That right there is an NSAID. Now let’s talk about the NSAIDs. Can we talk about the NSAIDs, please chat? I’ve been dying to talk about the NSAIDs with you all day.
“COX-2 inhibitors,” this name keeps coming up over and over again. Every day these prescriptions are getting sent back to me. Rofecoxib! Valdecoxib! I look in the mail, and this whole box is Celecoxib! So I say to myself, “I gotta find the FDA commissioner! I gotta go up to his office and put the peer-reviewed studies in the guy’s goddamn hands! Otherwise, he’s never going to get it and patients are going to keep coming back down here.”
So I go up to the FDA office and what do I find out, chat? What do I find out?! There is no FDA approval for coxibs. The drugs do not exist, okay? So I decide, “Oh shit, buddy, I gotta dig a little deeper.” There’s no COX-2 inhibitors? You gotta be kidding me! I got boxes full of patient documents with stomach ulcers! All right. So I start marchin’ my way down to the NLM in the NIH and I knock on her door and I say, “NLM! NLM! I gotta read more about coxibs.” And when I open the door what do I find? There’s not a single goddamn NSAID without cardiovascular risk! There. is. no. safe NSAID in HR. Chat, half the drug approvals in this country have been made up! The FDA is a goddamn ghost town!
It’s insane that the FDA pulled all the coxibs for cardiovascular risk (not universally banned, but celecoxib is the only one still even available with prescription, and pretty much only for osteoarthritis) and then just left the rest of the earlier NSAIDs on the market despite them having the same cardiovascular risk!
Straight up, 200-400 mg of celecoxib is associated with a lower risk of cardiovascular events than the equivalent dosage of ibuprofen or aspirin and avoids the stomach issues associated with traditional NSAIDs. The risk is dosage related.
FDA doesn’t give a shit, they just wanna ban mifepristone and get rid of vaccines.
That sounds a lot like how they invented ephedrine asthma inhalers and sold them over the counter, which you can give yourself a heart attack with. People died, so they decided future inhalers would have to have a prescription. Newer inhalers are safer and require a prescription, but then they left the old inhalers on the market and you can still buy them over the counter at CVS and Walgreens.
Oh, they’re trying to get rofecoxib back on the market in the US as an orphan drug for hemophilic arthropathy, despite celecoxib already existing and Vioxx having been pulled from the market after Bayer got caught hiding the obscene CV risk profile from the public. Once it’s available for people with joint damage from hemophilia there’s nothing (except a REMS program robust enough to keep it from coming back to market which, lol lmao) to stop it from being prescribed to anyone for anything.
All of the NSAIDs have some combination of GI, CV, and nephrotoxicity risks. Celecoxib is the least worst of them, but it still exists in the shadow of Vioxx. The conventional NSAIDs (except for naproxen and aspirin) are all associated with varying degrees of GI or CV risk and nephrotoxicity. It’s a class effect, some are worse than others, celecoxib and naproxen seem to have the best risk/benefit ratio for people who can take NSAIDs.
That right there is an NSAID. Now let’s talk about the NSAIDs. Can we talk about the NSAIDs, please chat? I’ve been dying to talk about the NSAIDs with you all day.
“COX-2 inhibitors,” this name keeps coming up over and over again. Every day these prescriptions are getting sent back to me. Rofecoxib! Valdecoxib! I look in the mail, and this whole box is Celecoxib! So I say to myself, “I gotta find the FDA commissioner! I gotta go up to his office and put the peer-reviewed studies in the guy’s goddamn hands! Otherwise, he’s never going to get it and patients are going to keep coming back down here.”
So I go up to the FDA office and what do I find out, chat? What do I find out?! There is no FDA approval for coxibs. The drugs do not exist, okay? So I decide, “Oh shit, buddy, I gotta dig a little deeper.” There’s no COX-2 inhibitors? You gotta be kidding me! I got boxes full of patient documents with stomach ulcers! All right. So I start marchin’ my way down to the NLM in the NIH and I knock on her door and I say, “NLM! NLM! I gotta read more about coxibs.” And when I open the door what do I find? There’s not a single goddamn NSAID without cardiovascular risk! There. is. no. safe NSAID in HR. Chat, half the drug approvals in this country have been made up! The FDA is a goddamn ghost town!
But like, seriously though.
It’s insane that the FDA pulled all the coxibs for cardiovascular risk (not universally banned, but celecoxib is the only one still even available with prescription, and pretty much only for osteoarthritis) and then just left the rest of the earlier NSAIDs on the market despite them having the same cardiovascular risk!
Straight up, 200-400 mg of celecoxib is associated with a lower risk of cardiovascular events than the equivalent dosage of ibuprofen or aspirin and avoids the stomach issues associated with traditional NSAIDs. The risk is dosage related.
FDA doesn’t give a shit, they just wanna ban mifepristone and get rid of vaccines.
That sounds a lot like how they invented ephedrine asthma inhalers and sold them over the counter, which you can give yourself a heart attack with. People died, so they decided future inhalers would have to have a prescription. Newer inhalers are safer and require a prescription, but then they left the old inhalers on the market and you can still buy them over the counter at CVS and Walgreens.
Oh, they’re trying to get rofecoxib back on the market in the US as an orphan drug for hemophilic arthropathy, despite celecoxib already existing and Vioxx having been pulled from the market after Bayer got caught hiding the obscene CV risk profile from the public. Once it’s available for people with joint damage from hemophilia there’s nothing (except a REMS program robust enough to keep it from coming back to market which, lol lmao) to stop it from being prescribed to anyone for anything.
All of the NSAIDs have some combination of GI, CV, and nephrotoxicity risks. Celecoxib is the least worst of them, but it still exists in the shadow of Vioxx. The conventional NSAIDs (except for naproxen and aspirin) are all associated with varying degrees of GI or CV risk and nephrotoxicity. It’s a class effect, some are worse than others, celecoxib and naproxen seem to have the best risk/benefit ratio for people who can take NSAIDs.
Great info! I’m shocked to hear they’re trying to get rofecoxib back on the market. Fuckin’ Merck.