These comments are made for the purpose of discussion and should NOT
be used as recommendations for or against therapies or other treatments. An indi
vidual patient is always advised to consult their own physician.
[posted 03/17/2000]
Question: I recently fell of a ladder and severly strained my back. My doctor put me on muscle relaxants and Vioxx, neither of which have had a satisfactory effect on the pain.
My brother-in-law is an MD practicing in another state, and he said Vioxx is typically prescribed for arthritis. He suggested a narcotic analgesic such as Lortab or Vicodin might work better than the Vioxx. I realize my brother-in-law is second-guessing my own physician with less information, but I still have a two-part question:
Are narcotic analgisics more effective than NSAIDs, and how much influence do I have with my doctor over what he prescribes?
Answer: Vioxx is commonly used for pain control in either the 25 or 50 mg dosage. However, like any pain if it is insufficient to control the pain, other options need to be considered. You can certainly use narcotic pain meds with vioxx(like Lortab or vicodin). Narcotic meds are usually more effective, but lack any inflammatory component (which both Cox 2 inhibitors-vioxx- and nsaids) have. We commonly use them together to get pain synergy. As I recall, your md works for you, you don’t work for him/her. Tell them your problem.
[posted 11/27/1999]
Question: I recently started taking zestril. Could this cause a very dry mouth? My doctor also started me on vioxin for arthritis could this be the culprit?
Answer: Not usually zestril. As to Vioxx, I haven’t seen this problem with the drug but I’ve only used it 6 months or so. Stopping it for a few days and using acetominophen would let you know since it would be out of your system in 24-36 hours.
[posted 08/30/1999]
Question: What is vioxx? Can psuedogout occour from an injury? If not, what caused it? My doctor only took an x-ray to determine it. My doctor is an M.D. I was told by relatives to see specialist for both of these problems.
Answer: Vioxx is a drug belonging to a new class of anti-inflammatories. These drugs workd by affecting the white blood cells ability to initiate the inflammatory cascade. They work differently from traditional drugs like Motrin and the like. Toxicities appear less, especially GI. Currently, they have been available about 4 months(10/99) so I don’t have long term experience. Some patients(4% or so) will have gastritis. They are pricey but appear to work well with much less toxicity than traditional anti-inflammatories. Pseudo Gout is inflammation in a joint due to the accumulation of calcium crystals(regular gout is inflammation from uric acid crystals). It has a different joint distribution from gout, but the diagnosis is made by joint aspiration looking for the characteristic crystals, not by x-ray.
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