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Medical Forum / Diseases and Disorders / Cancer / December 2004

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OT --- what NSAIDS now???

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MB_ - 21 Dec 2004 19:16 GMT
Latest news is finding problems with naprosyn and aleve.

What can one take for arthritic problems???

It looks like one can try generic ibuprufen, but it seems that is a primary
component of the aforementioned drugs.

Any thoughts?

(While this is not strictly cancer-related I suspect many patients do rely
on the NSAIDS for control in some inflammatory situations.)

MB
J - 21 Dec 2004 22:31 GMT
> Latest news is finding problems with naprosyn and aleve.
>
[quoted text clipped - 9 lines]
>
> MB

Hello MB.
Same questions are reverberating throughout various newsgroups.
One is supposed to talk to their doctor.
That's what I plan to do, eventually.
Or have a read of the most recent news
http://msnbc.msn.com/id/6742963/
HTH
J
J - 21 Dec 2004 23:59 GMT
> Latest news is finding problems with naprosyn and aleve.
>
> What can one take for arthritic problems???
>
> It looks like one can try generic ibuprufen, but it seems that is a primary
> component of the aforementioned drugs.

I forgot to mention potential gastro bleeds...
and someone on the arthritis newsgroup claims that "the aleve study showed a
slight increase of heart issues in a study in which all the participants were
over 70."
J
Mike Radcliffe - 22 Dec 2004 15:10 GMT
> Latest news is finding problems with naprosyn and aleve.
>
[quoted text clipped - 9 lines]
>
> MB

As with all drugs you make a risk/benefit choice. The problems with newer
cox2 inhibitors appear to be with large (above recommended) doses over long
periods. As there are no benefits in using these for long periods (over 3
months) over the older nsaids the answer would appear to be to use the older
nsaids which may be more effective for pain relief anyway and would save a
heap of money.
MIKE
bj - 22 Dec 2004 20:03 GMT
> problems with newer cox2 inhibitors appear to be with large (above
> recommended) doses over long periods. As there are no benefits in using
> these for long periods (over 3 months) over the older nsaids the answer
> would appear to be to use the older nsaids which may be more effective for
> pain relief anyway and would save a heap of money.

Of course, that "more effective" is a statistic -- and it's not 100%. For
some people, the "oldies" just aren't "goodies", either now or maybe just
"anymore". They're the ones I feel sorry for, as things they use to get at
least some relief start disappearing.
bj
Mike Radcliffe - 23 Dec 2004 11:57 GMT
>> problems with newer cox2 inhibitors appear to be with large (above
>> recommended) doses over long periods. As there are no benefits in using
[quoted text clipped - 8 lines]
> least some relief start disappearing.
> bj

While I'm not advocating removing the newer nsaids from the market when
simply following sensible prescribing rules would suffice I think that
consumers would not miss them very much if they did.
My understanding of the newer nsaids is not that they are better analgesics
but in SHORT term prescribing they reduce the likelihood of gastric
irritation for those people who are susceptible. It is probable that these
people should not be taking nsaid's in any form anyway.
A recent trial found that paracetamol (acetamenaphen) was just as effective
in relieving pain. Of course having to take two huge tablets four times a
day is not as convenient as taking one small nsaid pill is no fun,
especially for wimps like me, but the bottom line is you pay for convenience
both financially and, apparently, with increased risks.
MIKE
bj - 24 Dec 2004 02:28 GMT
> A recent trial found that paracetamol (acetamenaphen) was just as
> effective in relieving pain.

Was that for *everyone*? 100%? or "statistically significant" (but there
were some failures)?
I'm not trying to be obnoxious, I'm just curious.

I've used both Vioxx & Celebrex; one worked for me, the other didn't, and I
know people who had the same experience but in the opposite direction. But
they were both supposedly "effective". And when I was trying them,
acetaminophen did not do the job (that's *why* I was trying them; I was
quite willing to take pills several times a day, even horse pills, if it
would *work*). And fortunately my problem was not chronic, so I don't have
the pretty much permanent day-to-day problem some people have.
bj
Mike Radcliffe - 24 Dec 2004 10:56 GMT
>> A recent trial found that paracetamol (acetamenaphen) was just as
>> effective in relieving pain.
[quoted text clipped - 11 lines]
> the pretty much permanent day-to-day problem some people have.
> bj

Darned if I can remember the exact statistics of the trial but it was
'statistically significant'. There are no absolutes in medicine but there
are enough variants of nsaids around to sit just about everybody...which is
still only a statistic.
MIKE
HB Lites - 24 Dec 2004 18:09 GMT
>While I'm not advocating removing the newer nsaids from the market when
>simply following sensible prescribing rules would suffice I think that
>consumers would not miss them very much if they did.

I think much of the problem is a result of these drugs being overprescribed and
overadvertised. The pharm companies have found what I think is s dubious sales
technique in advertising directly to consumers and advising them to go to their
doctors and ask for these drugs. In this situation, many doctors will go ahead
a prescibe these drugs upon request if they think the risks are very low, even
if the patient doesn't really need them  -- otherwise their patient will just
go somewhere else.

Then when lots of people are taking these drugs unnecessarily, it is discovered
that the risks are greater than previously thought. Then everything kinda
backfires and the drug ends up getting pulled off the market.

My mom has severe rheumatoid arthritis and Bextra is the only thing that has
been able to help her. She would be willing to continue taking the drug even
after taking the new risks into consideration (she used to work in a medical
research lab as a technologist and I can assure you she understands the data).
She is rather annoyed that the drug may be pulled and we both feel doctors
should still be able to prescribe it to patients that understand the risk and
really need it.
MB_ - 24 Dec 2004 20:37 GMT
Mike:

As you must know, acet. (tylenol) doesn't really help with inflammation. I
found it great for headaches and all sorts of pain, but useless for my
severe back pain/inflammation.

Mel
>>> problems with newer cox2 inhibitors appear to be with large (above
>>> recommended) doses over long periods. As there are no benefits in using
[quoted text clipped - 23 lines]
> convenience both financially and, apparently, with increased risks.
> MIKE
J - 24 Dec 2004 21:07 GMT
> As you must know, acet. (tylenol) doesn't really help with inflammation. I
> found it great for headaches and all sorts of pain, but useless for my
> severe back pain/inflammation.

That's my experience too.
J
Mike Radcliffe - 27 Dec 2004 03:35 GMT
>> As you must know, acet. (tylenol) doesn't really help with inflammation.
>> I
[quoted text clipped - 3 lines]
> That's my experience too.
> J

The thing is you should always try the safest cheapest first. It's good
medicine, good economics and common sense.
MIKE
 
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