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HomeTopics...Osteoarthritis Treat...Osteoarthritis Prescription Medication
Prescription Arthritis Medications: NSAIDs and COX-2 InhibitorsNSAIDs (nonsteroidal anti-inflammatory drugs) block the body's production of prostaglandins, which are hormones that cause inflammation. Prostaglandins also protect the stomach lining, though, so side effects of NSAIDs include stomach or intestinal ulcers.
A newer family of NSAIDs, known as COX-2 inhibitors, has recently been developed. COX-2 inhibitors prevent the production of the prostaglandin hormone COX-2, which causes inflammation, but don't inhibit the body's production of COX-1, which protects the stomach. This significantly reduces the frequency of stomach problems and other side effects.
Relafen: A Prescription NSAIDRelafen® (nabumetone) is one of the prescription NSAIDs commonly used to treat osteoarthritis. The drug provides pain relief by reducing the levels of inflammation in the joints. Relafen can cause the sudden development of stomach ulcers, so regular check-ups with your health professional are recommended. If you have kidney or liver problems, these should be discussed with your doctor before starting Relafen.
Contraindications (conditions under which use of the drug is inadvisable) to the use of Relafen include asthma or allergic reactions to other NSAIDs, such as ibuprofen or naproxen. Because the effects of Relafen on a developing fetus have not been determined, its use is contraindicated during pregnancy or while breastfeeding, as the drug may pass through the milk to the infant. Your doctor should be made aware if you are pregnant or plan to become pregnant while taking Relafen.
Possible side effects include ulcers, fluid retention and swelling. Abdominal pains, diarrhea, constipation, dizziness, headaches and sensitivity to sunlight are other possible side effects. Interaction with other drugs may occur, especially lithium, diuretics and methotrexate.
The COX-2 InhibitorsCOX-2 inhibitors, such as Celebrex® (celecoxib), are as effective at reducing inflammation as older NSAIDs, but don't have the risk of stomach ulcer formation. And many COX-2 inhibitors are safe for people taking blood thinners, because they don't interfere with platelet function.
Like Relafen, contraindications for the use of any COX-2 inhibitor include allergic reactions to other NSAIDs. Other contraindications include pregnancy, existing kidney or liver disease, and heart failure.
Side effects range from weight gain, fluid retention and fatigue to more serious complications such as bloody stools, vomiting and severe abdominal pain. COX-2 inhibitors can cause adverse reactions when used in combination with several other drugs, including some nonprescription drugs, so a list of all medications you use should be given to your doctor.
The Recent News on COX-2 InhibitorsAs of September 30, 2004, Merck & Co., the company that produced the COX-2 inhibitor Vioxx®, pulled the drug from the market. This action took place after a recent study indicated that long term use of the drug, Vioxx, doubled a person's risk of heart attack and stroke.
On April 7, 2005, after months of debate on whether the risks of the COX-2 inhibitor Bextra® (valdecoxib) outweighed its benefits, Pfizer, Inc. voluntarily suspended, at the request of the Food and Drug Administration (FDA), sales of the drug. Possible side effects of Bextra include a potentially life-threatening reaction that causes skin blisters and lesions. The FDA also requested that Pfizer include a black box warning on Celebrex about the increased risk of cardiovascular and gastrointestinal effects.
Studies concerning COX-2 inhibitors are still in progress. The Food and Drug Administration is also investigating the safety and efficacy of the COX-2 inhibtor class of drugs.
If you are currently taking a COX-2 inhibitor, talk with your doctor about the best medication for you.
Resources DeNoon, Daniel. (2004). Arthritis drug Vioxx pulled off market. WebMD. Lewis, C. (updated 2001). Arthritis: Timely treatments for an ageless disease. FDA Consumer. Medications-Online.com. (updated 2004). Relafen. Ortega, E. (2004, September 30). Dow average falls as Merck withdraws Vioxx; semiconductors gain. Bloomberg Media. Ozols, J.B. (2004, November 12). Doctors don't agree on Bextra risk. Newsweek Inc. Pfizer Inc. (updated 2004). About Celebrex. Celebrex.com Pfizer, Inc. (2005, April 7). New FDA labeling for Pfizer's Celebrex and all other NSAIDs to reflect similar cardiovascular profile. Pfizer Investor News Release. Underwood, T.J. (nd). Osteoarthritis. ArthritisInsight.com.
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