NSAIDs are medications for arthritis and other painful inflammatory conditions in the body. Aspirin, ibuprofen (MOTRIN), naproxen (NAPROSYN), and etodolac (LODINE) are a few examples of this class of medication.
The chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs) should be restricted to those conditions that have not responded to more natural means or methods. Always deal with the underlying causes when known or possible. Side-effects vary among different NSAIDs with some being safer than others. Consider using the lowest possible dose to accomplish the job. If you are taking them already and tolerating them well, the reduced risk of Alzheimer’s disease may be another very motivating reason to continue.
Due to the detrimental effects of NSAIDs on the body, most physicians resort to a game of “NSAID musical-chairs,” taking a patient off one NSAID as soon as side effects become evident or the drug stops working, then treating the patient with another of the 10 most widely prescribed propionic acid-derived NSAIDs.
To provide a more consistent form of treatment, researchers have long searched for a side-effect free anti-inflammatory agent. Researchers have focused on selective cyclo-oxygenase (COX-2) inhibitors, more precise versions of NSAIDs. Whereas previous NSAIDs reduced inflammation by inhibiting all cyclo-oxygenase activity, these new selective COX-2 inhibitors (Celebrex, Vioxx, Bextra) differentiate between the two forms of COX: COX-1 appears to regulate many normal physiologic functions and COX-2 mediates the inflammatory response. These selective inhibitors are believed to reduce inflammation without influencing normal physiologic functions by inhibiting only COX-2. By leaving COX-1 alone, the selective inhibitors result in fewer gastrointestinal side effects.
Upon further inspection, however, Celebrex (celecoxib) use has been associated with headaches, change in bowel habits, abdominal discomfort and dizziness in osteoarthritis patients. Fewer adverse effects are reported in rheumatoid arthritis patients, but because the drug is metabolized in the liver by cytochrome P-450 isozyme CYP2C9, drug interactions are possible. Celebrex has generally gained popularity over Vioxx because of concerns that Vioxx use will increase the risk of heart related side effects. Further, the use of Celebrex is being questioned regarding whether there really is a reduced risk of stomach ulcers.
On September 30, 2004: “The Food and Drug Administration (FDA) acknowledged the voluntary withdrawl from the market of Vioxx (chemical name rofecoxib). Celebrex and Bextra were still available at that time.
The blockbuster painkiller Bextra was pulled off the market April 7, 2005, and the US government ordered that 19 other popular prescription competitors – from Celebrex to Mobic to high-dose naproxen – carry tough new warnings that they, too, may increase the risk of heart attacks and strokes.