Addressing Medication Concerns in Ankylosing Spondylitis Treatment

Q: Addressing Medication Concerns in Ankylosing Spondylitis Treatment

Hello, thank you for your questions. <br>Here are my responses：<br>1. <br>I have been taking Silodosin for about six months, but I feel it is not very effective. <br>What should I do? --> Please discuss this with your prescribing physician, as there are other medications availabl

Medication-related issues in ankylosing spondylitis?

Hello Doctor, I am #191834, and I have some additional questions to ask you.
Thank you for your help:
1.
I have been taking Silenor for about six months, but I feel it is not very effective.
What should I do?
2.
My doctor did not prescribe me Celebrex; should I discuss this with my doctor? Are there any other medications similar to Celebrex?
3.
Could you please tell me what side effects Celebrex may have? Does it harm the liver?
4.
So, if I take Celebrex long-term, will it lead to any issues? Does this mean I will have to take this medication for life?
5.
I would like to know if Celebrex and Silenor have similar ingredients to Naproxen and Naposin? I think I might have had allergies to these two medications in the past.
I apologize for bothering you with so many questions, and I appreciate your detailed response!

Niming, 20~29 year old female. Ask Date: 2023/01/26

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your questions.
Here are my responses:
1.
I have been taking Silodosin for about six months, but I feel it is not very effective.
What should I do? --> Please discuss this with your prescribing physician, as there are other medications available.
If necessary, further investigation into other underlying causes may be needed, as some types of pain do not respond well to Silodosin.
2.
My doctor did not prescribe me Tamsulosin; should I talk to my doctor about it? Are there other medications similar to Tamsulosin? --> You can ask your physician about it, as there is a reason Tamsulosin is prescribed.
If you do not meet the criteria or do not need it yet, your doctor may choose not to prescribe it.
There are alternative medications available, but they also have their own side effects, so they should not be prescribed casually.
3.
What side effects can Tamsulosin cause? Is it harmful to the liver? --> Side effects are rare; the most common side effect is a reduction in sperm count, but it does not affect sexual function, and this can improve after discontinuation.
For patients wishing to conceive, we typically recommend starting the medication after childbirth.
Allergic reactions are uncommon, but some may experience skin rashes.
A small percentage may have elevated liver enzymes, but Tamsulosin does not harm the kidneys.
There are other less common side effects, but overall, it is considered a safe medication.
4.
So, taking Tamsulosin long-term will not lead to problems? Will I have to take this medication for life? --> As long as you do not experience side effects initially, the likelihood of developing side effects later is low.
Patients with ankylosing spondylitis may have the opportunity to discontinue the medication after a period of stable treatment.
5.
Do Tamsulosin and Silodosin have similar components to Naproxen or Naposin? I think I was allergic to these two medications in the past.
--> No, Tamsulosin is not an anti-inflammatory or analgesic medication and will not interact with these drugs.

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

Reply Date: 2023/01/26

More Info

When addressing medication concerns in the treatment of Ankylosing Spondylitis (AS), it is essential to consider both the effectiveness and potential side effects of the medications involved. Your questions touch on several important aspects of managing AS, particularly regarding the medications you are currently taking and those that may be beneficial for you.

1. Ineffectiveness of Current Medication (Celecoxib): If you have been taking Celecoxib (often referred to as Celebrex) for about six months and feel that it is not providing adequate relief, it is crucial to discuss this with your healthcare provider. Celecoxib is a non-steroidal anti-inflammatory drug (NSAID) that is commonly used to reduce pain and inflammation in conditions like AS. However, individual responses to medication can vary significantly. If you are not experiencing the desired effects, your doctor may consider adjusting the dosage, switching to a different NSAID, or exploring other treatment options such as biologics.

2. Lack of Prescription for Sulfasalazine: If your doctor has not prescribed Sulfasalazine (often referred to as Salazopyrin), it is worth discussing this with them, especially if you are experiencing ongoing symptoms. Sulfasalazine is another medication used in the treatment of AS, particularly for patients who may not respond well to NSAIDs alone. There are also other medications in the same class, such as Methotrexate, that may be considered depending on your specific symptoms and overall health.

3. Side Effects of Sulfasalazine: Like any medication, Sulfasalazine can have side effects. Common side effects include gastrointestinal issues such as nausea, vomiting, and diarrhea. More serious side effects can include liver function abnormalities and blood dyscrasias (issues with blood cell counts). Regular monitoring of liver function tests and blood counts is typically recommended for patients on Sulfasalazine to mitigate these risks. It is essential to communicate any concerns about liver health with your doctor.

4. Long-term Use of Sulfasalazine: Long-term use of Sulfasalazine is generally considered safe for many patients, but it does require regular monitoring. While some patients may need to take it indefinitely to manage their symptoms effectively, others may find that their condition stabilizes, allowing for a reduction in medication. Your healthcare provider can help determine the best long-term strategy based on your response to treatment and any side effects you may experience.

5. Comparison with Other Medications (Naproxen, Naposin): Celecoxib and Sulfasalazine are different from Naproxen and Naposin (which is a brand name for Naproxen). Naproxen is another NSAID that works similarly to Celecoxib but may have a different side effect profile. If you have a history of allergies to Naproxen or Naposin, it is crucial to inform your doctor, as they may need to consider alternative medications that do not belong to the same class or have similar components.

In conclusion, managing Ankylosing Spondylitis often requires a tailored approach to medication, considering both effectiveness and side effects. Open communication with your healthcare provider is vital to ensure that you are receiving the best possible treatment for your condition. If you have concerns about your current medications or potential alternatives, do not hesitate to bring these up during your next appointment. Your health and comfort are paramount, and your doctor is there to help you navigate these decisions.

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