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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Greg on January 4, 2001, at 9:00:50
Hi all,
I was recently rx'd Vioxx for some persistent imflammation resulting from a knee surgery 10 weeks ago. Since starting it, my sleep patterns have been weird. I get very tired at night, but don't fall completely asleep. I get into that pre-sleep drowsy state and just stay there all night. I also notice that effect when taking Motrin and Advil.
I remember sometime in the last 4-5 months someone here posted about some strange side-effects from Vioxx and thought they might be having an interaction problem with their depression meds. I'm wondering if that's whats happening to me. I'm BiPolar II and taking Neurontin (900mgs), Zyprexa (2.5mgs) and Ambien (10mgs).
Does anyone have any experience or info about Vioxx or possibly remember the post that was left here about it? I've done some Net searches but haven't found any info on effect on sleep patterns. This is leading me to believe that it might be an interaction problem.
Any help would be appreciated. Thanks.
Greg
Posted by Cam W. on January 5, 2001, at 0:45:03
In reply to Know anything about Vioxx?, posted by Greg on January 4, 2001, at 9:00:50
Greg - The skinny on Vioxx™ (rofecoxib).
Insomnia is one of the side effects of Vioxx, but occurs only between 1% and 2% of people. Anxiety and drowsiness are seen in a similar percentage of people. As a note, some people do get mild photosensitivity reactions, but because the sun never shines where you live (that didn't come out right) you really don't have much to worry about. How's your liver? There are reports of some borderline elevations in liver tests (0.5% in those taking Vioxx and 1% in those taking placebo in clinical trials).
Although a minor metabolic pathway of Vioxx is the cytochrome system (CYP-3A4), the potent inhibitor ketoconazole, had no important effects on it's pharmacokinetics, so I very much doubt that there is any interaction with Zyprexa. Rifampin, a non-specific cytochrome P-450 inducer does decrease Vioxx levels by 50%, but this is of no concern to you. Neurontin is not metabolized, so you can rule that out as a pharmacokinetic interaction. Being Canadian, I don't know what the hell Ambien is (chemically), but since other hypnotics are not contrindicated, there probably is no problem between them, as well.
Also, dosage adjustments in the elderly are not needed ;^P
I'll bring the lawyer's document (aka product monograph - long version) when we come to visit and we can go over it with a fine-toothed comb (let's see how keen our sense of chemistry is).
I'll see what I can find on my sites at work on the morrow. Till then, try and get some sleep.
Keep on truckin' - Cam
P.S. Counting the minutes, dude.
Posted by Noa on January 6, 2001, at 10:45:47
In reply to Know anything about Vioxx?, posted by Greg on January 4, 2001, at 9:00:50
Greg, the only thing I know about it is not what you are looking for: it appears that Vioxx is one of those new meds that many insurance companies refuse to cover--it is not on the "formulary", I suspect because it is expensive?
This is the end of the thread.
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