Rofecoxib (Vioxx) was recently withdrawn from the market because of an increased risk of myocardial infarction and stroke. There is a similar public health concern about another coxib, valdecoxib (Bextra), which is used by 7 million patients worldwide.1 To protect the safety of the public, we write to recommend that clinicians stop prescribing valdecoxib except in extraordinary circumstances. This recommendation is based on the long delay between the initial evidence of the cardiotoxicity of rofecoxib and its withdrawal, recent studies demonstrating the cardiotoxicity of valdecoxib in high-risk patients, the availability of other therapies not currently known to have cardiovascular risks, and the lack of compelling evidence of countervailing benefits. We believe this restriction should remain in effect until there are better safety data for valdecoxib.