One little molecule??? Pharma Steve?

[mmglobal]

Yesterday, I was speaking to one of the spine surgeons I'll be seeing next month in Germany. He asked how I was doing and I said, "Much better! I've been doing substantially better for the last week, since I change anti-inflammatories. I switched from diclofenac (volateren) to meloxicam (mobic)."

He grumbled something like, "It's psychological. Those drugs are all the same. They change one molecule, give it a new name and charge more for it."

I've been on NSAIDS for most of the last 12 years. Without question, the one that worked best for me was Bextra. It was pulled from the market in 2005 after Vioxx (pulled 2004) because of increased risk of heart problems.

I switched NSAIDS because I'm starting to have some stomach issues. I also added a PPI (proton pump inhibitor) and that is going well too.

I'm not sure if it's the med change, but I have been doing better since starting the Mobic. The question for the community is:

Do you see a substantial difference from one NSAID to the next? (both side effects and effectiveness?

I'm curious what the pharmacist's take is on the variations from one drug to the next when you stay in the same class.

Mark

[Maria]

Mark,
It's been a number of years since I took oral Nsaids because of severe GI issues however I found that certain ones worked better for me than others that seemed not to be effective. In fact there were only several I felt at the time worked well. I skipped a bunch of years before trying anything again and then tried Vioxx which worked really well for arthritic pain and menstrual type cramps however the epigastric pain and feeling of tightness and pressure in my chest was super intense so had to d/c this drug even before pulled off the market.

What has worked really well for spasms for me and in fact amazingly well has been IM 60mg Toradol for both cervical and lumbar probs. Oral Toradol didn't seem to make much diff.

It could just be a combination of the drug working well for you and you're doing better (coincidence) ~ you could always check it out by switching back to the other medication tho I'm sure you don't want to waste your time with feeling worse if it's really the medication?

[Pharmacist.steve]

So what .. if it is a placebo effect.. if the patient's quality of life improves.. it improves.

Most of these "new & improved" drugs often demonstrates some better therapy over the original... seldom more than a 5% improvement. But those studies are typically in a fairly small group.. and the typical clinical study group tends to be someone "sterile" of other disease states than the one that the drug is suppose to treat.

Once the drug gets out in the "real world" the improvement may be better/worse that the original and what the study would suggest.

Until we are all clones of each others and not individuals.. we will not have nor need medications that treat all of us equally.

[Gil Denis]

Mark

I have been taking naproxin and now having some stomach issues after i eat get gasey , burp sour stuff, and sometimes vomit This last for hours.

I agree on Bextra this work very well for me.

Take Care

Glad to hear you are feeling better,

Gil