Medication Concerns for Ankylosing Spondylitis: Celebrex vs. Salazopyrine

Q: Medication Concerns for Ankylosing Spondylitis: Celebrex vs. Salazopyrine

Hello, thank you for your inquiry. <br>Here are my responses：<br>1. <br>When I previously consulted with my doctor regarding the use of Salazopyrin (Salar), the doctor believed that my condition was not severe enough to warrant its use, so I was prescribed Celebrex instead. <br>H

Medication-related issues in ankylosing spondylitis?

Hello, doctor.
I am #191897.

1.
During my previous visit, I asked the doctor about the medication Celebrex (celecoxib).
The doctor believed that my condition was not severe enough to require the use of Salazopyrin (sulfasalazine) and recommended continuing with Celebrex instead.
However, I am aware that Salazopyrin has fewer side effects, and I am unsure why the doctor chose to prescribe Celebrex, especially since I have been taking it for almost a year now.
I am concerned about the long-term effects of taking Celebrex.
Given my current condition, do you think I should consider taking Salazopyrin? Is continuing with Celebrex harmful to my health?
2.
A couple of days ago, after warming up, I suddenly felt a slight tingling sensation in the back of my left calf.
My left pinky finger and the little finger on my left hand also felt a bit tingly.
The next day, I experienced some pain in my left calf (unsure if it was a strain or another issue), and I still feel some tingling, although it has improved significantly since two days ago.
3.
Recently, I have been feeling a bit of tightness in the center of my chest.
I have a history of autonomic nervous system dysfunction (with neck tightness).
Therefore, I am uncertain if the chest tightness is related to my autonomic nervous system or my lifestyle.
I have measured my blood pressure several times, and it has been normal.

Considering points 2 and 3, could these symptoms be related to Celebrex? I have read online that this medication may increase the risk of stroke and cardiovascular diseases.
Thank you for taking the time to read my concerns and for your response!

Niming, 20~29 year old female. Ask Date: 2023/05/05

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your inquiry.
Here are my responses:
1.
When I previously consulted with my doctor regarding the use of Salazopyrin (Salar), the doctor believed that my condition was not severe enough to warrant its use, so I was prescribed Celebrex instead.
However, I am aware that Salazopyrin is not without side effects, and I am unsure why my doctor chose to continue with Celebrex instead, especially since I have been taking it for nearly a year and I am concerned about potential harm from long-term use.
Therefore, I would like to ask if my current condition is suitable for Salazopyrin, and whether continuing Celebrex could be harmful.

--> Salazopyrin does have side effects and specific indications for use, which is likely why your physician did not prescribe it.
While Celebrex is generally easier on the stomach, long-term use can still place a burden on kidney function.
However, it is considered a relatively safe medication as long as routine blood tests are conducted, so there is no need for concern.
I recommend discussing the rationale for your treatment with your physician and inquiring about Salazopyrin; they will be able to provide you with more information.
2.
A couple of days ago, after warming up, I suddenly felt a slight tingling sensation in the back of my left calf (very mild).
My left pinky finger and the little finger on my left hand also experienced some tingling.
The next day, I felt some pain in the back of my left calf (unsure if it was a strain or another issue), and I still have a bit of tingling now, although it is much better than it was two days ago.
3.
Recently, I have felt a bit of tightness in the center of my chest, but I have a history of autonomic nervous system dysregulation (with neck tightness).
Therefore, I am uncertain if the chest tightness is related to my autonomic nervous system or my lifestyle.
(I have measured my blood pressure several times, and it has been normal.)
--> I believe these symptoms are unrelated to Celebrex.
Autonomic nervous system dysregulation is a broad term, and it is usually alleviated with aerobic exercise, but it should not be connected to Celebrex.

The Allergy, Immunology, and Rheumatology Department of Changhua Hospital, Ministry of Health and Welfare, is concerned about your well-being.

Reply Date: 2023/05/05

More Info

When considering the treatment options for Ankylosing Spondylitis (AS), it's essential to understand the differences between Celebrex (celecoxib) and Salazopyrine (sulfasalazine), as well as the potential risks associated with long-term use of these medications.

1. Celebrex vs. Salazopyrine: Celebrex is a nonsteroidal anti-inflammatory drug (NSAID) that is often prescribed for pain relief and inflammation reduction in conditions like AS. It is generally well-tolerated and has a lower risk of gastrointestinal side effects compared to traditional NSAIDs. However, long-term use can still pose risks, particularly to kidney function and cardiovascular health. On the other hand, Salazopyrine is a disease-modifying antirheumatic drug (DMARD) that is used to treat inflammatory bowel disease and rheumatoid arthritis, and it can also be effective for AS. It works by suppressing the immune system and reducing inflammation. While it can be beneficial, it does have potential side effects, including gastrointestinal issues, skin reactions, and blood dyscrasias.

Your physician's decision to prescribe Celebrex instead of Salazopyrine likely reflects an assessment of your current condition's severity and the potential benefits versus risks of each medication. If your AS symptoms are manageable with Celebrex, your doctor may prefer to avoid the additional risks associated with Salazopyrine, especially if you are not experiencing significant flare-ups.

2. Concerns about Long-term Use of Celebrex: Taking Celebrex for an extended period can raise concerns about kidney function and cardiovascular risks, including an increased risk of heart attack and stroke. Regular monitoring through blood tests can help assess kidney function and other potential side effects. If you have been on Celebrex for nearly a year, it is advisable to discuss your concerns with your healthcare provider. They can evaluate your overall health, the effectiveness of the medication, and whether transitioning to Salazopyrine or another treatment option is appropriate for you.

3. Symptoms of Numbness and Chest Discomfort: The symptoms you describe, including numbness in your left calf and fingers, as well as chest discomfort, warrant careful consideration. While these symptoms may not be directly related to Celebrex, they could indicate other underlying issues. Numbness can arise from nerve compression, muscle strain, or circulatory problems, while chest discomfort could be related to anxiety, musculoskeletal issues, or even cardiovascular concerns. Given your history of autonomic nervous system dysregulation, it is essential to monitor these symptoms closely. Although your blood pressure readings are normal, any persistent or worsening symptoms should be evaluated by a healthcare professional.

4. Communication with Your Doctor: It is crucial to maintain open communication with your healthcare provider regarding your treatment plan. If you have concerns about the long-term use of Celebrex or the appropriateness of Salazopyrine for your condition, discuss these openly. Your doctor can provide insights based on your medical history, current symptoms, and overall health status. They may also consider adjusting your treatment plan if necessary.

In summary, while Celebrex is a commonly used medication for AS with a favorable safety profile compared to traditional NSAIDs, it is essential to monitor for potential side effects, especially with long-term use. Salazopyrine may be an option if your symptoms warrant it, but it also comes with its own set of risks. Always consult with your healthcare provider to ensure that your treatment plan aligns with your health needs and concerns.

Similar Q&A

Medication vs. Biologics: Which is Better for Ankylosing Spondylitis?

Hello Doctor, my son is 20 years old and has been diagnosed with ankylosing spondylitis for 3.5 years. It took 1.5 years after the onset of symptoms to confirm the diagnosis and begin formal treatment. The overview of his treatment over the past two years is as follows: In the fi...

Dr. Zeng Guosen reply Internal Medicine
The general principle is that traditional oral medications are the first-line treatment. If the condition is stable, the use of biologics is not recommended. It may be worth considering a reduction in medication and monitoring the situation. Biologics are also a type of medicatio...

Managing Ankylosing Spondylitis: Medication and Pain Relief Tips

Hello Doctor, I would like to ask you the following questions: 1. Between Salazine and Celebrex, which one has fewer side effects and is more suitable for long-term use? 2. I am currently taking two capsules of Celebrex a day, and I am only 21 this year. Will I need to take it ...

Dr. Gao Jiankai reply Internal Medicine
Hello, thank you for your question. Here are my responses: 1. Between Salazine and Celebrex, which has fewer side effects and is suitable for long-term use? Salazine needs to be taken long-term and consistently. This medication addresses the root cause of the disease rather than...

How Long Does It Take for Medications to Relieve Ankylosing Spondylitis Pain?

Hello Doctor: 1) For patients with ankylosing spondylitis experiencing sacroiliac joint pain, if they find relief with Celebrex (celecoxib), how long should they take it to achieve complete pain relief? Similarly, if they find relief with Salazopyrin (sulfasalazine), how long s...

Dr. Gao Jiankai reply Internal Medicine
Hello, thank you for your question. Here are my responses: 1) For patients with ankylosing spondylitis experiencing sacroiliac joint pain, if they find relief with Celebrex (celecoxib), it typically takes a few days (usually less than a week) to notice an effect. We usually mon...

Is My New Lower Back Pain a Side Effect of Salazopyrin or AS Symptoms?

Hello Dr. Zeng, I am a patient with ankylosing spondylitis and have been experiencing symptoms for 2 years. In the first year, I mainly took anti-inflammatory and pain relief medications, and my symptoms were limited to pain in the sacroiliac joint. In the second year, I switched...

Dr. Zeng Guosen reply Internal Medicine
Is it true that the side effects of Seroquel need to be differentiated? If back pain is a side effect, it will not cause permanent harm to the body. It is recommended to follow up with the attending physician for evaluation.