11-12-2003, 07:16 PM
New at this , very depress. Have joint pain all the time. need to find a new anti-inflammatory med . Can any one help.
11-13-2003, 10:18 AM
Hi Millie :lol:
Welcome to our forum. We all know, too well, the feelings of depression and loneliness. Did you know that depression was a common symptom of LUPUS. Due, in part, to the chemical imbalance in your body and to the effects of the disease. You have every right to discuss treatment for your depression with your doctor. You are not alone, it is certainly not all in your head and your feelings are very, very real!
What type of anti-inflammatory drugs (NSAIDs) are you taking right now? I've included information about types and uses of anti-inflammatory drugs (NSAIDs- non-sterodial anti-inflammatory drugs):
Pain and inflammation are common in people with systemic lupus erythematosus (SLE). Sometimes these symptoms indicate serious organ involvement which may require more powerful anti-inflammatory and immunosuppressive drugs, such as steroids (cortisone, prednisone).
At other times the inflammation is not as severe or does not affect major organs, and a less potent drug is indicated. In these cases, other milder anti-inflammatory and analgesic drugs can be used, especially a group of drugs called the non-steroidal anti-inflammatory drugs (NSAIDs).
While NSAIDs are not approved specifically for SLE by the Food and Drug Administration, they are approved for use in many musculoskeletal pain conditions such as arthritis and tendinitis, which also afflict people with lupus.
Types of NSAIDs
There are many different types of NSAIDs, available either by prescription or over the counter. Newer ones will be marketed over the next few years. Aspirin is anti-inflammatory when given in high doses; otherwise it is a pain killer such as tramedone (Ultram) or acetaminophen (Tylenol).
NSAIDs work primarily by preventing the formation of substances called prostaglandins. But there are two types of prostaglandins, and the body has problems when both types are inhibited.
1. "Maintenance" prostaglandins are made regularly by the body.
* They are produced by an enzyme labeled cox-1.
* They play a role in maintaining normal function in several organ systems. Examples include:
o the protective lining of the stomach
o normal platelet function
o kidney blood flow.
2. "Inflammatory" prostaglandins are produced by the body in response to an inflammatory stimulus.
* They are produced by an enzyme labeled cox-2.
* They play a role in causing inflammation and pain.
Traditional NSAIDs are: ibuprofen (Motrin, Advil), naproxen (Naprosyn, Alleve), and piroxicam (Feldene)( to name a few) and they inhibit both cox-1 and cox-2 prostaglandins. Many of the undesirable side effects of using these non-selective NSAIDs result from inhibiting the cox-1 "maintenance" prostaglandins.
The beneficial effects of the newer NSAIDs result from inhibiting, or limiting, only the cox-2 "inflammatory " prostaglandins. These specific NSAIDs are effective for treatment of musculoskeletal pain and are without many of the side effects associated with the traditional agents.
As a general rule, NSAIDs are most useful in treating
* joint pain,
* muscle pain, and
* joint swelling experienced by individuals with lupus.
There are two major drawbacks to NSAID therapy in people with lupus:
1. They do not help serious organ inflammation as is seen with kidney or brain involvement.
2. They may be associated with troublesome, irritating, or even serious side effects.
* Severe headache with neck stiffness is a rare side effect seen almost exclusively in people with lupus.
* Skin rashes
o Hives and other skin rashes, although uncommon, occur with these medications and may require the discontinuation of the NSAID.
o Photosensitive skin rashes, which could mimic a flare of SLE, also rarely occur with some NSAIDs.
While NSAIDs are widely used with good results and without problems, individuals with lupus and their prescribing doctors need to pay special attention to the potential side effects. Since drug side effects and symptoms of increased lupus activity may be identical, it is important to alert a physician if any of these symptoms occur. For example:
* fluid retention,
* headache, or
may be side effects, but they also may occur when the disease activity increases. Notify your doctor when any side effect occurs so therapy can be adjusted.
The majority of NSAID-related side effects are reversible once the drug is stopped. Some side effects are seen initially or only in the blood. Therefore, with continued NSAID use, regular blood counts-including tests of liver and kidney function-should be monitored every three to four months.
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* NSAIDs are often used to treat the musculoskeletal pain and inflammation which may accompany active lupus.
* If well tolerated, they can be effective as the only treatment for people with mild lupus flares.
* They can also be used in combination with stronger medications to treat greater disease activity.
* These medications are not immunosuppressive, therefore it is inappropriate to use them alone for the treatment of severe lupus.
* NSAIDs may have either irritating or serious side effects.
* People with SLE taking NSAIDs require clinical and laboratory monitoring by their physicians.
Here are some of the NSAIDs used:
diclofenac (Voltaren, Cataflam)
ibuprofen (Motrin, Advil)
ketoprofen (Orudis, Oruvail)
naproxen (Naprosyn, Alleve)
Cox-2 selective NSAIDs
Talk to your doctor about the one that you are using now, its effects (or lack thereof) and try to see which of the above might work for you!
Take care of your self, and know that you are not alone!!