Celebrex, Advil, Ibuprofen

[Duane Thomas]

I've been considering Celebrex for a knee injury, but when I discussed the matter with an MD friend, he told me that Celebrex, Advil, etc. are all just brand names for plain old Ibuprofen, and I'd be just as well off taking that. Anybody well-versed in this matter who could either refute or verify that?

[Shooter Grrl]

DT,

A quick search at webmd.com shows that Celebrex is an nsaid like Naproxen, but it appears that it MAY be less likely to cause ulcers and other stomach problems than regularly taking ibuprofen.

There are a number of sites you can research - I'll post the rest when I get home, for now, start here

http://my.webmd.com/search/search_results?...bmd_news_filter

[Nik Habicht]

Duane,

F.W.I.W. I once took 2 extra-strength Tylenol and three Advil (together) every six hours for about three years to control dental pain. The only reason I can think of that I didn't get an ulcer is because I consumed 'em with either a cup of milk or a container of yoghurt. My chiropractor still recommends advil for when my neck acts up...

[lynn jones]

duane,

i have a bad knee also. most of the cartilage is gone. i use aleve, it works for me.

i also take Glusomine Chondroitant Sulfate MSM and this helps a lot. here's a link

http://www.consumerlab.com/results/gluco.asp

good luck,

lynn jones

[Run n Gun]

lynn,

I too have VERY bad knees, my problem being the same as yours. I hobbled into the doctor a couple of years ago and after X-rays he told me there was nothing he could do!

After doing some research I discovered Glucosamine and with nothing left to lose, started to use it. It has been like a miracle drug for me! I’m still somewhat limited as to what I can do but the pain is MUCH diminished. I need 2-3 days to recover from a match but at least I CAN compete (well, actually HAVING some talent WOULD help)! I’m also a diabetic so I was advised not to take the Glucosamine/Chondroitin combo.

Thank you for the link, I’ve found it to be most helpful!

Ed

[Shooter Grrl]

I’m also a diabetic so I was advised not to take the Glucosamine/Chondroitin combo.

I was just getting ready to throw out this "disclaimer"!!!!

So does this mean you only take the glucosamine?

Did your Dr. approve it?

[John Dunn]

Duane,

Without getting into a huge pharmacological morass:

All Non-steroidal anti-inflammatory drugs (NSAIDS) work by inhibiting prostaglandin synthesis (Prostaglandins being a group of chemical mediators of inflammation). The NSAIDS target a group of enzymes called cyclooxygenases (or COX). There are "good" and "bad" prostaglandins. The good prostagladins actually help protect the stomach from ulceration and are produced by COX I, while the bad prostaglandins are produced predominantly by COX II.

Celebrex is a selective COX II inhibitor (as are Vioxx and Bextra) and therefore has a lower rate of gastric ulceration. It is also comparitively new and expensive. The efficacy of all the NSAIDS is about the same in large clinical trials with regards to pain relief, but sometimes one will work better for a particular patient than another. Some insurance companies won't cover the COX II inhibitors without documentation of peptic ulcer disease (PUD) or intolerance of less expensive NSAIDS.

Advil and Motrin are brand names for the generic medication Ibuprofen, it inhibits both COX I and COX II. It's available over the counter and has been around a long time, and is relatively cheap.

Generally, in a patient without previous PUD or high risk factors for ulceration I'll start with Ibuprofen or Naprosyn. There is some thought process that goes into these decisions, and like the TV commercials say, "Ask YOUR doctor."

[rhino]

The efficacy of all the NSAIDS is about the same in large clinical trials with regards to pain relief, but sometimes one will work better for a particular patient than another.

In my layman's opinion . . .

If one can separate the antiinflammatory aspect and analgesic aspect of NSAIDs (which I'm not sure one can do), it seems like some are noticeably better analgesics (i.e. pain relievers) than others, especially for a given person. I would expect that is why some are better for relieving "generic pain" such as a typical headache or toothache than others. In fact, for "over the counter" dose levels, I suspect that the antiinflammatory benefits are minimal for aspirin, ibuprofen, naproxen, ketoprofen, etc.

Sometimes it helps to take an NSAID with acetaminophen (aka "Tylenol") or alternate doses (as noted in a previous message, always consult one's physician first!). Some preparations contain both, such as Excedrin which contains both aspirin (the first NSAID!) and acetaminophen, plus caffeine to help relieve most headaches.

But again . . . I'm just a layman who has some personal experience and a pinch of an academic background in medicinal organic chemistry. I love it when people talk about prostaglandins!

[kimel]

I'll add a vote for Glucosamine/Chondritin. I use the commercial stuff called "Move Free" (was Pain Free but the lawyers made them change the name) available at Costco. Yes, I know there are cheaper versions but this one works for me and some of the cheaper ones do not seem to do the job, for me.

Take 2 with breakfast and 2 with dinner with lots of water and life is good. This is the difference between walking/moving in severe pain and walking/moving/running with no pain at all during some seasons (cold wet weather is the worst for me).

A guy at work literally cannot walk without this stuff even after several surgeries and what not but he gets around just fine with no pain when he takes it.

Some people have to take this for weeks to see any improvement, others see it within days. Took me about 5 days to see improvement.

YMMV....

Fair warning...some people experience some intestinal discomfort followed by rapid trips down the hall to the bathroom if they take too much of this stuff at a time. Ramp up slowly.

[Shooter Grrl]

In my layman's opinion . . .

Um Rhino... John Dunn, is a M.D. (Ortho Surgeon if memory serves!) Is it okay if I prefer his advice over yours?

[George D]

Celebrex is a selective COX II inhibitor (as are Vioxx and Bextra) and therefore has a lower rate of gastric ulceration.

Duane,

My wife used to use Celebrex for her back injury but has now switched to Vioxx. She takes half the dose for twice the relief and no side effects.

[Run n Gun]

Shooter Grrl,

Yes, I only take Glucosamine, Spring Valley brand of glucosamine sulfate; 1000mg and I buy it at Wal-Mart.

Did my Doctor approve it? Frankly I don’t remember. I do know that my Doctor wrote A+ (isn’t that cute) on my last blood work-up and that I shot a match last Saturday and placed fifth.

Even if there’s a certain level of “placebo effect”, I can (and do) live just fine with that.

[TBF]

Just my experience, Vioxx is rougher on your stomach than Celebrex.

Both are better than over the counter stuff.

Glucosamine chondroitin MSM works pretty well, but takes a while to kick in ( about 2 months)

Celebrex flat works and is worth trying.

Travis F.

[BigDave]

Naproxen is the active ingredient in Aleve. I was prescribed it in 375mg capsuls for a pulled muscle inside my chest once, and it cost me about $20 as I remember. I could have purchased the same medicine for $6.99 OTC.

[EricW]

I'll add a vote for Glucosamine/Chondritin.  I use the commercial stuff called "Move Free" (was Pain Free but the lawyers made them change the name) available at Costco.  Yes, I know there are cheaper versions but this one works for me and some of the cheaper ones do not seem to do the job, for me.

That's actually some good information, Kimel. Thanks. Ever wonder why there's a difference?

I did a little research in to the Glucosamine/Chondritin issue because my dog was really limping and I thought they might help. Because these fall under herbal supplements, there are zero standards as a dietary supplement for their manufacture. They might have the formulation "strength" printed on the bottle but there is no FDA oversight, so you really don't know what you're buying in the end - which leaves it up to the individual to experiment around to see which mystery meat they li :(ke best. Not a good situation.

It's a shame too, since reputable studies seem to indicate G/C seems to help some people.

For some quality info, check out:

http://www.canoe.ca/HealthAlternativeColum...mns/020124.html

and then do a search on Glucosamine and/or Chondritin at:

http://www.quackwatch.com

Notable excerpts:

"It may take two months [for G/C supplements] . . . to produce any significant improvement. If you see no effect by then, it's probably best to try a different approach."

"Whether glucosamine offers any advantages over better established drugs such as acetaminophen, traditional NSAIDS or selective Cox-2 inhibitors remains to be determined."

FWIW, Quackwatch.com is my first stop whenever I hear about some new "miracle" medical product or procedure that I'm unfamiliar with. I want to go to med school now, just so I can be as smart as the guy who publishes it. It's a tremendous public service.

[eric nielsen]

I had a ganglion cyst blow out in my left wrist. I blamed myself for all the practice mag changes that I did, but then my brother (non-shooter) had a blow-out in HIS left wrist as well.

After having it surgically repaired, I went back to shooting about 3 mos later. Cyst blew out AGAIN & was prescribed (new doctor) a wrist splint & Celebrex. I used it simply for the anti-inflamatory aspect, and for that it works GREAT !!! Back to normal.

Later on the wrist got a hard spot & started hurting like CRAZY for the 1st time ever. Thought it was a calcium deposit (bone spur) but trusty Doctor #2 did x-rays & said its scar tissue from the surgery. More Celebrex, another 100% recovery. If Vioxx is even better, it must be DAMN good. My $.02. DVC

Eric Nielsen

A28026

[lmccrock]

I had shoulder pain bad enough to keep me awake at night. It was left side, and made worse by shooting highpower (and the sling use). Before a match I would dose up with nsaids (tried them all) and ice it down (ice helped some, heat not at all). Decided that it was no fun, and quit shooting highpower. Doctor's orders, tried prescription-level doses of nsaids, then Vioxx. No stomach problems unless I drank a few cups of coffee the same day. Tried the glucosamine/chondroitin stuff. Nothing worked.

New doctor, shoulder/arm specialist. He pointed out the bone spurs which the previous orthopedic surgeon and radiologist missed on the Xrays. I am now recovering from surgery. Pain free, unless I do something stupid, like try to move a heavy box from a high shelf. Over the next few weeks this is supposed to get better; it takes time. Handgun (major pf 45) and shotgun are okay now. I have not tried offhand or sling highpower positions yet, and I will wait a while longer before I do.

Inflammation will be helped by the chemicals/heat/cold, but if there is something jabbing the inside of the joint, they will not help. There is still some arthritis in my shoulders, and I expect the drug treatments will help if they flare up.

Also, it was explained to me that calcium deposits are more like a smear inside the joint, and they gradually grind away at tissue. Bone spurs are little spikes. There are injected treatments to dissolve calcium deposits to some extent (my wife had them) but bone spurs require surgery.

I could be wrong; this was just my experience.

Lee

[kimel]

I had a chance to ask my vet about G/C for dogs as my dog has some joint stiffness now and then and she was all for it. Mentioned that a friend of mine was giving it to her dog and it made a huge difference (10+ yr old black lab with joint problems). Called my friend and asked her about it and she said it was a night/day difference. Took about a week before they noted the difference. They use the powder as the dog got wise to the pills and would spit them out.

Good old quackwatch is a great site. I think they tend to be real conservative and will often shoot down some herbal/non-traditionals because the one or two brands they tried were not effective.

I think you really do get what you pay for.

And like someone said...if it is a placebo effect...so what? I feel better. Somehow I doubt the dog knows and therefore that isn't a placebo effect. In the case of my dog we just switched food brands and the joint problems went away almost overnight.

[EricW]

Good old quackwatch is a great site. I think they tend to be real conservative and will often shoot down some herbal/non-traditionals because the one or two brands they tried were not effective.

I think you really do get what you pay for.

Agreed! I do think this is one are where the herbal people really shot themselves in the foot. I decided *not* to give my dog G/C just because the array of products was so confusing, and there was no objective testing. Without conducting your own research program, you don't know if you're buying an effective medication or something as useless as St. John's wort.

[Ron Ankeny]

Now there is a new kid on the block, Arthrotec. Like John said, talk to your doctor.