Dipyrone/etoricoxib/ibuprofen misuse
- PDF / 170,440 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 81 Downloads / 207 Views
1
Dipyrone/etoricoxib/ibuprofen misuse Headache, chronic lower back pain and groin pain: 5 case reports A case series of described five patients (4 women and 1 man) aged 48–78 years, who developed non-specific chronic lower back pain (CLBP) with headache (1 patient), non-specific CLBP (3 patients) and non-specific CLBP with groin pain (1 patient) following overuse (misuse) of dipyrone, etoricoxib or ibuprofen for pain [exact doses, routes and times to reactions onsets not stated]. The patients, who had pain, were receiving ibuprofen given at a dose of 300–2400 mg over a period of 1.5–2 years (3 patients), ibuprofen and etoricoxib at a dose of 1200 mg and 90mg, respectively over a period of 20 years (1 patient) and dipyrone [metamizole] at a dose of 2000 mg over a period of 15 years (1 patient). All patients received ibuprofen, etoricoxib or dipyrone on 30 days/month basis. Subsequently, one patient developed chronic CLBP with headache, three patients developed only non-specific CLBP and one patient developed non-specific CLBP with groin pain following overuse (misuse) of dipyrone, etoricoxib or ibuprofen. Thereafter, they were enrolled in out-patient withdrawal protocol in a step-wise manner and were instructed to maintain a pain diary. During the first week, they either received ibuprofen (3 patients), etoricoxib (1 patient) and dipyrone (1 patient) every second day to overcome catastrophising thoughts and to avoid an increase in fear-avoidance behaviour. In the second week, they did not receive either of these medications for a minimum of 2 weeks. Among these five patients, one patient required two withdrawal attempts due to minimal improvement in pain. They successfully completed discontinuation of withdrawal protocol without any withdrawal symptom. After a slight increase in pain score, they had pain relief at the 1 month follow-up. They again received either ibuprofen, etoricoxib or dipyrone, which were surprisingly found to be effective. Author comment: "Medication-overuse has been associated with chronic headache, but never with CLBP". "We substantiate our hypothesis with a preliminary case-series analyzing five patients suffering from CLBP with a marked medication-overuse." Luchting B, et al. Eighty years of Medication-Overuse Headache: what about Medication-Overuse Backpain?. Journal of Neurology 266: 3167-3170, No. 12, Dec 2019. Available from: URL: http://doi.org/10.1007/s00415-019-09611-7 803440618 Germany
0114-9954/19/1784-0001/$14.95 Adis © 2019 Springer Nature Switzerland AG. All rights reserved
Reactions 21 Dec 2019 No. 1784
Data Loading...
