Because of back pain due to osteoporosis, I take the painkiller Diclofenac 50 in moderation. But I keep having pain, so I prefer to take a little more. Should I start taking Movicox 7.5? I used to have stomach ulcers twice.
Mrs. Dussen-Alfrink
Joris Bartstra, journalist with medical diploma
Painkillers such as diclofenac and movicox are called NSAIDs and all have almost the same mechanism of action. They counteract the production of prostaglandins. These substances play a role in feeling pain, initiating blood clotting and protecting the mucous membrane against the effects of stomach acid. All these substances reduce the pain but increase the risk of stomach ulcers and, in the severe case, stomach bleeding.
Some of these drugs actually stimulate blood clotting a little, so that they increase the risk of a heart attack or stroke. The annoying thing is that drugs specially designed to spare the stomach increase the risk of a heart attack. Vioxx is a notorious example.
Diclofenac has long been popular with general practitioners, but recent research shows that this drug also increases the risk of a heart attack or stroke.
Movicox is from a somewhat earlier generation. This drug has not been shown to increase the risk of a heart attack or stroke, nor is it less likely to reduce the risk of stomach bleeding than when using an ‘old-fashioned’ drug.
A drug that reduces the risk of stomach bleeding and does not increase the risk of a heart attack or stroke is Celebrex or celecoxib. Another option to spare the stomach is to take a gastric acid inhibitor such as omeprazole in addition to the painkiller.
I also wondered what was the cause of the stomach ulcers from the past. Were these caused by the use of such painkillers or were you (and perhaps still are?) infected with the stomach bacterium Helicobacter pylori? In that case, it must be treated.
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