Instead, Merck is grappling with patent expirations for cardiac drugs like Prinivil and Mevacor.
An advisory panel to the Food and Drug Administration will convene to consider Mevacor on Thursday.
Not that Merck didn't have the goods: Vasotec, Mevacor and now Fosamax are great successes.
Three once lucrative cholesterol-cutters have already lost patent protection (Merck's Mevacor and Zocor, and Bristol-Myers Squibb's Pravachol).
The products that will have these label changes include Lipitor (atorvastatin), Mevacor (lovastatin), Crestor (rosuvastatin) and Zocor (simvastatin).
"In clinical trials, 20 milligrams of Mevacor has shown roughly the same side effect profile as placebo, " he says.
The first of these cholesterol-lowering medicines, Merck 's Mevacor, was approved in 1987.
Nissen also says he's worried about safety, because Mevacor interacts with many drugs.
Its successes included the first statin cholesterol drugs Mevacor and Zocor, the first mumps vaccine and some of the first HIV drugs.
Mevacor already faces generic competition, and Pravachol will face generics in 2006.
Patients on this vegetarian diet for four weeks reduced their bad cholesterol levels just as much as a control group on Merck's Mevacor.
The first of these cholesterol-lowering medicines, Merck 's (nyse: MRK - news - people ) Mevacor, was approved in 1987.
One of the recent surprises in the cholesterol market has been the continued use of Mevacor--a weak statin that is available as a cheap generic.
There also will be a label change specific to lovastatin (Mevacor).
But Merck doesn't have much experience in central nervous system drugs, whose success is more difficult to judge than heart drugs like Mevacor, Prinivil and Zocor.
They already have contributed to the development of the antibiotics erythromycin and tetracycline, the cancer chemotherapy drug doxorubicin, Wyeth's transplant drug Rapamune, and Merck's cholesterol-lowering medicine, Mevacor.
The agency says some drugs should never be taken with Mevacor including protease inhibitors, a class of HIV drugs and certain drugs used to treat bacterial and fungal infections.
Yesterday, the Food and Drug Administration's Nonprescription Drugs Advisory Committee decided by a vote of 11 to 1, with one abstention, that Merck's Mevacor should not be sold over the counter.
By June, it will lose patent protection on four drugs--Vasotec and Prinivil for hypertension, Mevacor for high cholesterol and Prilosec, which it shares with AstraZeneca (nyse: AZN - news - people), for ulcers.
Three once lucrative cholesterol-cutters have already lost patent protection ( Merck (nyse: MRK - news - people )'s Mevacor and Zocor, and Bristol-Myers Squibb (nyse: BMY - news - people )'s Pravachol).
For cholesterol lowering, brand-name Lipitor from Pfizer and Crestor from AstraZeneca are the most potent "statin" medications, but generic versions of Zocor and Mevacor from Merck, or Pravachol from Bristol-Myers Squibb are all proven to prevent heart attacks and may do just fine for you.
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