With all the talk about COX-2 painkillers in the news, you might be wondering why drugs such as Vioxx, Celebrex, and the newest COX-2 med Arcoxia increase cardiovascular risks while non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen don't.
Well, first it's important to know that COX-2s are NSAIDs, in the same general class of drugs as ibuprofen or naproxen. They're just a newer kind of NSAID. And research has shown that all NSAIDs--not just the COX-2 painkillers--raise heart risks to some degree.
The key to why COX-2 inhibitors such as Celebrex cause more of a heart risk is in the way both kinds of NSAIDs work in your body.
As MedicineNet.com explains in this overview, both older NSAIDs and COX-2s work by blocking enzymes--called COX-1 and COX-2--that are present both in your stomach and in places in your body where there's inflammation that's causing pain. Older NSAIDs block both COX-1 and COX-2, while COX-2 inhibitors block only the COX-2 enzyme, as their name suggests.
But here's a big difference between these two enzymes: COX-1 is in the stomach and in the whole body, and COX-2 is only in other parts of the body--not in the stomach.
COX-1 protects your stomach by making sure there's enough protective mucous in the stomach lining to keep the organ from being damaged. Because older NSAIDs block both COX-1 and COX-2, they stop this COX-1 in the stomach from producing that protective mucous. This can lead to ulcers and other gastrointestinal problems.
That's what's so helpful about COX-2 inhibitors. Because they only block COX-2 (which isn't in the stomach), Celebrex and other COX-2 painkillers only block the enzymes that are causing pain in your body. They don't bother the COX-1 that's protecting your stomach.
Sounds great, right? Well, unfortunately blocking only COX-2 in the body causes other risks.
As Dr. Joseph Mercola says on his Web site, COX-1 has another job besides making the stomach's protective mucous. It also controls how "sticky" your blood platelets are and it makes your blood vessels constrict or become more narrow. COX-2 balances these COX-1 effects. It keeps blood platelets from clumping together and causing clots, and it keeps blood vessels more open so blood can flow more freely.
Take away only COX-2 and you can guess what happens. Your body has too much COX-1, which means your blood could be thick and more prone to clots. And your blood vessels could be too closed, which could trap those clots. And these are major risk factors for cardiac problems such as stroke and heart attack.
Thursday, April 26, 2007
Top News: April 19-26
This week's Top News is for people with arthritis --and it's not good news for arthritis sufferers looking for new ways to manage their pain.
First, researchers say that a new study has shown that arthritis supplements that contain glucosamine and chondroitin don't actually relieve arthritis pain any better than a placebo. But the study's authors say that the supplements don't harm patients either, so patients who are finding relief from the supplement combo can keep using them without fear of adverse effects.
The other piece of Top News for the week is that the outside panel that advises the U.S. Food and Drug Administration (FDA) about new drugs' safety has recommended that the FDA not approve Arcoxia, a new COX-2 inhibitor for treating arthritis pain. The advisory panel says that Arcoxia--a drug in the same class of medicines as Vioxx, Bextra, and Celebrex--has shown the same increased cardiovascular risks as these other COX-2 medicines. Celebrex is currently the only COX-2 inhibitor still on sale in the United States.
First, researchers say that a new study has shown that arthritis supplements that contain glucosamine and chondroitin don't actually relieve arthritis pain any better than a placebo. But the study's authors say that the supplements don't harm patients either, so patients who are finding relief from the supplement combo can keep using them without fear of adverse effects.
The other piece of Top News for the week is that the outside panel that advises the U.S. Food and Drug Administration (FDA) about new drugs' safety has recommended that the FDA not approve Arcoxia, a new COX-2 inhibitor for treating arthritis pain. The advisory panel says that Arcoxia--a drug in the same class of medicines as Vioxx, Bextra, and Celebrex--has shown the same increased cardiovascular risks as these other COX-2 medicines. Celebrex is currently the only COX-2 inhibitor still on sale in the United States.
Monday, April 16, 2007
Zelnorm's been pulled--now what?
If you’ve been taking Zelnorm, you may be wondering what to do now that the drug has been taken off the market in the United States. Drugmaker Novartis recently pulled the medication after the FDA expressed concern that it increased the chances of heart attack and other cardiovascular problems. But even the FDA said that the risks were “quite small.” (Thirteen cases of heart attacks and stroke in 11,600 patients.)
Of course the truth is that no one wants to take a medication that may be dangerous. But Zelnorm was one of the only drugs approved to treat constipation-predominant irritable bowel syndrome (IBS) and it was an effective remedy for many women. So what are your options now that Zelnorm is unavailable?
First, talk to your doctor about other treatments. Some patients have found relief using the med Amitiza. Still others have turned to probiotic treatments and other forms of natural constipation relief. In our newsletters recently we’ve reported on natural remedies for constipation such as gingersnaps, bran, and applesauce.
And, if none of those work you may not be entirely out of luck. The FDA says that it may continue to allow doctors to prescribe Zelnorm if a patient’s disease does not respond to other treatments, or if the benefits outweigh the heart risks.
Of course the truth is that no one wants to take a medication that may be dangerous. But Zelnorm was one of the only drugs approved to treat constipation-predominant irritable bowel syndrome (IBS) and it was an effective remedy for many women. So what are your options now that Zelnorm is unavailable?
First, talk to your doctor about other treatments. Some patients have found relief using the med Amitiza. Still others have turned to probiotic treatments and other forms of natural constipation relief. In our newsletters recently we’ve reported on natural remedies for constipation such as gingersnaps, bran, and applesauce.
And, if none of those work you may not be entirely out of luck. The FDA says that it may continue to allow doctors to prescribe Zelnorm if a patient’s disease does not respond to other treatments, or if the benefits outweigh the heart risks.
Thursday, April 5, 2007
Just the Facts: Cholesterol
With all the talk about good cholesterol, you might be wondering what's so good about it and why researchers are so interested in boosting its numbers in people at risk for heart disease. You might also be wondering what all those numbers of your own cholesterol-level lab reports mean and if you're in the category of people whose levels are putting them at increased cardiovascular risk.
Knowing the differences in the kinds of cholesterol is an important first step. Experts at MSNBC have this to say about the differences in the types of cholesterol:
- Low-density lipoproteins (LDL) are the “bad” cholesterol. LDL is mostly fat with only a small amount of protein. It can clog your arteries. If you have high cholesterol, your doctor will want you to lower your LDL.
- High-density lipoproteins (HDL) are the “good” cholesterol. HDL is more protein than fat. It helps clear the bad cholesterol from your blood so it does not clog your arteries. A high level of HDL can protect you from a heart attack.
- Triglycerides are another type of fat in the blood that can affect your health. If you have high triglycerides and high LDL, your chances of having a heart attack are higher.
And just what should the levels of these kinds of cholesterol be? Well, according to these same MSNBC experts:
- LDL ("bad" cholesterol) should be less than 100. LDL increases your risk of heart problems, so the lower your LDL, the better. A level of 160 or above is high.
- HDL ("good" cholesterol) should be more than 40. HDL over 60 helps protect against a heart attack. HDL below 40 increases your risk of heart problems. The higher your HDL, the better. A high HDL number can help offset a high LDL number.
- Triglycerides should be less than 150. A level above 150 may increase your risk for heart problems.
Source: MSN. Read this whole story here.
Knowing the differences in the kinds of cholesterol is an important first step. Experts at MSNBC have this to say about the differences in the types of cholesterol:
- Low-density lipoproteins (LDL) are the “bad” cholesterol. LDL is mostly fat with only a small amount of protein. It can clog your arteries. If you have high cholesterol, your doctor will want you to lower your LDL.
- High-density lipoproteins (HDL) are the “good” cholesterol. HDL is more protein than fat. It helps clear the bad cholesterol from your blood so it does not clog your arteries. A high level of HDL can protect you from a heart attack.
- Triglycerides are another type of fat in the blood that can affect your health. If you have high triglycerides and high LDL, your chances of having a heart attack are higher.
And just what should the levels of these kinds of cholesterol be? Well, according to these same MSNBC experts:
- LDL ("bad" cholesterol) should be less than 100. LDL increases your risk of heart problems, so the lower your LDL, the better. A level of 160 or above is high.
- HDL ("good" cholesterol) should be more than 40. HDL over 60 helps protect against a heart attack. HDL below 40 increases your risk of heart problems. The higher your HDL, the better. A high HDL number can help offset a high LDL number.
- Triglycerides should be less than 150. A level above 150 may increase your risk for heart problems.
Source: MSN. Read this whole story here.
Failed drug puts good cholesterol in the news
You've probably noticed a lot of news about raising so-called "good" (HDL) cholesterol in the news lately. Some of the reason for this upshoot in news about HDL cholesterol is because of the the failure of an experimental drug called torcetrapib in clinical trials. People in the trials were showing an increased risk of heart problems and even death after taking the drug, so its manufacturer--Pfizer--stopped the trials.
There was even more bad news about torcetrapib this week, when researchers found that in addition to showing these increased cardiovascular risks, torcetrapib also didn't appear to slow the buildup of artery plaque as the drug's makers hoped.
Torcetrapib wasn't the answer, it seems. But researchers won't stop trying to find a drug that will work for you--you can count on that. To keep up with this story, subscribe to High Cholesterol Rx News and/or Heart Disease Rx News at MedTrackAlert. We'll do our best to keep you informed on the latest "good" cholesterol news!
There was even more bad news about torcetrapib this week, when researchers found that in addition to showing these increased cardiovascular risks, torcetrapib also didn't appear to slow the buildup of artery plaque as the drug's makers hoped.
Torcetrapib wasn't the answer, it seems. But researchers won't stop trying to find a drug that will work for you--you can count on that. To keep up with this story, subscribe to High Cholesterol Rx News and/or Heart Disease Rx News at MedTrackAlert. We'll do our best to keep you informed on the latest "good" cholesterol news!
Monday, April 2, 2007
Welcome to the MedTrackAlert blog
Hello and welcome to Take As Directed, a blog designed by a few editors from MedTrackAlert. Those of you who receive newsletters from MedTrackAlert are probably already familiar with the focus of our company—to bring you the latest and most important information regarding your prescription medications. And for those of you who don’t receive our newsletters, what are you waiting for? Head on over to www.medtrackalert.com and sign up to receive important medication and condition-related news directly into your email inbox!
Reading prescription news day after day, week after week has made us newsletter editors feel like unintentional experts on several topics. We’re routinely stopped in the grocery store by friends and made to sit down with our grandmothers to discuss the finer points of their prescriptions with them. And though we would never claim to be doctors or pharmacists, we do often know the latest information about many prescription medications and the conditions they treat.
Most of the information we find as part of our work never makes it into your newsletters. After all, nobody needs a six-hundred word email! But of course news is never static. Studies, clinical trials, and other research goes on every day, and often what is “news” today is contradicted two weeks from now with even newer "news." Which is why we hope this blog becomes a place where you can see the larger picture. We’ll do our best to summarize the most important aspects of ongoing research and give you a chance to take charge of your health armed with the most up-to-date information possible.
Be sure to bookmark this blog and to come back for weekly roundups of news on conditions like heart disease, cancer, asthma, ADHD, diabetes, mental health, migraines, Alzheimer’s and many more.
-The MTA editorial team
Reading prescription news day after day, week after week has made us newsletter editors feel like unintentional experts on several topics. We’re routinely stopped in the grocery store by friends and made to sit down with our grandmothers to discuss the finer points of their prescriptions with them. And though we would never claim to be doctors or pharmacists, we do often know the latest information about many prescription medications and the conditions they treat.
Most of the information we find as part of our work never makes it into your newsletters. After all, nobody needs a six-hundred word email! But of course news is never static. Studies, clinical trials, and other research goes on every day, and often what is “news” today is contradicted two weeks from now with even newer "news." Which is why we hope this blog becomes a place where you can see the larger picture. We’ll do our best to summarize the most important aspects of ongoing research and give you a chance to take charge of your health armed with the most up-to-date information possible.
Be sure to bookmark this blog and to come back for weekly roundups of news on conditions like heart disease, cancer, asthma, ADHD, diabetes, mental health, migraines, Alzheimer’s and many more.
-The MTA editorial team