COX2

Anti-inflammatory Medicines

Celecoxib – Celebrex®
Etoricoxib – Arcoxia®
Valdecoxib - Bextra®

Advice to patients about recent evidence

What's this about?

We regularly check and review the medicines that are prescribed for you. Government doctors and scientists also issue us with national guidance.

As part of this check and review new evidence shows the possibility of the above medications having extra side effects.

These are a type of anti-inflammatory medicine, commonly used in painful conditions such as osteoarthritis and rheumatoid arthritis.

Why are these medicines different to other anti-inflammatory medicines?

Anti-inflammatory medicines have been available for many years. They play an important role in the treatment of arthritis and many other painful conditions.

One problem with them is they may sometimes cause stomach and gut side effects, which in rare cases can be serious (e.g. ulcers and bleeding).

These new medicines were introduced to try and reduce the stomach and gut side effects.

What is the new evidence with these medicines?

American trials, using doses that are higher than we usually use, have showed an increased risk of heart and circulation problems. The British Government does not yet know all the details, so is asking us to “err on the side of caution’ and double check all our patients.

How big might the problem be?

The evidence is still being analysed. Therefore because of the uncertainty medical advice is that we see if we can give you a different painkiller.

This is more important if you already have a heart problem, or have had a stroke.

As with all medicines, and many other things in life, we need to weigh up the benefits these medicines give you with the risks they may carry.

What medicine might it be changed to?

We are all different, so we will discuss the best medicine for you. Also if you need to have medicines to help protect your stomach we will give you these.

What do I need to do?

Please contact the surgery as soon as is convenient. You are asked to make a non-urgent routine appointment for us to check your pain-killing medicines.

We want to check all patients, and are in-particular patients on these medicines who have heart problems, or have previously had a stroke.

Whilst we are keen to check your anti-inflammatory painkillers, this is not a medical emergency.

Can I stop taking these medicines?

If you are concerned, there are no harmful effects from stopping these medicines. However you may need to take something else to help with your pain, while waiting for your appointment.

There are many other types of painkiller and anti-inflammatory. You can ask your pharmacist for initial advice on whether paracetamol or ibuprofen might be suitable for you. Both are available over-the-counter.

Thank you to North Warwickshire PCT Medicines Team who produced this information.

December 22nd 2004

Contact Rugby PCT 01788 550860 – Medicines Management team or your GP surgery