Does Long-Term Use of Medication Reduce Its Effectiveness?

Q: Does Long-Term Use of Medication Reduce Its Effectiveness?

Hello, thank you for your questions. <br>Here are my responses：<br>1) Is it possible that the efficacy of Celebrex decreases with prolonged use, or could there be other reasons? --> To my knowledge, this is unlikely. <br>There are many reasons for increased pain, such as adhesion

Does taking medication for a long time reduce its effectiveness?

Hello Doctor: I am a patient with ankylosing spondylitis and have been diagnosed for over two years.
For the past six months, I have been taking one Celebrex in the morning and one in the evening (a total of two per day), and I have not experienced any pain in my buttocks, and my inflammatory markers are normal (my symptoms are primarily sacroiliac joint pain).
However, recently, despite taking the same dosage of two pills a day, I have started to experience pain again, as if the medication is no longer effective.

1) Is it possible that after prolonged use, the efficacy of Celebrex diminishes, or could there be other reasons for this change?
2) Could it be that my increased fruit intake over the past six months has strengthened my immune system, thereby reducing the effectiveness of the medication?
3) If I am already experiencing mild pain in the sacroiliac joint (even if it is just a slight sensation), is it still appropriate for me to play badminton? (I understand that patients with ankylosing spondylitis should exercise regularly, but if I am already experiencing mild pain, is it still advisable to engage in physical activity?) Thank you.

Yong, 20~29 year old female. Ask Date: 2022/02/04

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your questions.
Here are my responses:
1) Is it possible that the efficacy of Celebrex decreases with prolonged use, or could there be other reasons? --> To my knowledge, this is unlikely.
There are many reasons for increased pain, such as adhesions due to lack of exercise, overexertion, or sudden physical labor leading to muscle fatigue or injury, which could also worsen pain.
Therefore, I recommend that you have your physician reassess your condition.
If there is a worsening of the disease, it may be necessary to add immunomodulatory medications.
2) Could it be that my immune system has strengthened due to my frequent fruit consumption over the past six months, thereby diminishing the original drug efficacy? --> The likelihood of this is also very low.
Food has a mild effect on immune function and is unlikely to significantly impact the action of medications.
3) If I am already experiencing mild pain in the sacroiliac joint (even if it's just a slight sensation), is it still appropriate to play badminton? (I understand that patients with ankylosing spondylitis should exercise more, but if there is already mild pain, is it still suitable to engage in physical activity?) --> I think you can assess this for yourself, as everyone's perception of pain is different.
If the mild pain does not significantly affect your activity, you can still engage in activities you enjoy.
To determine if it is too much, you can observe how your body feels the next day.
If you feel discomfort, you may need to adjust the type, duration, or intensity of your exercise; conversely, if you feel fine the next day, you can continue exercising.

Best regards from the Allergy, Immunology, and Rheumatology Department of Changhua Hospital, Ministry of Health and Welfare.

Reply Date: 2022/02/04

More Info

Long-term use of medications, particularly in the context of chronic conditions such as ankylosing spondylitis (AS), can raise several questions regarding their effectiveness and the potential for tolerance. Let's address your concerns systematically.

1. Does long-term use of medication reduce its effectiveness?
In general, the phenomenon of tolerance can occur with certain medications, where the body becomes accustomed to the drug, leading to a diminished response over time. However, this is not universally applicable to all medications. In the case of medications like celecoxib (the active ingredient in your medication, often referred to as "Celebrex"), which is a non-steroidal anti-inflammatory drug (NSAID), tolerance is less commonly reported. Instead, the effectiveness may fluctuate due to various factors, including disease progression, changes in inflammation levels, or even lifestyle changes. It is essential to consult your healthcare provider to evaluate your current symptoms and medication regimen.

2. Could dietary changes affect medication effectiveness?
Your mention of increased fruit consumption and potential improvements in your immune system is interesting. While a healthy diet can indeed support overall health and may influence inflammation levels, it is unlikely to directly negate the effects of your medication. However, dietary changes can lead to variations in how your body responds to medications. For instance, certain foods can interact with medications, either enhancing or diminishing their effects. It's crucial to maintain open communication with your healthcare provider about any dietary changes you make, as they can help assess how these changes might be impacting your treatment.

3. Is it advisable to engage in sports like badminton if experiencing mild pain?
Exercise is generally encouraged for individuals with ankylosing spondylitis, as it helps maintain mobility and reduce stiffness. However, it is essential to listen to your body. If you are experiencing even mild pain, it may be wise to modify your activity level. Engaging in low-impact exercises, such as swimming or walking, can be beneficial without putting excessive strain on your joints. If you choose to play badminton, consider adjusting the intensity and duration of your play to avoid exacerbating your symptoms. Always consult with your healthcare provider or a physical therapist for personalized advice on exercise, especially when experiencing pain.

In summary, while long-term use of medications can sometimes lead to reduced effectiveness, various factors can influence this, including disease progression and lifestyle changes. It's crucial to maintain regular follow-ups with your healthcare provider to monitor your condition and adjust your treatment plan as necessary. Additionally, while exercise is beneficial for ankylosing spondylitis, it is essential to be mindful of your body’s signals and adjust your activities accordingly.

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