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Anti-inflammatory drug banned

[Posted: Tue 15/05/2007 www.irishhealth.com]

The Irish Medicines Board has suspended products containing an anti-inflammatory substance called nimesulide.

Medicines containing nimesulide are used to treat acute pain including period pains and osteoarthritis.

Tablets and granules marketed under the names Aulin and Mesulid can no longer be sold or marketed.

The IMB says liver damage is a rare but serious adverse effect that has been observed with nimesulide.

Since nimesulide was first licensed in Ireland in 1995, there have been 53 liver-related adverse reaction reports.

The IMB advises patients who have been prescribed Aulin or Mesulid to stop taking the drug immediately and return to a doctor for a review.

The IMB has these helpline numbers: Freephone 1-800-251054, or (01) 634 3555.

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  Tina  Posted: 15/05/2007 13:39
My granny suffeed terribly with osteoarthritis and was on Aulin for years. I imagine if anyone was taing these for period pains, they should see a gynae - pronto
 
  Marie  Posted: 15/05/2007 16:18
I came off Aulin because my blood pressure was exremely high. I am off it a couple of months now and am just beginnig to feel better.
 
  lavender  Posted: 15/05/2007 18:58
What does one do with their current prescription of Aulin? Will the chemist refund for them or replace them with an alternative for free? I dont think so! I need them for arthritis, they are a brilliant pain killer and I am reluctant to just bin them and have to go to the doctor pay €50 and then also pay for new drugs too which may not be as effective anyway. Is the risk that great anyway?
 
  Angela  Posted: 15/05/2007 22:58
What worries me is that I only heard today that this drug/s (Aulin and Mesulid) have been banned in Europe for some time so why has it been continuously used here. It is prescribed by absolutely all medics here including dentists. Again, it goes back to the only way that G.P.'s know about any drug is from the Reps calling on them and this is not good enough but then again, that is the way things are done with our backward health system which is actually run in total by the HSE and the Pharmaceutical companies and both those parties are the ones making all the money too.
 
  Mazza  Posted: 15/05/2007 22:59
I've been on Aulin since August and am quite concerned to know if the drug has caused me any liver damage. One of the side effects that I had was that it stopped me from peeing.
 
  marty  Posted: 15/05/2007 23:36
I have been taken aulin occasionally for arthritis and found it good in the early days. Had liver function test recently and all was ok. Doctors now talking about infliximab. Anyone know anything about this drug?
 
  Mairead  Posted: 16/05/2007 12:39
I was given Aulin, but after reading the side effects I decided i would not take it. I am very happy now with the decision i made.
 
  Anonymous   Posted: 16/05/2007 13:48
Angela, ponstan is very effective for dental pain and an a dentist should have no problem perscbing it for you. In the meantime ibuprofen my help.
 
  Ann  Posted: 16/05/2007 16:08
Lavender, Yes, your prescription will be replaced with an alternative and you should not have to pay anything for this. The drug has been banned/withdrawn so the financial loss will not be down to you.
 
  jessie  Posted: 16/05/2007 23:28
I would like to know who will pay for the blood tests to find out if my liver is ok. Surely not me. I already pay 50 euro for a visit to my GP and then more money at the chemist, surely I shouldn't have to pay for the blood tests and the results as well. This country is a total rip off.
 
  Anonymous   Posted: 17/05/2007 10:31
Jessie if your GP (or you) have reason to suspect liver damage tthey will have no problem taking blood samples at your next appointment.
 
  rick  Posted: 17/05/2007 12:21
Unfortunately the media and a certain RTE phone in programme are going overboard on this.There have been 53 adverse reactions of this drug in 12 years despite some 30000 prescriptions written every month by doctors and dentists so based on figures alone the overall risk is very low.I am not belittling the fact that it is a significant event for the families involved. The advantage of Nimesulide was that it was a very good antiinflammatory yet it caused very few stomach sideeffects so it could be taken long term. All antiinflammatories on the market can cause liver impairment(overall risk is v small) but the older products can be very hard on the stomach. There may well be job losses as all these products were made in Ireland.
 
  John(johnwilliams)  Posted: 17/05/2007 20:59
There are two main points about the withdrawal of nimesulide. Firstly the doctors who prescribed the drug and the pharmacists who dispensed it have questions to answer on the inappropriate use of the drug. The medical literature on nimesulide makes it quite clear that liver damage can result from its use and all patients on this medicine should have their liver function checked regularly. Nor should anyone be on this medicine longterm 'the lowest effective dose for the shortest time' is the manufacturers advice. The doctors, as prescribers nad pharmacists as monitors should have been more proactive in the use of this drug. The second point about the withdrawal of mnimesulide is the Irish Medicine Board's method of announcing it. It rushed to the media BEFORE it informed doctors or pharmacists. It caused unnecessary panic among users of these medicines and had its helpline jammed with callers. Maybe that was the intention.
 
  Jessie  Posted: 17/05/2007 21:21
Anonymous any GP should not have a problem taking a blood test, thats not answering my question, what I want to know is who pays for the blood test and in order for me to get the results, I have to pay as well. So who is responsible
 
  Anon  Posted: 17/05/2007 22:54
John, the next worrying thing is why was this drug being used or prescribed at all in this country considering only Ireland and Italy are the only 2 countries in the world who have not banned it (until now). Why is this do you think?
 
  Homer  Posted: 18/05/2007 00:20
Hello I was taking Aulin for Osteoarthritis for some time now. I wear a good quality copper bracelet & I am using Paracetamol. In relation to my experience over the years not every pain killer will suit. What pain killers help 1 person may not help the next it is a matter of process of elimination. Goodluck
 
  Polly  Posted: 18/05/2007 08:29
Jessie, if a GP refers you to have blood tests done, then there is no fee. You can then ring your GP 10 days after & your results should be back with him.
 
  Anonymous   Posted: 18/05/2007 09:01
Jessie the blood test will be done and processed as part of your normal GP appointment which you woud normally eiter be paying for or have as part of your medical card services.
 
  quail  Posted: 18/05/2007 09:17
I have been on this drug for several years and decided myself to come off it last Christmas for various reasons including, it had become ineffective for the pain, I had blurred vision which is fine not, I experienced tiredness and imbalance, weight loss I guess caused by diahorrea. In general I felt unwell and had poor concentration. This is only an opinion but I dont think it works well in conjunction with other medication either. I fell vindicated in my decission not that the drug has been removed from use and am very happy that other people will not have to go through what I have nbeen through.
 
  john1507  Posted: 18/05/2007 14:32
I have been taking Aulin for 4 years now. No side effects. I have a blood test every 2 months and my liver function is ok. If your liver is affected you will know about it.
 
  narf  Posted: 18/05/2007 16:58
Who indeed will pay the cost? first my husband went to the doctor 55euro, prescription 45euro, now having returned the meds to chemist, it is suggested I return to doctor and get another prescription? hmm! . If I went to a shop and bought something which was later discovered to be faulty and was recalled I very much doubt I would be happy with a shop telling me to go to shop again and buy another item at my cost. It is not our fault so whose is it? indeed why should I pay or you for that matter for costs incurred.
 
  Anonymous  Posted: 19/05/2007 00:12
Narf, Why should you pay? I wouldn't pay, if I were you. I would go back to your G.P. and tell him that he needs to give you an new prescription to replace the one he last gave you for a drug that is now withdrawn. If he mentions money, I would simply ask him why he thinks you should pay because you are only there because the drug has been withdrawn and not because you needed to visit a G.P. After all, the withdrawn drug in its 3 forms Aulin, Mesine and Nimesulide will be returned by the Pharmacists to the manufacturers/distributors without any cost to the Pharmacist so why should it cost the patient?
 
  rusty  Posted: 19/05/2007 15:41
I have haemochromotosis, a sympton of which is arthritis. I was prescribed Aulin which I took when necessary-I found it excellent.As a result of iron overload I am given a liver function test regularly & so far so good.
 
  Jessie  Posted: 19/05/2007 20:22
Anonymous: Firstly the reason I would be going to see my GP in the first place is because of the banning of Aulin and my need for another type of anti-inflammatory, otherwise I would not be going to see my GP. Secondly I don't have a medical card, I have to pay for everything. To Polly: My GP does blood tests in her surgery, I pay €35 for that. When I phone to see if the results are back, I'm told "Yes they are". They won't tell you over the phone if the results are positive or negative, you must go to the surgery and that is another €45. So you see I'm caught every way.
 
  Dr Jon  Posted: 22/05/2007 01:35
As a GP myself I am fascinated by the tone of repeated discussions of how much it costs to visit the family doctor. The whole archaic and primitive method of paying cash on the nail for medical services at the time when one is sick should be abandoned and replaced. Most other developed countries in the world have some kind of insurance scheme. Everybody pays in, even when well, and those who cannot afford to pay are subsidised by the rest. Would this not be more civilised? Bear in mind that Primary Care in Ireland is not well funded, in spite of the apparent cost of a consultation. How much would you pay to see a solicitor, an architect etc? How many GPs are working out of smart, new surgeries? Not many. Look at creating a better system and vote wisely on Thursday.
 
  Anonymous   Posted: 22/05/2007 17:33
the mesulid topical cream was very effective on my arthritic ankle & knee & shouldn't have been lumped in with this ban - did the liver failure occur with anyone who had just used the cream?
 
  Anonymous   Posted: 23/05/2007 08:45
Jessie, surely the reason you are taking Aulin is because you have an underlying medical condition which required it. It is for this condition surely that you woud be visiting your doctor and to get your perscription renewed as, as far as I understand, Aulin perscriptions were issued monthy. As another poster said, if you have liver trouble - you will know and so will your GP from the symptoms you display.
 
  Missie  Posted: 26/05/2007 15:56
Please can anyone help me! I am trying to find out if my drugs payment card will cover me for anti-TNF which I have to take by intranvenous infusion which is done every 6 weeks at a hospital, I have medical insurance with Quinn Health and was told they wouldn't cover me, I don't know how much it costs every time so I am worried that I won't be able to afford the treatment, I have ankylosing Spondylitis, If anyone can give me an idea how much it costs I would be grateful thanks
 
  Homer  Posted: 27/05/2007 23:59
Hello I cannot understand when drug pharmacy manufactures new medicines / tablets. They have to go through clinical trials. What happened with Aulin & medicenes alike.?
 
  John(johnwilliams)  Posted: 31/05/2007 22:36
Homer. My understanding is that the liver problems with these drugs were clearly flagged in the medical literature. I would say that doctors and pharmacists prescribed and dispensed these drugs without carrying out proper checks. Had the recommendations been adhered to there would probably be no problem.
 
  Joe(joet61)  Posted: 01/06/2007 22:29
Homer & Johnwilliams, I'm afraid your faith in "clinical trials" is misplaced. Most drug trials are paid for by the pharmaceutical companies themselves. If you think everything is thoroughly monitored by independent scientists, you're very naive. As the well-known journalist Dr Ben Goldacre (who writes the "Bad Science" column in the Guardian) puts it: “Everybody has some kind of interest in their results; and everyone makes mistakes, perhaps - we’ll say unconsciously - more often in their own favour. So science relies on independent replication; but drug trials are so expensive, and state funding of research so miserly, that pharmaceutical research is rarely independently funded.” (www.badscience.net/?p=397)
 
  JG  Posted: 17/06/2007 10:17
Hi Missie. I also have AS and am starting anti-TNF treatment next week. You do not pay for this treatment yourself. Also if you have AS you are entitled to a medical card because you have a chronic illiness. Your doctor can sort this out for you. Good luck with your treatment
 
  Ann  Posted: 18/06/2007 19:16
JohnWilliams, That is not quite correct. And either is what anonymous said about liver disease. You can have quite a severe liver problem and not feel even ill for quite a while, in the same way as you can have quite chronic kidney disease without knowing anything at all is wrong. The reason that Aulin was banned was because it did cause liver disease and death in a number of people who had no predisposing reason to develop liver disease. This was known world wide and with the exception of Ireland and Italy, all other countries banned its use. The drug trials as mentioned above by another poster is right as far as I'm concerned. The only trials that are conducted are those with vested interests. That is why we are all being pumped with statins. Read up on the use of statins and you will soon see that there is no reason in the world why they should be prescribed as much as they are being. Its back to the old vested interests again and the bankrolling of the pharm co's.
 
  Owen  Posted: 21/06/2007 21:10
I've chronic AS and on two different anti TNFs. take care as your natural immune system will be NIL!! Cost is paid by HSE. My quality of life has improved greatly, although pain still a major issue. Forced to retire at 49 on an 'ill pension'. Was taking aulin, which I found to be fairly effective, now replaced by arcoxia. Most important to have blood tests done at least once a month. Not so sure that I qualify for medical card (means tested?). As these drugs are tough on the tummy, make sure to protect it (e.g.pariet). My GP charges €20 for blood tests - I insist that he tells me, by text, if something shows up - I note comments re charges applied for visits - stand up for yourself -don't forget it is YOU that pays the bill. I think it's a disgrace that people are paying a full consultation fee just to have bloods done. Make sure to get receipts for all medical related bills as you can reclaim through MED1 at year end, when completing tax return. Finally, any day that you can get out of bed is a good day. Chin up.
 
  JG  Posted: 22/06/2007 11:25
I did not think I qualified for a medical card and under the normal means test I certainly don't, however, my GP said that I had a chronic illness and that because of this I would get one. He sent of a form he had filled in and I was given one. Up until then I was paying €55 per GP visit and €35 for my blood test. My cousin and aunt also have AS and they have also been given medical cards, neither would be entitled under means testing. Maybe it depends on your GP and whether they accept medical card patients. It really is terribly unfair that people are being charged a full fee for regular blood tests.
 
  Charlie  Posted: 24/07/2007 00:45
What medication is now being prescribed for patients with a previous peptic ulcer instead of Aulin?
 
  Anonymous  Posted: 24/07/2007 22:34
Charlie, Aulin was an anti inflammatory and not effective treatment for a peptic ulcer. There is a huge variety of drugs on the market for peptic ulcers. I suggest you go and have a chat with your G.P.
 
  Charlie  Posted: 25/07/2007 11:32
Sorry for the misunderstanding in my previous posting. What I should have said was that I was taking Aulin for the treatment of arthritis. It was the only NSAID available which would not upset my tummy as I had previously had (And been treated for) a peptic ulcer. What I want to know is, what anti-inflammatory medication is now being prescribed for patients with arthritis who have had a peptic ulcer in the past?
 
  Anonymous  Posted: 25/07/2007 18:03
Charlie, I cannot tell you a specific drug but there are many on the market. If you discuss this with your G.P. he will guide you and prescribe one that won't upset your tummy.
 
  john(MYJ64821)  Posted: 12/09/2007 10:27
this drug was perscribed to me by my doctor because i recently had a c6 c7 fusion in my neck which became inflamed constantly,when i took these tablets i used to get VERY bad pain in my stomach its good to know that we have researchers in the health system that found out that these tablets caused a lot of problems
 
  patricia  Posted: 13/09/2007 17:52
My husband had an accident two yrs ago he was put on Aulin for a bulging disc and trapped nerve in his lower back. He suffered excruciating stomach pains and diarrhea. When he went back to the doctor he was taken off Aulin and put on Mesulid. He was on it till last week when he went to the doctors for a repeat prescription from the receptionist. On taking it to the chemist he was told it had been taken off the market.
 
  johnny mc  Posted: 14/09/2007 12:09
patricia, hello i know where your husband is coming from. i had an accident in work in 04 and havnt worked since due to disc problems. i actually had a disc fusion in my neck that means i had a titanium plate put into my neck like hanging a hinge on a door and believe me have being through some pain professor ciaran bolger of beaoumont did it for me. he's the best surgeon in europe i still have a lot of bother with it but the point that i'm trying to make to you is to get your husband to go to his gp and get him refered for an mri and ask his doctor about zydol 50mg tablets for the pain that's what i'm on and i find them ok but they should be very good for your husband.....
 
  patricia  Posted: 14/09/2007 16:10
Johnny mc.. my husband had an mri last july,had to wait 8 weeks for results( no available appointment and that's private) told he had bulging disc and trapped nerve. then had to wait to see surgeon another 4 weeks. We were told they won't operate on bulging disc so booked him in for injection in spine, had that, checkup 6 weeks later, no improvement said he needed to have physio tried to book it but there was 6 month waiting list, we waited 4 months by then the injection had worn off.
 
 
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