COX-2 ALTERNATIVES
With the growing concern surrounding the Cox-2 inhibitor arthritis drugs like Celebrex and Vioxx, many patients are turning to other anti-inflammatory drugs. And the fastest growing one is suspected of carrying cardiovascular risk by some experts.
Prescriptions for the pain drug Mobic have tripled since September, when Vioxx was voluntarily withdrawn from the market because of findings of heart disease risk.
But is Mobic a good choice, and, are any of the anti-inflammatory drugs truly safe? Or are they all safe if used properly?
Naomi Yokel has a history of headaches and arthritis. She uses anti-inflammatory medicines to give her relief. Recently, she was on Celebrex, but when it stopped working her doctor recommended a brief break from it.
“I thought since it didn’t seem to be doing any good there was no point continuing with it,” says Naomi.
Actually, lots of people need pain relievers, since pain is the number one reason why people go to the doctor. Many of those who need anti-inflammatories are now seeking alternatives to the Cox-2 inhibitor drugs like Celebrex and Vioxx.
The non-steroidal anti-inflammatory medications come in many different classes, or flavors. The Cox-2 inhibitors are an example of one of these classes. But the question is do the other classes have at least some degree of heart disease risk as well?
Many patients are turning to Mobic. In fact it’s the top-selling arthritis prescription painkiller. But some critics say, it may be a Cox-2 inhibitor in sheep’s clothing. “In Europe, Mobic is approved as a Cox-2 inhibitor. It never pursued that labeling in the United States because there were certain extra studies that weren’t done, so it’s viewed as a drug in between a Cox-1 and a Cox-2,” says Dr. Stewart Greisman, a rheumatologist at St. Luke’s Roosevelt Hospital.
And now there’s even been some evidence that there is at least a slightly increased cardiovascular risk associated with naproxen use, the active ingredient in Aleve. “Though there are many studies that do not show the same finding. I’m afraid we do not have a definitive answer. What is true today maybe something different in the next week or month, or even tomorrow,” Dr. Greisman says.
It may be that a safe alternative to the Cox-2 inhibitors is just a lower dose of Cox-2 inhibitors. “The lower dose is safer. The shorter the treatment duration the better, and the less medication the better,” believes Dr. Greisman.
Some doctors are using stomach-protecting medicines. Like Prilosec or Prevacid, along with the more traditional anti-inflammatories to protect the stomach. Experts say, discuss with your doctor when using these medicines for any prolonged period.
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