December 2004 – In the midst of the Vioxx fallout, some suggestions for patients who needed a COX-2:
If Celebrex and the other COX-2’s are pulled in the near future, here are the options you want to discuss with your physician:1) Switch to Tylenol.
2) Switch to Lodine, Mobic, or Relafen which are COX-2 preferential; or,
3) Switch to a non-selective NSAID, i) in combination with a PPI or misoprostol if you are at high risk for GI bleeding, or ii) in combination with a PPI if you have a history of GI bleeding.
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- Classic post: Cut Medicare payments for doctors, you’ll have fewer doctors
- "The great majority of women in the United States should not be getting MRI scans for breast cancer screening"
- Give ‘em 3 Tylenols
- Vicodin and Percocet banned and taken off the market, or is a black box warning more likely?
- Should you stop taking Vytorin if you’re already on the drug?
- Medicare fallout
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{ 10 comments }
I have a spondyloarthropathy. I’ve had anaphylactoid reactions to many of the long-acting NSAIDs, and elevations of liver transaminases and bleeding related to use of other meds, including shorter acting NSAIDS and even Celebrex.
Then, by accident, I stumbled on pain relief that neither makes me wheeze and break out in spots, nor does it (apparently) eat my liver- and best of all, it doesn not turn me into a pale and wan ice-chewer.
I started using Aspartame to put on my plain yogurt and sweeten my morning coffee about six months ago.
My arthritis is remarkably better – I don’t wear my night splints anymore for heel pain. I can dance around and be normal.
The psycho patient posting above is why practicing medicine is torture…thinking she had anaphylaxis to an nsaid and that a placebo is helping her arthritis. What a lunatic…
Follow the link, jerk. Or this one.
As for allergy to NSAIDS, you are an ignorant, dangerous jerk if you think anaphylactoid reactions are some kind of impossibility for that class of meds.
You can fight with my rheumatologist about the anaphylactoid symptoms. That’s what HE called the rash, (followed by)petichiae, swollen face, lips, hands and feet, and wheezing.
I don’t feel it’s necessary for anyone to attack another. I do see, however; the need for some education in this matter. I have in fact seen true anaphylaxis in a pt. that took tolectin. It can and does happen. As for the aspartame, I don’t know as that is a safe alternative to any condition. Please check into the use of a man made sweeter for such ailments.
I have no clue who is right here but I know I use artificial sweetener on my shredded wheat every day and it doesn’t do a thing for my arthritis. I’m happy if it helps yours but I don’t think that’s a normal expectation from sweetners.
Celebrex will not be pulled. Pfizer sold 5 billion dollars worth of the product in the last fiscal year. And people are fed up with the Mark Lanier type bullshit going on a against companies like Merck, witness that their stock has exploded to the upside.
People being “fed up” has nothing to do with Merck’s stock price. Ridiculous earnings are what is driving that price. And eliminating the claims of how litigation is bringing down business.
I hope you’re not a financial analyst.
RE: “Some Suggestions for patients who needed a COX-2″
Why do members of the medical profession continue to hold onto the myth that these medicines have ANY benefit which outweighs the risk-longer term- of taking them.
Presenting to patients a menu of choices and suggestions – as seen in this “Classic” post – only confuses people and pin-holes them into ‘your box’ method of analysis of this problem.
Even moderate dosages of nsaids and tylenol do damage. I predict that over the next several years you will see a growing number of studies and clinical scenarios to support this statement.
Specifically-if the pain is of spinal origen- place them on a slow release opioid and titrate to effect. Otherwise-be prepared for some significant long term complications your patients WILL SUFFER.
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P.S. I’m not going to get into a debate on this-so don’t expect me to answer any blogs. I put this communication out because I am concerned about the way doctors analyze their choices when treating pain.
You need to be more critical of NSAIDS and less critical of opioids. Especially in the elderly.
“People being “fed up” has nothing to do with Merck’s stock price. Ridiculous earnings are what is driving that price. And eliminating the claims of how litigation is bringing down business. “
“Ridiculous” earnings wouldn’t help this stock if analysts thought Mark Lanier could sodomize 30 billion dollars out of the company. Look what happened to other companies, ie wyeth, due to lawyer rape.
Please, enlighten us on how the lawyers have brought Wyeth down. Put that finance degree to good work.
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