Guest guest Posted April 23, 2001 Report Share Posted April 23, 2001 This is interesting.. I don't try and keep up with all the latest info on medications outside my specialty area. However, I recall that both Vioxx and Celebrex are COX II inhibitors, the newest class of NSAIDs. Neither is supposed to inhibit the COX I pathway- which is the cause of the risk to the stomach lining by other NSAIDs. In all my professional drug info programs Vioxx and Celebrex have the same warnings, " Due to rofecoxib's (or celecoxib's) specificity for the COX-2 cyclooxygenase pathway, it has the potential to cause less gastropathy and risk of GI bleeding; however, severe gastrointestinal adverse events have occurred in patients receiving rofecoxib (or celecoxib). If there is new research out there or solid clinical experience indicating that Celebrex/celexoxib is easier on the stomach than Vioxx/rofecoxib, I'd really like to know that and take another look at which my patients are having prescribed by other providers. Sounds like you have info I need, Liane. in Seattle Re: VIOXX > > > :::::::::::waving arms::::::::::::::: > I know! > Celebrex predisposes your stomach to ulcers and is not recommended for > those w/a history of bleeding ulcers, GI bleeds, Stomach surgery, etc. > > Hugs, > Liane > > > > > Before surgery I had been taking Celebrex or Vioxx and Dr. told > me > > to take Vioxx. I believe it easier on the stomach (can't remember > the > > reason right now). Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 2001 Report Share Posted April 24, 2001 Thanks, Liane. I'm on a psychopharmacology mail list and find that clinical experience often precedes journal articles and double blind studies by years. So the anecdotal reports of today may well be the research supported findings in time. I'll look tomorrow and see if both are on our hospital formulary. And will pay attention to which is being rx'd to my patients by their PCP. Appreciate your info... you wave your hand well thanks, in Seattle ----- Original Message ----- > --- In duodenalswitch@y..., > - > Ummm... No, not really. I know only that I worked in geriatrics for > a while, and all the docs switched from celebrex to Vioxx. The one > patient that was left on Celebrex was also on Coumadin for a history > of A Fib.. and he had a serious GI bleed after being on Celebrex only > about a month. The Doctors all decided it was due to a combination of > things: the celebrex, the coumadin, and the fact that this man ate > very little (and DS-ers would have 2 out of 3 of those..). I asked > about the switch when it happened, & the answer I was given was that > Vioxx seemed to have fewer problems with GI bleeding as compared to > Celebrex (in the elderly). There's no definitive proof yet, just > anecdotal information from personal experiences. I got the same answer > from 4 Doctors & one NP, so I decided that it was what they were > seeing personally. Sorry to have gotten your hopes up. > Hugs, > Liane Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 2001 Report Share Posted April 24, 2001 Thanks, Liane. I'm on a psychopharmacology mail list and find that clinical experience often precedes journal articles and double blind studies by years. So the anecdotal reports of today may well be the research supported findings in time. I'll look tomorrow and see if both are on our hospital formulary. And will pay attention to which is being rx'd to my patients by their PCP. Appreciate your info... you wave your hand well thanks, in Seattle ----- Original Message ----- > --- In duodenalswitch@y..., > - > Ummm... No, not really. I know only that I worked in geriatrics for > a while, and all the docs switched from celebrex to Vioxx. The one > patient that was left on Celebrex was also on Coumadin for a history > of A Fib.. and he had a serious GI bleed after being on Celebrex only > about a month. The Doctors all decided it was due to a combination of > things: the celebrex, the coumadin, and the fact that this man ate > very little (and DS-ers would have 2 out of 3 of those..). I asked > about the switch when it happened, & the answer I was given was that > Vioxx seemed to have fewer problems with GI bleeding as compared to > Celebrex (in the elderly). There's no definitive proof yet, just > anecdotal information from personal experiences. I got the same answer > from 4 Doctors & one NP, so I decided that it was what they were > seeing personally. Sorry to have gotten your hopes up. > Hugs, > Liane Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 2001 Report Share Posted April 24, 2001 Thanks, Liane. I'm on a psychopharmacology mail list and find that clinical experience often precedes journal articles and double blind studies by years. So the anecdotal reports of today may well be the research supported findings in time. I'll look tomorrow and see if both are on our hospital formulary. And will pay attention to which is being rx'd to my patients by their PCP. Appreciate your info... you wave your hand well thanks, in Seattle ----- Original Message ----- > --- In duodenalswitch@y..., > - > Ummm... No, not really. I know only that I worked in geriatrics for > a while, and all the docs switched from celebrex to Vioxx. The one > patient that was left on Celebrex was also on Coumadin for a history > of A Fib.. and he had a serious GI bleed after being on Celebrex only > about a month. The Doctors all decided it was due to a combination of > things: the celebrex, the coumadin, and the fact that this man ate > very little (and DS-ers would have 2 out of 3 of those..). I asked > about the switch when it happened, & the answer I was given was that > Vioxx seemed to have fewer problems with GI bleeding as compared to > Celebrex (in the elderly). There's no definitive proof yet, just > anecdotal information from personal experiences. I got the same answer > from 4 Doctors & one NP, so I decided that it was what they were > seeing personally. Sorry to have gotten your hopes up. > Hugs, > Liane Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 2001 Report Share Posted April 24, 2001 I had written: ....recent articles indicate that both of them (the cox2 inhibitors) may give short-term relief, but may also cause more long-term damage to cartilage. Some of you asked for the reference(s). I could not find the original article(s) that i had seen, but today located another article. Excerpts are included below. it would appear that there still is no free lunch! --Steve ================================================= http://www.lef.org/magazine/mag2001/jan2001_report_cox2_1.html ARTHRITIS UPDATE Drugs That Inhibit COX-2 May Cause Tissue Damage by: Faloon [part of] Page 1 of 3 The Scales Tilt on the Side of Nature Drugs that inhibit the cyclooxyenase-2 (COX-2) enzyme have shown efficacy in alleviating inflammation and pain caused by arthritis. Celebrex and Vioxx are two popular COX-2 inhibitors that are being aggressively marketed to arthritis patients by drug companies. A new study published in the Journal of Immunology(1) acknowledges the temporary benefits of COX-2 inhibitors, but identifies a potential long-term problem that could lead to cartilage and other tissue degeneration if these drugs are taken over an extended time period. The authors of this study found that COX-2 inhibitors cause metabolic imbalances that can result in the over production of two toxic cytokines, tumor necrosis factor alpha (TNF-a) and interleukin one beta (IL1B). Both TNF-a and IL-1B have been shown to play a role in the cartilage destruction and the inflammation process.(2-4) TNF-a and IL-1B have been found to be elevated in the synovial fluid and the cartilage of osteoarthritis patients.(2,5) Thus, the short term beneficial effects of these agents on arthritic pain and inflammation may be achieved at the cost of an increased propensity to long term tissue damage caused by TNF-a and IL1B. Too much TNF-a results in a host of aging-related disorders including autoimmune disease, congestive heart failure, insulin resistance and catabolic wasting.(6-10) When TNF-a attacks the linings of the joints, the result is inflammation, pain and eventual immobility.(11-13) Over expression of the destructive cytokines TNF-a and IL-1B are not the only problem that COX-2 inhibitors may induce. While COX-2 inhibitors suppress an inflammatory fatty-acid called prostaglandin E2, they fail to block the formation of a joint-destroying cytokine called leukotriene B4.(14) This all helps explain why COX-2 inhibitors do not always provide complete relief from arthritis symptoms. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 2001 Report Share Posted April 24, 2001 I had written: ....recent articles indicate that both of them (the cox2 inhibitors) may give short-term relief, but may also cause more long-term damage to cartilage. Some of you asked for the reference(s). I could not find the original article(s) that i had seen, but today located another article. Excerpts are included below. it would appear that there still is no free lunch! --Steve ================================================= http://www.lef.org/magazine/mag2001/jan2001_report_cox2_1.html ARTHRITIS UPDATE Drugs That Inhibit COX-2 May Cause Tissue Damage by: Faloon [part of] Page 1 of 3 The Scales Tilt on the Side of Nature Drugs that inhibit the cyclooxyenase-2 (COX-2) enzyme have shown efficacy in alleviating inflammation and pain caused by arthritis. Celebrex and Vioxx are two popular COX-2 inhibitors that are being aggressively marketed to arthritis patients by drug companies. A new study published in the Journal of Immunology(1) acknowledges the temporary benefits of COX-2 inhibitors, but identifies a potential long-term problem that could lead to cartilage and other tissue degeneration if these drugs are taken over an extended time period. The authors of this study found that COX-2 inhibitors cause metabolic imbalances that can result in the over production of two toxic cytokines, tumor necrosis factor alpha (TNF-a) and interleukin one beta (IL1B). Both TNF-a and IL-1B have been shown to play a role in the cartilage destruction and the inflammation process.(2-4) TNF-a and IL-1B have been found to be elevated in the synovial fluid and the cartilage of osteoarthritis patients.(2,5) Thus, the short term beneficial effects of these agents on arthritic pain and inflammation may be achieved at the cost of an increased propensity to long term tissue damage caused by TNF-a and IL1B. Too much TNF-a results in a host of aging-related disorders including autoimmune disease, congestive heart failure, insulin resistance and catabolic wasting.(6-10) When TNF-a attacks the linings of the joints, the result is inflammation, pain and eventual immobility.(11-13) Over expression of the destructive cytokines TNF-a and IL-1B are not the only problem that COX-2 inhibitors may induce. While COX-2 inhibitors suppress an inflammatory fatty-acid called prostaglandin E2, they fail to block the formation of a joint-destroying cytokine called leukotriene B4.(14) This all helps explain why COX-2 inhibitors do not always provide complete relief from arthritis symptoms. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 2001 Report Share Posted April 24, 2001 I had written: ....recent articles indicate that both of them (the cox2 inhibitors) may give short-term relief, but may also cause more long-term damage to cartilage. Some of you asked for the reference(s). I could not find the original article(s) that i had seen, but today located another article. Excerpts are included below. it would appear that there still is no free lunch! --Steve ================================================= http://www.lef.org/magazine/mag2001/jan2001_report_cox2_1.html ARTHRITIS UPDATE Drugs That Inhibit COX-2 May Cause Tissue Damage by: Faloon [part of] Page 1 of 3 The Scales Tilt on the Side of Nature Drugs that inhibit the cyclooxyenase-2 (COX-2) enzyme have shown efficacy in alleviating inflammation and pain caused by arthritis. Celebrex and Vioxx are two popular COX-2 inhibitors that are being aggressively marketed to arthritis patients by drug companies. A new study published in the Journal of Immunology(1) acknowledges the temporary benefits of COX-2 inhibitors, but identifies a potential long-term problem that could lead to cartilage and other tissue degeneration if these drugs are taken over an extended time period. The authors of this study found that COX-2 inhibitors cause metabolic imbalances that can result in the over production of two toxic cytokines, tumor necrosis factor alpha (TNF-a) and interleukin one beta (IL1B). Both TNF-a and IL-1B have been shown to play a role in the cartilage destruction and the inflammation process.(2-4) TNF-a and IL-1B have been found to be elevated in the synovial fluid and the cartilage of osteoarthritis patients.(2,5) Thus, the short term beneficial effects of these agents on arthritic pain and inflammation may be achieved at the cost of an increased propensity to long term tissue damage caused by TNF-a and IL1B. Too much TNF-a results in a host of aging-related disorders including autoimmune disease, congestive heart failure, insulin resistance and catabolic wasting.(6-10) When TNF-a attacks the linings of the joints, the result is inflammation, pain and eventual immobility.(11-13) Over expression of the destructive cytokines TNF-a and IL-1B are not the only problem that COX-2 inhibitors may induce. While COX-2 inhibitors suppress an inflammatory fatty-acid called prostaglandin E2, they fail to block the formation of a joint-destroying cytokine called leukotriene B4.(14) This all helps explain why COX-2 inhibitors do not always provide complete relief from arthritis symptoms. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2001 Report Share Posted April 26, 2001 For what it's worth. I took Vioxx. After 2 days, I began to feel great. After 4 days I began to bleed. Appeared rectal. Had several tests including a colonoscopy. It turns out I have hemrhoids(Spelling?). Anyway, I stopped taking Vioxx. n Pre-Op Dr. Pomp/Mt Sinai n Boden (maboden@...) _______________________________________________________ Send a cool gift with your E-Card http://www.bluemountain.com/giftcenter/ Quote Link to comment Share on other sites More sharing options...
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