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Antirheumatic |
Arthritis is inflammation
of one or more joints, characterized by swelling, warmth, redness of the
overlying skin, pain and restriction of motion. It can be caused by any
disease involving the synovial membranes or causing degeneration of cartilage.
Aspirin and analgesics are usually prescribed to suppress inflammation.
Rheumatoid arthritis is a form of arthritis which typically involves the
joints of the fingers, wrists, feet and ankles. The joints are affected
symmetrically and there is a considerable range of severity. In late stages
deformity and ankylosis develop. |
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CELEBREX
Substance: Celecoxib
Manufacturer : Pfizer
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Dosage |
Packing |
Price |
Pay now |
200 mg |
20 tab |
USD 59.00 |
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200 mg |
60 tab |
USD 169.00 |
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CELEBREX - GENERIC
Substance: Celecoxib
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Dosage |
Packing |
Price |
Pay now |
100 mg |
100 caps |
USD 65.00 |
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100 mg |
200 caps |
USD 125.00 |
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200 mg |
100 caps |
USD 99.00 |
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200 mg |
200 caps |
USD 212.00 |
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METOPROLOL
Generic name: metoprololium tartaricum
Brand name: Betaloc
Manufacturer: Astra (Sweden license)
Metoprolol is used for chest pain (angina),
high blood pressure and irregular heartbeats.
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Dosage |
Packing |
Price |
Pay now |
50 mg |
100 tab |
USD 19.00 |
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100 mg |
60 tab |
USD 24.00 |
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ARAVA
Substance: Leflunomide
Manufacturer: Sanofi-Aventis
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Dosage |
Packing |
Price |
Pay now |
10 mg |
30 tab |
USD 219.00 |
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100 mg |
3 tab |
USD 106.00 |
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20 mg |
30 tab |
USD 229.00 |
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Dosage |
Packing |
Price |
Pay now |
10 mg |
100 tab |
USD 147.00 |
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20 mg |
100 tab |
USD 199.00 |
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MOBIC - MOVALIS
Substance: Meloxicam
Manufacturer: Boehringer Ingelheim
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Dosage |
Packing |
Price |
Pay now |
15 mg |
20 tab |
USD 29.00 |
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Dosage |
Packing |
Price |
Pay now |
7.5 mg |
100 tab |
USD 69.00 |
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15 mg |
100 tab |
USD 79.00 |
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Dosage |
Packing |
Price |
Pay now |
10 mg |
100 tab |
USD 0.00 |
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20 mg |
100 tab |
USD 0.00 |
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Research articles
on Antirheumatic Agents |
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South Med J. 2005
Feb;98(2):205-9.
Treatment of osteoarthritis.
Barnes EV, Edwards NL.
Division of Rheumatology, Department of Medicine, University of Florida,
Gainesville 32610, USA. barneev@medicine.ufl.edu
OBJECTIVES: Although cyclooxygenase-2 inhibitors (coxibs) were developed
to cause less gastrointestinal hemorrhage than nonselective nonsterodial
antiinflammatory drugs (NSAIDs), there has been concern about their cardiovascular
safety. The relative risk of acute myocardial infarction (AMI) was studied
among users of celecoxib, rofecoxib, and NSAIDs in Medicare beneficiaries
with a comprehensive drug benefit. METHODS: A matched case-control study
was conducted of 54,475 patients 65 years of age or older who received
their medications through two state-sponsored pharmaceutical benefits
programs in the United States. All healthcare use encounters were examined
to identify hospitalizations for AMI. Each of the 10,895 cases of AMI
were matched to four controls on the basis of age, gender, and the month
of index date. A matched logistic regression model was constructed, including
indicators for patient demographics, healthcare use, medication use, and
cardiovascular risk factors to assess the relative risk of AMI in patients
who used rofecoxib compared with persons taking no NSAID, taking celecoxib,
or taking NSAIDs. RESULTS: Current use of rofecoxib was associated with
an elevated relative risk of AMI compared with celecoxib (OR 1.14; 95%
CI, 1.05-1.46; P = 0.011), and with no NSAID (OR, 1.14; 95% CI, 1.00-1.31;
P = 0.054). The adjusted relative risk of AMI was also elevated in dose-specific
comparasions; rofecoxib < or = 25 mg versus celecoxib < or = 200
mg (OR 1.21; 95% CI, 1.01-1.44; P = 0.036) and rofecoxib > 25 mg versus
celecoxib > 200 mg (OR 1.70; 95% CI, 1.07-2.71; P = 0.026). The adjusted
relative risks of AMI associated with rofecoxib use of 1 to 30 days (OR,
1.40; 95% CI, 1.12-1.75; P = 0.005) and 31 to 90 days (OR, 1.38; 95% CI,
1.11-1.72; P = 0.003) were higher than > 90 days (OR, 0.96; 95% CI,
0.72-1.25; P = 0.8) compared with celecoxib use of similar duration. Celecoxib
was not associated with an increased relative risk of AMI in these comparisions.
CONCLUSIONS: In this study, current rofecoxib use was associated with
an elevated relative risk of AMI compared with celecoxib use and no NSAID
use. Dosages of rofecoxib greater than 25 mg were associated with a higher
risk than dosages of 25 mg or less. The risk was elevated in the first
90 days of use, but not thereafter. |
Clin Chim Acta. 2003
Dec;338(1-2):123-9.
Antioxidant status in rheumatoid arthritis and role of antioxidant therapy.
Jaswal S, Mehta HC, Sood AK, Kaur J.
Department of Biochemistry, GMCH, H No. 2506-A, Sector 47-C, 160047, Chandigarh,
India
BACKGROUND: Oxygen free radicals have been implicated as mediators of
tissue damage in patients of rheumatoid arthritis (RA). This study was
designed to elucidate plasma oxidant/antioxidant status in rheumatoid
arthritis, with the aim of evaluating the importance of antioxidant therapy
in the management of this disease. METHODS: The study included 40 patients
of rheumatoid arthritis who were randomly divided into two subgroups of
20 each. One group received conventional treatment for 12 weeks and in
the other group conventional treatment was supplemented with antioxidants
for the same duration. Twenty age- and sex-matched normal individuals
constituted the control group. Blood samples of controls and patients
were collected at the time of presentation and analyzed for total thiols,
glutathione, vitamin C and malondialdehyde (MDA-marker of oxidative stress).
The investigations were repeated in the patients after 12 weeks. RESULTS:
The blood concentrations of total thiols, glutathione and vitamin C were
found to be significantly lower in rheumatoid arthritis patients as compared
to healthy controls, while the concentrations of MDA were much higher.
There was a statistically significant increase in the posttreatment concentrations
of these antioxidants, along with a decrease in the concentrations of
MDA. CONCLUSIONS: The antioxidant defense system is compromised in rheumatoid
arthritis patients. There is a shift in the oxidant/antioxidant balance
in favor of lipid peroxidation, which could lead to the tissue damage
observed in the disease. The results suggest the necessity for therapeutic
co-administration of antioxidants along with conventional drugs to such
patients. However, due to the limited number of cases included in this
study, more studies may be required to substantiate the results and arrive
at a definite conclusion, in terms of safety and efficacy of adding on
antioxidant therapy for the treatment of RA. |
Nippon Rinsho.
2002 Dec;60(12):2351-6.
Combination therapy of disease-modifying antirheumatic drugs(DMARDs) in
rheumatoid arthritis
Kobayashi S, Kanai Y.
Department of Rheumatology, Juntendo University, School of Medicine.
The early suppression of disease activity during the first 2 years in
rheumatoid arthritis (RA) has been reported to be exclusively important
to prevent joint destruction and functional decline. Since single disease-modifying
antirheumatic drugs(DMARDs) therapy is still disappointing, many rheumatologists
today advocated a more aggressive approach using combinations of classic
DMARDs. Many clinical trials on combination therapy have been reported
and most studies of combination therapy focused on the efficacy of a treatment
strategy. Therefore, the possible synergistic action of combination of
drugs has not been demonstrated. Among combination of therapy of classical
DMARDs, only few trials demonstrated the efficacy of combination therapy.
The incidence of adverse effects among 341 RA patients was investigated
by our department. The incidence of adverse effect in combination therapy
revealed 36.4% which was not statistically different from that in monotherapy(33.6%,
p = 0.41). The recent studies on combination therapy on classical DMARDs
are not encouraging, however, the combination therapy for patients with
early RA, drugs utilizing immunosuppressant, biologics and other newly
developed drugs will still have a chance to expect a potent efficacy for
RA.
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J Rheumatol Suppl.
2002 Nov;66:38-43.
Longterm maintenance therapy with disease modifying antirheumatic drugs.
Capell H.
Centre for Rheumatic Disease, Royal Infirmary, Glasgow, Scotland.
Longterm safety and efficacy of disease modifying antirheumatic drugs
(DMARD) have been challenging to assess. There are few studies that have
evaluated patient outcome beyond 5 years. As patients may receive several
DMARD over the course of their disease a long with nonsteroidal antiinflammatory
drugs, corticosteroids, and other drugs for comorbidities, it is difficult
to design and implement a trial to define a specific drug's longterm effect.
Based on the findings of several key studies, however, it does appear
that DMARD are safe when taken longterm, and that they are more likely
to be discontinued because of inefficacy than toxicity. Although DMARD
are often discontinued because of lack of efficacy, 12 year data suggest
that DMARD can provide benefit over this period. The toxicity profiles
vary significantly between DMARD. In addition, the time during therapy
when the majority of these adverse effects most frequently appear is DMARD-specific.
Prospective studies are needed to further clarify longterm safety and
efficacy of the newer DMARD.
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