14 August, 2007

In light of the recent decision by the Therapeutic Goods Administration for the urgent recall of the COX-2 selective nonsteroidal anti-inflammatory drug (NSAID) lumiracoxib (Prexige), National Prescribing Service Limited (NPS) has prepared prescribing advice to health professionals.

The TGA is advising people to stop taking lumiracoxib immediately and to discuss alternative treatments with their doctor. It is also recommending that all people taking lumiracoxib are assessed by their doctor for any clinical or biochemical evidence of liver damage. Patients found with liver abnormalities should be referred for specialist hepatologist review.

NPS advice to health professionals is that paracetamol is preferred as a first line analgesic to nonsteroidal anti-inflammatory agents (NSAIDs) – both conventional and COX-2 selective – because it is an effective analgesic and has a lower risk of adverse effects. Health professionals can consider adding an NSAID when paracetamol and non-drug therapies do not provide adequate pain relief.

According to NPS CEO, Dr Lynn Weekes, when considering starting or switching NSAIDs, health professionals need to bear in mind the patient’s risk of all adverse effects, including cardiovascular, gastrointestinal and renal complications. Severe hepatic reactions are rare sideeffects of all NSAIDs, including COX-2 selective NSAIDs.

“People at high risk of cardiovascular, gastrointestinal and renal adverse effects should avoid using an NSAID if possible,” added Dr Weekes. “If an NSAID is used, it should be at the lowest effective dose for the shortest possible duration to minimise the risk of adverse effects.”

Further information for patients and health professionals can be obtained by contacting the TGA Info Line on 1800 004 599 (8.30 am – 8.30 pm seven days a week); Novartis Pharmaceuticals on 1800 671 203; and NPS Therapeutic and Information Service (TAIS) on 1300 138 677.

ENDS