The news article “Ibuprofen should go behind-the-counter says expert panel” (CMAJ 2006;175[3]:253-4) requires further elaboration of Health Canada's position on this issue. Health Canada started its internal scientific review on the safety of long-term use of COX-2 more than 6 months before convening an Expert Advisory Panel on the Safety of COX-2 Selective Non-steroidal Anti-Inflammatory Drugs. The Health Canada review did not initially specifically look at the safety of ibuprofen. However, according to Dr. Marc Berthiaume, director of the Marketed Pharmaceuticals and Medical Devices Bureau: “Health Canada has since studied the available safety data on ibuprofen and has found no evidence of increased cardiovascular risk when the product is used over-the-counter as directed, i.e. for short-term and at low-dose [200-400 mg]. However, Health Canada acknowledges that increased cardiovascular risk may be associated with high-dose ibuprofen, as with COX-2-selective and other “non-selective” NSAIDs. Berthiaume added: “Patients have the responsibility to use as directed any nonprescription or prescription drug, and ibuprofen is no exception.” In general, he says there is a need for more long-term comparative studies to further characterize cardiovascular safety concerns surrounding NSAID drugs including ibuprofen and COX-2.