Aleve, Vioxx, Celebrex, and Bextra: What It is advisable to Know About Arthritis Pain Medications

By Rashar Vick

Recent controversy within the safety of pain medications for arthritis has left patients and well being care professionals alike confused about which medications are safe to use. In fact, a recent survey by the Boston-based Rippe Lifestyle Institute indicated that numerous persons with arthritis are suffering unnecessarily due to the fact they've stopped or reduced their use of pain relievers as a result of confusion about which drugs are regarded as safe.

The survey also showed that now, more than ever, people with arthritis have to understand the rewards and possible side outcomes associated with all arthritis pain medications. In order to do so, folks with arthritis, their caregivers and families should be familiar with recent news about the a couple of forms of drugs most typically applied to treat arthritis pain - non-selective, non-steroidal anti-inflammatory drugs (NSAIDs), and one more group of NSAIDs named cyclooxygenase-2 (COX-2) specific inhibitors.

COX-2 particular inhibitors vs. Other NSAIDs

COX-2 particular inhibitors are the newest members from the NSAID class of medications. Offered by prescription only, they became extensively employed in recent years to reduce joint pain and swelling. COX-2 specific inhibitors work by selectively blocking, or inhibiting, one with the 2 enzymes associated with inflammation. Some experts think that this selective inhibition can be a single reason for some of the bad side effects currently associated with COX-2 particular inhibitors.

Non-selective NSAIDs have been developed earlier than COX-2 specific inhibitors and were widely used to relieve arthritis pain and inflammation for quite a few years. Unlike COX-2 specific inhibitors, non-selective NSAIDs inhibit each major enzymes involved during the inflammatory process, COX-1 and COX-2. The non-selective NSAID category has a number of several medications that are offered in both prescription and over-the-counter (OTC) products.

Timeline of Events

To understand the modern state of affairs, it's essential to understand the sequence of events. The controversy started once a understand published inside the October 21, 2004, issue of the New England Journal of Medicine cited the COX-2 particular inhibitor, Vioxx as potentially causing "major bad events," such as heart attack and stroke, between patients taking the drug. As a result, Merck (the drug's manufacturer) voluntarily withdrew Vioxx inside the market. However, within the months following, the safety from the other obtainable COX-2 particular inhibitors for example Celebrex and Bextra, and other arthritis pain medications within the non-steroidal anti-inflammatory (NSAID) class, had been also known as into question.

Consequently, in February 2005, the us Food and Drug Administration (FDA) convened a particular Advisory Committee, created up of members of the Arthritis and Drug Safety Advisory Committees, to review the cardiovascular safety of these arthritis pain medications.

FDA Directive: Stronger Warning Labels for Some Pain Medications

On April 7, 2005, taking into account the recommendations in the Advisory Committee, the FDA issued right here directives:

o Bextra, a COX-2 specific inhibitor made by Pfizer, was withdrawn from the market.

o All prescription NSAIDs need to revise their labeling to include a "black box" warning that highlights the ability increased risk for cardiovascular (CV) events as well as the potentially life threatening gastrointestinal (GI) bleeding associated with these drugs. Celebrex, the only COX-2 particular inhibitor remaining on a US market, was included in this directive.

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