Question
I have taken vioxx the past couple of years with great results. I am now being given the opportunity to replace Vioxx with Mobic. With the recent announcement of Bectra(sp) also under attack, is it ‘smart’ to proceed down the Cox2-road with Mobic or should I try something else?
Answer
Mobic is technically not a full fledged COX-2 agent. It is not as selective for the COX-2 enzyme as Celebrex, Vioxx and Bextra and thus the FDA did not give it a COX-2 labelling. But your question is a good one nonetheless.
If you have signficant GI problems such as a history of stomach ulcer or GI bleed, or if you are taking anticoagulants (coumadin) you may still need or want to be on a COX-2 agent because they are safer on the stomach. However, if you cardiovascular problems you may wish to avoid the COX-2 agents even the near COX-2 drugs such as Mobic. If you are on these COX-2 drugs, your doctor may want you to take low dose aspirin to protect against heart attacks and strokes. Taking an older NSAID together with a medication to protet your stomach such as Prilosec may also make sense.
You also need to be aware that the cardiovascular risk of Bextra, Celebrex or Mobic has not been proven and is only theoretical at the present time.
The risks of the COX-2 drugs and the alternative older NSAIDs (naproxen, ibuprofen, etc) need to be assessed for the individual patient. You need to discuss your situation with your doctor. It can be a complex decision.
