Celebrex

LignumVitae
LignumVitae Member Posts: 1,972
edited 27. Jun 2015, 17:55 in Living with Arthritis archive
I've had a letter from my GP telling me that my celebrex script has been revierwed and asking me to make an appointment with the pharmacist at the practice. After my initial wobble about the fact that I have only just got things back on track with the help of humira I decided to look into the matter (with the oh so heplful Dr Google). :lol:

It would seem that celebrex and other COXIIs are no longer deemed to be so much more gentle on the stomach than NSAIDs as per their original claims. It also seems that celebrex, as a long term option, comes at a heightened risk of cardiovascular problems. My inital thought was that my list of complications from meds was already big so who cares. Then I figured that taking one risk off was better than adding to the list. I am now pondering a good chat with the pharmacist about my use of anti-inflammtories (should they be a daily use regardless of the state of my arthritis) and my use of codiene and paracetamol too. I had hoped to reduce all of these once the humira was working. It is wokring and I haven't. Time for an MOT and some sensible advice on the way forward I think.
Hey little fighter, things will get brighter

Comments

  • stickywicket
    stickywicket Member Posts: 27,697
    edited 30. Nov -1, 00:00
    'Reviewed' is a sort of multi-purpose word with many meanings. All my meds are 'reviewed' every year but nothing much changes. I've even instigated some changes myself as, like you, I see no point in taking more than is necessary.

    'Necessary' is another tricky word :lol: I was taken off NSAIDS for life just before the Cox2 inhibitors came out and I was rather glad when I saw they were easier on the stomach but needing care on the cardio-vascular front. It's the old Arthritis Tightrope again, isn't it?

    I remember your last thread about coming off meds. You inspired me to give up my routine bedtime cocos. I did but drifted back on after a some nights on / some nights off period. I think this means I've more or less got things right.

    I think your idea of a 'good chat with the pharmacist' is the sensible way to proceed - exactly what I'd expect of you :wink: ) I hope things work out well.
    If at first you don't succeed, then skydiving definitely isn't for you.
    Steven Wright
  • dibdab
    dibdab Member Posts: 1,498
    edited 30. Nov -1, 00:00
    Sounds like a really sensible next step LV, all the meds we swallow/inject take their toll I guess but where would we be without them? Always at the back of my mind is the memory of my grandmother with RA in the days when gold and aspirin were the only options, and she suffered so much......I am eternally grateful that we have the whole range of modern drugs, and there is almost always another option if one becomes untenable for whatever reason.

    Hope the conversation with the pharmacist is useful, it would be interesting to hear what they advise.

    Deb x
  • LignumVitae
    LignumVitae Member Posts: 1,972
    edited 30. Nov -1, 00:00
    Thank you both for your kind comments. Sensible, me :D

    I think we are lucky with the range of meds we have. My best friend's mum when I was little had horrendous RA and died from organ involvement. We are lucky but I don't want to be complacent and in terms of a review I've not had my celebrex fiddled with since about 2006 when I first started it, except for a brief period after the girls were born so I think my review is long overdue :oops:
    Hey little fighter, things will get brighter
  • theresak
    theresak Member Posts: 1,998
    edited 30. Nov -1, 00:00
    I can see where your GP is coming from, LV, as my own GP will not prescribe Cox 2s, or not to me anyway. I was fortunate in that once the humira started working - which it did, quite quickly - I was able to come off the NSAIDs unless I had a flare. My GP explained the cardiovascular risks, plus the stomach risks on the other anti-inflammatories. I found Diclofenac the most effective, but take Naproxen as it's milder.

    I have a medication review annually with the GP.
  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
    My first anti-inflam was Celebrex because it was lauded for its more gentle approach to the stomach but as time has gone on it seems natural for other problems to crop up as knowledge and experience of the drug grows. It worked for me but the GPs changed it due to cost (two tablets instead of one was the cheaper option). No matter what the med it can cause trouble somewhere else in the body - I'm on BP meds thanks to the humira (raised BP is a listed side-effect).

    I rarely take an anti-inflammatory now (in my case diclofenac) because my inflammation is negligible thanks to my tripe therapy (deliberate typo) but when the OA has a snap I find it helpful to take one or two. I also take the omep when the diclo is needed. I agree, LV, you are in need of a review and I hope it proves to be a useful experience. Please let us know what is decided. DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • LynneS
    LynneS Member Posts: 26
    edited 30. Nov -1, 00:00
    I'm with the others, I think a review is a good thing. As a newbie I probably ask too many questions and challenge too much, but with the advent of Dr Google we are better informed so can ask appropriate questions to help us understand/feel more engaged with our treatment plans.

    It'll be interesting to hear what they say.
  • barbara12
    barbara12 Member Posts: 21,280
    edited 30. Nov -1, 00:00
    Good luck with the review LV, I had to give up the antiinflamatorys due to getting kidney disease, I do miss them but so glad it was spotted...hopefully they can offer something else...
    Love
    Barbara
  • LignumVitae
    LignumVitae Member Posts: 1,972
    edited 30. Nov -1, 00:00
    Wel I'm not sure if that was a full MOT or a revolution. I guess time will tell. FIrst off, after 18 months of trying to enact the change with the GP, despite several letters from the hospital detailing my dosage, my folic acid script is now correct :D All I have to do is remember to take them.

    I had a good chat with the prescribing pharmacist. All practices should have one, I think ours got the lovely one we have as an NHS experiment and the plan is to widen the use of them. She was possibly far more knowledgeable than many GPs would be regarding my meds, why I take so many and what they all do plus how we might make the system of drugs work better for me.

    I've dropped the celebrex and started naproxen with the understanding that if it isn't work there will be something else and we will simply find that. I explained my codiene use. I always just get the over the counter stuff. Sometimes I can get away with just a couple at bedtime but on bad nights, of which there are a few, I take the entire daily recommended dose during the night. I explained that bad times weren't all the time but that once they start, stopping the cycle of pain, no sleep causing pain and no sleep was tricky. In response she has suggested I try a different dose of codeine so I will take one 30mg tablet with one paracetamol at bedtime with the option of two codeine and no paracetamol on really bad days. The codeines have paracetamol in them, hence it being an either or rather than both or none. She was sure I will not become addicted because addiction is rare in those using it for genuine pain relief apparently. I'm quite excited about bedtime now and seeing if the one codeine will do all I hope :lol:

    I'm not sure if I am now in a state of less is more or more is less but either way, it was so useful talking to somebody who understood and had the time to work out a plan. My first review of that side of things for 10 years I think. :o
    Hey little fighter, things will get brighter
  • stickywicket
    stickywicket Member Posts: 27,697
    edited 30. Nov -1, 00:00
    I'm quite excited about bedtime now and seeing if the one codeine will do all I hope :lol:

    Yeees. The things that excite us at bedtime do change a bit with arthritis, don't they :wink::lol:

    I'm so pleased you've had a good review and the prospect of help at hand when meds-tweaking is required. We shall await the verdict with anticipation :D
    If at first you don't succeed, then skydiving definitely isn't for you.
    Steven Wright
  • LignumVitae
    LignumVitae Member Posts: 1,972
    edited 30. Nov -1, 00:00
    I know, if you had told me at 18 that this would be the most exciting thing to consider late on a friday night by my mid 30s I would probably have shot myself! Good job my days are lively affairs.
    Hey little fighter, things will get brighter
  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
    That sounds to be an interesting meeting and I hope that the new regime works better - please tell me that you have a stomach protector too! I find that getting ahead of the pain is the key for me, this is why I keep my coco intake (30/500) at a steady level of (currently) four per day rather than trying to do without: once it gets a hold it is harder to shift to a more manageable level.

    I too am excited about bed time because we have a new bed. My side is bliss. I hope to be in it by 8.30pm. :D DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • Starburst
    Starburst Member Posts: 2,546
    edited 30. Nov -1, 00:00
    Hello LV,

    I was in a similar position last year and was taken off celebrex and put on naproxen. I've not had too much trouble with the switch over and on balance, I felt the risks of heart disease outweighed my worry about the naproxen not managing my pain as well.

    There is a school of thought that if you take paracetamol regularly over the long term, it keeps a certain level in your blood and dampens the pain. I tend to take co-codamol (500mg paracetamol and 30mg codeine) when I'm desperate. I was advised not to wait until desperate and take paracetamol even if I'm feeling like my pain is manageable. This is working and I've been able to slightly reduce my codeine dose.

    I'm super tired, so hope the above made sense and wasn't too rambly.

    Take it easy and be kind to yourself. x
  • GraceB
    GraceB Member Posts: 1,595
    edited 30. Nov -1, 00:00
    Years ago I was put on Celebrex for my OA. I seem to recall it took the edge off things but no real fantastic results. The major issue I had with this was one of the side effects, which I am embarrassed to say was - wait for it - wind. :oops: Yup, very awkward at times. :oops:

    GraceB
    Turn a negative into a positive!
  • lynnemarie1123
    lynnemarie1123 Member Posts: 295
    edited 30. Nov -1, 00:00
    I'm on Celebrex , not noticing any significant changes ? Been on lots of different ones in the past !

    Take care xx