Generic Vioxx - Emcoxib

What Generic Vioxx is used for

Generic Vioxx is used for the following:

• to treat the signs and symptoms of osteoarthritis, including pain, stiffness, and tenderness of the joints
• to treat the signs and symptoms of rheumatoid arthritis
• to treat cramp-like pain or discomfort before or during a menstrual period
• to relieve other types of pain.
• To treat migraine attacks.

Osteoarthritis

Osteoarthritis is a joint disease. It results from the gradual breakdown of the cartilage that covers the joints and cushions the ends of bones.

Symptoms of osteoarthritis include pain, tenderness, stiffness of one or more joints, and physical disability. The hips and knees are the most commonly affected joints, but other joints such as those of the hands and spine may also be affected.

Osteoarthritis is more common in women than in men. Many factors can lead to the development of osteoarthritis including obesity and joint injury (eg. from sport).

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic disease that causes pain, stiffness, swelling and loss of function in the joints and inflammation in other body organs.

Migraine

Migraine is an intense, throbbing, typically one-sided headache that often includes nausea, vomiting, sensitivity to light and sensitivity to sound. Some people may have visual symptoms before the headache, such as flashing lights or wavy lines, called an aura.

How Generic Vioxx works

Generic Vioxx belongs to a group of medicines called cyclooxygenase-2 (COX-2) specific inhibitors (also known as Coxibs).

The body produces two similar enzymes called COX-1 and COX-2. COX-1 amongst other functions, is involved with protecting the stomach, while COX-2 plays a role in joint inflammation and arthritis pain.

Generic Vioxx reduces pain and inflammation by blocking COX-2, an enzyme in the body.

Generic Vioxx does not block COX-1, the enzyme involved in protecting the stomach from ulcers.

Other anti-inflammatory medicines (NSAIDS) block both COX-1 and COX-2.

Generic Vioxx relieves pain and inflammation with less risk of stomach ulcers compared to NSAIDS.

Your doctor may have prescribed Generic Vioxx for another reason. Ask your doctor if you have any questions about why Generic Vioxx has been prescribed for you.

Generic Vioxx is not addictive.

Before you take Generic Vioxx

When you must not take it

Do not take Generic Vioxx if:

• you have an allergy to Generic Vioxx or any of the ingredients listed at the end of this leaflet
• the packaging is torn or shows signs of tampering
• the expiry date on the pack has passed.
  If you take this medicine after the expiry date has passed, it may not work.

If you are not sure whether you should start taking Generic Vioxx, talk to your doctor.

Do not give Generic Vioxx to a child.
The safety and effectiveness of Generic Vioxx in children have not been established.

Before you start to take it

Tell your doctor if:

• you are pregnant or intend to become pregnant
  Generic Vioxx is not recommended for use during late pregnancy. If there is a need to consider using Generic Vioxx during your pregnancy, your doctor will discuss with you the benefits and risks of using it.
• you are breast-feeding or plan to breast-feed
  It is not known if Generic Vioxx passes into breast milk. You and your doctor should discuss whether you should stop breast-feeding or not take Generic Vioxx.
• you have or have had any medical conditions, especially the following:
  history of angina, heart attack or a blocked artery in your heart
  kidney disease
  liver disease
  heart failure
  high blood pressure
• you have had an allergic reaction to aspirin or other anti-inflammatory medicines (commonly known as NSAIDs)
  Symptoms of an allergic reaction may include asthma, pinkish itchy swellings on the skin (hives), runny or blocked nose.
• you have an infection
  If you take Generic Vioxx while you have an infection, it may hide fever and may make you think, mistakenly, that you are better or that your infection is less serious than it might be.
• you have any allergies to any other medicines or any other substances, such as foods, preservatives or dyes.

If you have not told your doctor about any of the above, tell them before you take any Generic Vioxx.

Taking other medicines

Tell your doctor if you are taking any other medicines, including medicines that you buy without a prescription from your pharmacy, supermarket or health food shop.

Some medicines and Generic Vioxx may interfere with each other. These include:

• warfarin, a medicine used to prevent blood clots
• theophylline, a medicine used to treat asthma
• rifampicin, an antibiotic used to treat tuberculosis and other infections
• ACE inhibitor medicines used to lower high blood pressure or treat heart failure
• lithium, a medicine used to treat a certain type of depression

These medicines may be affected by Generic Vioxx or may affect how well it works. You may need different amounts of your medicine, or you may need to take different medicines.

Your doctor or pharmacist has more information on medicines to be careful with or avoid while taking Generic Vioxx.

Generic Vioxx can be taken with low dose aspirin (less than or equal to 325mg daily). If you take both aspirin and Generic Vioxx, you may have a greater chance of serious stomach problems than if you take Generic Vioxx alone. If you are currently taking low dose aspirin for the prevention of a heart attack or stroke, you should continue to do so unless specified by your Doctor. Generic Vioxx cannot replace aspirin for this purpose.

How to take Generic Vioxx

How much to take

Take Generic Vioxx only when prescribed by your doctor.

For osteoarthritis, the usual starting dose is 12.5 mg taken once a day. The dose may need to be increased, depending on your response, to a maximum of 25 mg once a day.

For rheumatoid arthritis, the recommended dose is 25 mg once a day. The maximum recommended daily dose is 25 mg.

For the relief of menstrual pain or other types of pain, the recommended dose is 50 mg taken once a day on the first day. On the second day and after that, the dose is 25 or 50 mg once a day, as prescribed by your doctor. The maximum recommended daily dose is 50 mg.

For the treatment of migraine attacks, the recommended starting dose is 25mg taken once a day. Your doctor may increase the dose to 50mg. The maximum recommended daily dose is 50mg.

If you have moderate liver disease, you should not take more than 12.5 mg a day in long-term use.

Follow all directions given to you by your doctor carefully. They may differ from the information contained in this leaflet.

If you do not understand the instructions on the box, ask your doctor or pharmacist for help.

How to take it

Generic Vioxx comes as tablets.

When taking the tablets, swallow them with a glass of water.

When to take it

Take your Generic Vioxx at about the same time each day.

Taking Generic Vioxx at the same time each day will have the best effect. It will also help you remember when to take the dose.

It does not matter if you take Generic Vioxx before or after food.

How long to take it

Do not use Generic Vioxx for longer than your doctor says.

Depending on your condition, you may need to take Generic Vioxx for a few days or for a longer period.

For osteoarthritis, and rheumatoid arthritis, Generic Vioxx helps relieve your symptoms but it does not cure it. Continue taking Generic Vioxx for as long as your doctor prescribes.

For the relief of menstrual pain or other types of pain, Generic Vioxx is usually only needed for a few days.

If you are not sure how long to take Generic Vioxx, talk to your doctor. Your doctor will decide what dose of Generic Vioxx you should take and how long you should take it.

If you forget to take it

If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to. Otherwise, take it as soon as you remember, and then go back to taking your tablet(s) as you would normally.

If you are not sure whether to skip the dose, talk to your doctor or pharmacist.

Do not take a double dose to make up for the dose that you missed.

If you have trouble remembering to take your tablets, ask your pharmacist for some hints.

If you take too much (overdose)

Immediately telephone your doctor or National Poisons Information Centre (telephone 0800 POISON or 0800 764 766), or go to accident and emergency at your nearest hospital, if you think that you or anyone else may have taken too much Generic Vioxx. Do this even if there are no signs of discomfort or poisoning.

While you are using Generic Vioxx

Things you must do

If you become pregnant while taking Generic Vioxx, tell your doctor immediately.

If you get an infection while taking Generic Vioxx, tell your doctor.
Generic Vioxx may hide fever and may make you think, mistakenly, that you are better or that your infection is less serious than it might be.

If you are about to be started on any new medicine, tell your doctor and pharmacist that you are taking Generic Vioxx.

Things you must not do

Do not give Generic Vioxx to anyone else, even if they have the same condition as you.

Things that would be helpful for your arthritis

Some self help measures suggested below may help your condition. Talk to your doctor or pharmacist about these measures and for more information.

• Exercise - regular exercise can help reduce pain and disability from osteoarthritis by increasing muscle strength and reducing the load on joints, but it is important not to overdo it. Walking is good exercise, however, before starting any exercise, ask your doctor about the best kind of programme for you.
  
  
• Weight - your doctor may suggest losing some weight to help reduce the strain on your joints. Some people may need a dietician's help to lose weight.

Adverse Effects

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Generic Vioxx.

Generic Vioxx helps most people with osteoarthritis, rheumatoid arthritis, menstrual pain or other types of pain, but it may have unwanted adverse effects in a few people. All medicines can have adverse effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the adverse effects.

Ask your doctor or pharmacist to answer any questions you may have.

Tell your doctor if you notice or have any of the following and they worry you:

• feeling sick (nausea), vomiting
• heartburn, indigestion, uncomfortable feeling or pain in the stomach,
• diarrhoea
• constipation
• swelling of the legs, ankles or feet
• high blood pressure
• mouth ulcers
• dizziness
• headache
• drowsiness
• dry mouth
• hair loss
• difficulty concentrating
• anxiety
• blurred vision
• colitis
• confusion
• depression
• wheezing
• rash, itching
• pinkish, itchy swellings on the skin, also called hives or nettlerash
• severe skin reactions
• tingling sensation
• palpitations
• pancreatitis
• ringing in the ears
• hallucinations
• increased levels of potassium in the blood
• low blood cell count
• menstrual disorder
• vertigo
• insomnia
• worsening of epilepsy
• 
  These are usually the mild adverse effects of Generic Vioxx.

If any of the following happen, stop taking Generic Vioxx and tell your doctor immediately or go to Accident and Emergency at your nearest hospital:

• stomach ulcers that may become serious and may bleed
• fluid in the lungs
• swelling of the face, lips, tongue or throat which may cause difficulty in swallowing or breathing
• severe increase in blood pressure
• heart failure
• serious kidney problems
• serious liver problems
• unusual headache with a stiff neck

Other adverse effects not listed above may also occur in some patients. Tell your doctor if you notice any other effects.

Do not be alarmed by this list of possible adverse effects. You may not experience any of them.

After using Generic Vioxx

Storage

Keep your tablets in the blister pack until it is time to take them.
If you take the tablets out of the blister pack they may not keep well.

Keep Generic Vioxx in a cool dry place where the temperature stays below 30°C. Do not store it or any other medicine in the bathroom or near a sink.
Do not leave it in the car or on window sills.
Heat and dampness can destroy some medicines.

Keep it where children cannot reach it.
A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.