HR--Celebrex?

[Proactive]

Hello Hep Researcher-
Question, is it safe for me to take Celebrex for moderate to severe osteoarthritis?
History- 2/2 biopsy a few years ago, completed 72 weeks of tx, 3 month undectable, now 4 months post tx.
I've read the warning indications for celebrex and liver disease (active liver disease) is mentioned as being a possible problematic contradiction in combo W/celebrex.
Any opinions would be appreciated, haven't spoken to my hep doc yet (he ordered the pelvic xrays), or been referred up (over) the ladder to a different specialist. But I do have 100 or so celebrex laying around and they appear to aleaviate my pain much better than the ibuprophen (?) I've been taking..
Thanks for any opinions you (or anyone) care to offer.
pro

[HectorSF]

Here is some info that you might find useful.

From Pfizer's for healthcare professionals(manufacturer of Celebrex) web site...

"Hepatic Effects: Borderline elevations of one or more liver associated enzymes may occur in up to 15% of patients taking NSAIDs, and notable elevations of ALT or AST (approximately 3 or more times the upper limit of normal) have been reported in approximately 1% of patients in clinical trials with NSAIDs. These laboratory abnormalities may progress, may remain unchanged, or may be transient with continuing therapy. Rare cases of severe hepatic reactions, including jaundice and fatal fulminant hepatitis, liver necrosis and hepatic failure (some with fatal outcome) have been reported with NSAIDs, including CELEBREX (see ADVERSE REACTIONS – post-marketing experience). In controlled clinical trials of CELEBREX, the incidence of borderline elevations (greater than or equal to 1.2 times and less than 3 times the upper limit of normal) of liver associated enzymes was 6% for CELEBREX and 5% for placebo, and approximately 0.2% of patients taking CELEBREX and 0.3% of patients taking placebo had notable elevations of ALT and AST.

A patient with symptoms and/or signs suggesting liver dysfunction, or in whom an abnormal liver test has occurred, should be monitored carefully for evidence of the development of a more severe hepatic reaction while on therapy with CELEBREX. If clinical signs and symptoms consistent with liver disease develop, or if systemic manifestations occur (e.g., eosinophilia, rash, etc.), CELEBREX should be discontinued."

From Laura Palmer M.D. Hepatologist

    " It is recommended that people with advanced liver disease avoid using all NSAIDs. If NSAIDs are medically required for the treatment of another medical disorder, a reduced dose should be used for a limited period of time and only by people with stable liver disease. Older women with liver disease seem to be particularly susceptible to the hepatotoxicity of NSAIDs and are advised to avoid NSAIDs altogether.  Since NSAIDs may cause salt and water retention people with fluid retention problems such as ascites or leg swelling may suffer worsening of these conditions.  People with decompensated cirrhosis are at increased risk kidney damage stemming from the use of NSAIDs. Since this may lead to hepatorenal syndrome, people with advanced liver disease are advised to totally avoid all NSAIDs.  Furthermore, people with ascites (fluid accumulation) may not respond to treatment with water pills (diuretics), while on NSAIDs, as they counteract their actions. People with liver disease who have had internal bleeding, - from an ulcer or esophageal varices, for example, may be at risk for recurrent bleeding induced by NSAIDs, and should totally avoid this class of medications. People who are also taking corticosteroids (such as prednisone), or anticoagulants (such as coumadin) may have and increased risk of complications from NSAIDs.  Finally, people with liver disease who smoke cigarettes or drink alcohol should avoid NSAIDs as they are also at increased risk for its complications."

Cheers!
Hector

[briannacorn]

I can't help but notice that you seem to be suffering from arthritis after your hep-c treatment I'm also a post hep-c treatment survivor who sucessfully ?cleared virus but now have developed arthritis symptoms. My rheumatologist has mentioned my hep-c in connection with my arthrits and I'm seeking more info. Co incidentally he took me off aspirin put me on celebrex pending more results from more tests .Have you explored connection of arthritis and hep-c post treatment? Good Luck
briannacorn

[alagirl]

both hepc and the treatment for it can cause RA.  I got RA during treatment.  Research shows almost a quarter of everyone who goes through treatment comes out with a permanent autoimmune disease of which RA is the most common.  Hepc is also famous on its own for causing RA though so Rheumies are really checking for it more and more with their patients.

[Proactive]

Thanks for the comments...I think there is a pretty clear association between hepc and ra arthritis. I have just begun to crack the research books on arthritis, so I admit I am totally naive on the subject. As mentioned, my initial diagnosis (by the radiologist) is osteoarthritis, I've yet to speak to my hep doc who ordered the pelvic xrays, so I'm still pretty much in the dark as to my condition and where I go from here.  To be honest, I don't know how, or if rheumatoid arthritis, plays into this whole thing...Are they not two entirely different conditions?( ra and oa?) Is one a result of the other? I'll stop asking questions until I can educate myself a bit more on the subject. I do not believe the tx drugs caused my arthritis, was aching to a lesser degree prior to tx, and my family history is one of -mother had both knees replaced, father had hip replacement, sister has bad knees. So is hepc the cause, catalyst or just a coincidental occurance---who's to say..
It is my understanding that tx drug related aching/pain is a result of it's effect on the nerve endings, but again, I have to devote some time to study..
thanks again,
Pro

[briannacorn]

I'm no expert but having been doing a lot of reading lately had some very helpful insights provided by some savvy individuals like alagirl, osteo is and please excuse my decidedly unscientific interpertation but the way I understand it is normal wear and tear on the bony joints where as ra ( or the other and I'm not sure of the exact number of arthritis like processes are caused by a beserker like immune system.Some stay just to the joints others can be systemic and cause problems in everything from your eyes, kidneys ,etc.Keep reading .
briannacorn