Celebrex
and Vioxx are the two new arthritic medications that have hit the market this
year and have certainly generated excitement among physicians and patients.
Celebrex
(celecoxib) was approved in January and has generated close to 400,000 prescriptions
per week. Vioxx(rofecoxib) introduced last month should follow close to that number.
What
are these medications and how do they work? Both belong to the category of medications
known as non-steroidal anti-inflammatory drugs (NSAIDs) which alsoinclude aspirin
and ibuprofen.
These
pain relievers work by blocking the enzyme cyclooxygenase, which helps produce
prostaglandins which are responsible for pain and medication.
However,
one type of cyclooxygenase (known as Cox-1) is responsible for protection of our
stomach lining by producing a mucus barrier. Because ibuprofen and aspirin blocks
Cox-1, we are prone to developing gastric ulcers, upset stomach and bleeding.
With the new medications of Celebrex and Vioxx, these target only Cox-2, which
is responsible for inflammation.
These
new pain pills aren't cheap, with each pill costing up to $3.00 compared to ibuprofen
which is only about 10 cents. However, they do represent a breakthrough for arthritic
patients, especially the elderly, where gastrointestinal bleeding can be a life
and death matter.
In
terms of quality of pain relief, they appear to be on the same level as ibuprofen
as naproxen. People allergic to sulfa drugs should not take Celebrex as it contains
sulfa compounds. Vioxx is apparently sulfa-free. Both medications have been approved
for treatment of osteoarthritis and rheumatoid arthritis, and vioxx has been approved
for acute pain and menstrual pain.
Both
have not been approved for pediatric use. Side effects have generally been mild,
including headache, diarrhea, and insomnia.
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