Hello djsdcp,
What an interesting question! I?m afraid there is no conclusive
evidence of a time frame for the potential risks of using Celebrex.
Celebrex warnings surfaced after Vioxx was found to increase heart
attacks. Celebrex and Vioxx are in the same class of Cox-2 inhibitors,
making Celebrex a suspect drug as well! Conclusive studies on Celebrex
are ongoing, and not complete. One study of Celebrex being used as a
colon polyp inhibitor, found no increase in heart attacks.
?Pfizer said the Celebrex trial, sponsored by the National Cancer
Institute, involved patients taking 400-milligram and 800-milligram
daily doses of the drug to prevent tumors known as adenomas that grow
from glandular tissue. High doses of the anti-inflammatory drug were
being tested on the theory that inflammation is a cause of cancer.
Vioxx and Celebrex both work by selectively blocking a protein called
COX-2 that has been linked to inflammation. They were both launched in
1999 and quickly became top-selling drugs, helped by massive
television and print advertising.
Pfizer also said on Friday that Celebrex was not shown to increase
heart risk in a second long-term trial designed to see if the drug
could prevent colon polyps. Negative findings in a similar trial led
to the withdrawal of Vioxx.
New York-based Pfizer said National Cancer Institute officials decided
to halt the Celebrex trial on adenomas after confirming "an
approximately 2.5-fold increase" in the risk of fatal or non-fatal
heart attack in patients taking the drug, compared with patients
taking a placebo.?
http://www.drugs.com/forum/topic.asp?TOPIC_ID=6402
One recent Swiss study, cited below, suggests that heart attack may
be more likely in patients who abruptly stopped taking Celebrex and
Vioxx. They suggest tapering off of any NSAIDS. Most sources are
saying using Celebrex occasionally, as opposed to regular use, is
safe. It is also suggested that patients find alternatives to Cox-s
inhibitors until further studies are completed. Some doctors feel
taking Celebrex is worth the risk for some patients.
The FDA says the danger is greatest for patients taking Celebrex ?long
term?, after heart surgery, and in high risk patients. The definition
of long-term is relative, and could mean 6 months to years.
Merriam-Webster says that long term can be greater than 10 years
(!), greater than 6 months, or a relatively long period of time.
http://m-w.com/cgi-bin/dictionary?book=Dictionary&va=long+term&x=0&y=0
Dec. 25, 2004 ?The Food and Drug Administration (FDA) today issued
a Public Health Advisory summarizing the agency's recent
recommendations concerning the use of non-steroidal anti-inflammatory
drug products (NSAIDs), including those known as COX-2 selective
agents. The public health advisory is an interim measure, pending
further review of data that continue to be collected.?
?DA is issuing an advisory because of recently released data from
controlled clinical trials showing that the COX-2 selective agents
(Vioxx, Celebrex, and Bextra) may be associated with an increased risk
of serious cardiovascular events (heart attack and stroke) especially
when they are used for long periods of time or in very high risk
settings (immediately after heart surgery).?
http://www.pharma-lexicon.com/medicalnews.php?newsid=18294&language=spanish
From a Swiss study, on this Harvard site
?Quitting nonsteroidal anti-inflammatory drugs (NSAIDs) such as
aspirin and ibuprofen, especially after long use, increases the risk
of heart attack for the next few weeks, says a study published
December 14 in The Archives of Internal Medicine. Swiss researchers
examined data on 8,688 British patients who had a first heart attack
and 34,000 similar patients who did not have a heart attack. Those who
quit taking NSAIDs were 50 percent more likely to have a heart attack
in the next month than people who had not been using the drugs.?
And this interesting statement:
?If the association between heart attack and stopping an NSAID is
real, you would not want to abruptly stop an NSAID if you have taken
it for a long time. However, there will be circumstances when a person
must do this. Examples are sudden deterioration of kidney function,
extreme elevations in blood pressure, and stomach ulcers, especially
if they are causing internal bleeding.
Although there is no proven strategy or best method for weaning off
NSAIDs, I can think of two possible ways that make sense. One is to
quickly taper the dosage you are taking to a very small dose that
would still have some action on platelets. The other is to stop the
NSAID and use one low dose aspirin (a baby aspirin has one quarter the
amount of active ingredient compared to a full size aspirin tablet or
capsule).?
?This study has raised many additional questions about NSAIDs and
COX-2 specific inhibitors. Could it be that the additional heart
attacks and strokes linked to Vioxx are related to abruptly stopping
an older NSAID that blocked platelet function and switching to Vioxx
-- meaning that the Vioxx is less of an independent bad actor? This
would clearly have important ramifications for the other COX-2
inhibitors still on the market and new ones in the pipeline.
Until we know more, use of COX-2 inhibitors should remain limited to
people who have no other alternative. People at high risk of heart
disease and stroke will need to decide about simultaneously taking a
baby aspirin with the COX-2 inhibitor, with or without another
medication to protect the stomach lining from ulcers.?
http://www.intelihealth.com/IH/ihtIH/WSIHW000/24479/36146/405412.html?d=dmtContent
?Merck recalled Vioxx on Sept. 30 after a study found that long-term
use of the drug doubled the risk of heart attack and stroke. Both
Celebrex and Vioxx belong to a class of drugs known as COX-2
inhibitors, as does Bextra.?
http://www.drugs.com/forum/topic.asp?TOPIC_ID=6402
This is a transcript from a CNN interview, Dec. 18, 2004
?Dr. Griffin, I know a lot of people are wondering this. If you took
Celebrex, Vioxx or Bextra and stopped, are you still at an increased
risk for heart attack or stroke?
GRIFFIN: We don't think so. From what we know about these drugs, the
effects should be just while you're taking the drugs. So people should
not worry about past use.?
?COHEN: Now the dose patients took in the study, the dose that puts
them at an increased risk for heart attacks is the dose recommended by
Pfizer, 400 milligrams a day. Now many will be watching Pfizer to see
if it takes Celebrex off the market or perhaps if the FDA pressures
the company to do so.?
?COHEN: Now sometimes doctors prescribe Celebrex for, let's say a
sports injury or some kind of short-term problem. So that you're not
taking it for very long. Is that a safer use of Celebrex because it's
for a short period of time?
GRIFFIN: Well, obviously if you take it for shorter, you limit your
risk. But it's really no more effective than the older drugs for that
type of injury. And so, at this point, I don't really see that there's
any benefit to using this drug where we're questioning the safety, as
far as cardiovascular risk, as far as heart attacks or strokes.?
http://cnnstudentnews.cnn.com/TRANSCRIPTS/0412/18/hcsg.01.html
This WebMd page, from August, 2001 warns of heart attack from taking
Cox-2 inhibitors such as Vioxx and Celebrex.
?Aug. 21, 2001 -- Heart researchers from the Cleveland Clinic
Foundation say that the popular arthritis drugs Vioxx and Celebrex may
increase the risk for heart attacks and are cautioning doctors to use
the drugs very carefully, especially in people with heart disease.
But the makers of the drugs say that the researchers are
misinterpreting data and are ignoring many favorable studies of the
drugs.
Steven Nissen, MD, says an analysis of existing medical research of
the drugs suggests that the people taking them are twice as likely to
have heart attacks as people who take older anti-inflammatory drugs to
treat arthritis. But Nissen, who is vice chairman of cardiology at the
Cleveland Clinic, adds that even with this increased risk, the number
of heart attacks is still very low.?
http://my.webmd.com/content/article/34/1728_87301
?At this time, if physicians determine that continued use is
appropriate for individual patients, FDA advises the use of the lowest
effective dose of Celebrex."?
http://www.cnn.com/2004/HEALTH/conditions/12/17/celebrex.heart/index.html
Below is an excerpt from a cached page of the Celebrex maker
Pfizer?s site. The original page,
http://www.celebrex.com/errorhandler.asp?404;http://www.celebrex.com/faq.asp
is no longer visible.
?Important safety information: CELEBREX is not for everyone. CELEBREX
should not be taken in late pregnancy or if you've had
aspirin-sensitive asthma or allergic reactions to aspirin or other
arthritis medicines or certain drugs called sulfonamides. In rare
cases, serious stomach problems, such as bleeding, can occur without
warning. The most common side effects in clinical trials were
indigestion, diarrhea, and abdominal pain. Tell your doctor if you
have kidney or liver problems. If you think you are having an allergic
reaction or if you have other severe or unusual symptoms while taking
CELEBREX, call your doctor or other healthcare professional
immediately. For more information, see important prescribing
information.?
http://cc.msnscache.com/cache.aspx?q=632553721867&lang=en-US&FORM=CVRE5
?Moreover, he says that his study suggests the problem is not with a
single molecule found in a single drug like Vioxx, but rather a
problem for the entire class of drugs that Vioxx and Bextra belong to,
called Cox-2 inhibitors. One other Cox-2 inhibitor is available in the
U.S. -- Celebrex. Bextra and Celebrex are made by Pfizer, a WebMD
sponsor.
FitzGerald says he is not recommending that Cox-2 inhibitors be taken
off the market but that he thinks patients with heart disease should
be advised of the risk associated with the drugs.?
http://my.webmd.com/content/article/97/103958.htm
If you have been prescribed Celebrex, and are concerned, see your
doctor. S/he can examine you and supervise you in tapering off of the
medicine, and suggest an alternative. I can tell you anecdotally of a
report I heard on cable news; doctors were suggesting the use of
Tylenol and weight loss as an alternative to Cox-s inhibitors. (I
can?t find a transcript form of this report!)
If any part of my answer is unclear, please request an Answer
Clarification, before rating, and I will be happy to assist you
further.
Regards,
crabcakes
Search terms
Cox-s inhibitors + heart attack
Risk Celebrex
Length treatment Celebrex + risk |
