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After Vioxx was eventually pulled from the shelves, Topol wrote an article published in the New England Journal of Medicine stating that there may be tens of thousands of patients who have had major adverse events attributable to rofecoxib. Sadly, it is clear to me that Mercks commercial interest in rofecoxib sales exceeded its concern about the drugs potential cardiovascular toxicity, he wrote

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Relative Contraindications: Injection into Fingers & Toes Historically, the injection of epinephrine containing solutions into end-artery structures such as fingers and toes has been widely discouraged due to the concern that prolonged vasoconstriction may cause vascular insufficiency resulting in tissue necrosis and permanent injury

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