people. The fact is, today's high-tech (and high-priced!) wonder drugs all come with a dose of risk.