E-drug: ADRs and cox 2 inhibitors (continued)
---------------------------------------------
Celecoxib (CELEBREX) is a sulfonamide derivative. Sulfonamides are
well known to cause (allergic) thrombocytopenia and may present as
SCHONLEIN HENOCH syndrome in children. Therefore, this should be
considered in the case reported by Jody Dalmacion from the
Philippines, especially if there were preceding expositions to
sulfonamides.
Furthermore, all NSAIDs occasionally cause damage of the bone marrow
including thrombocytopenia. However, the apparent acute onset argues
against a toxic and for a immune allergic event.
Gastro-intestinal bleedings are not rare events with
cox-2-inhibitors, since there is only a reduction of serious GI
events (bleeding, perforation, ulcers) from 1.8 to 1.3 events per 100
treatment years. You have to treat 200 patients for 1 year to prevent
1 ulcer, at about 200.000 US$ treatment costs.
Healing such an event in the hospital only cost 2,000 US$. That is the
price of innovations: 198.000 US$ more per ulcer treatment.
Regards,
Peter
Prof.Dr. Peter S. Sch�nh�fer
Institute of Clinical Pharmacology
Central Hospital St.J�rgen Str.
D-28209 Bremen, Germany
Klin.Pharm@ZKHSTJUERGEN.BREMEN.DE
scientific adviser of
BUKO Pharma-Kampagne
August-Bebel-Str. 62
33602 Bielefeld
Germany
bukopharma@compuserve.com
BUKO is a NGO in Germany doing public awareness raising work on drugs
in developing countries and is lobbying for rational drug policies
worldwide.
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