Unfortunately, because everyone has different risks and different levels of benefit from the same drug, there are no hard and fast rules about how long someone can safely take a drug. The risks of Mobic, like other nonsteroidal antiinflamamtory drugs include stomach ulcers with or without bleeding, liver irritation, kidney failure. In general, these risks are highest in the elderly, those who also take steroids, those with prior similar side effects with other nonsteroidal antiinflammatory drugs, those with underlying kidney or liver disease.
NSAID Q & A
Methotrexate falls into the category of medications called DMARDs (Disease modifying anti-rheumatic drugs). This is a medication that has been shown to slow down the destructive process in joints of patients with rheumatoid arthritis.
Vioxx (no longer available) is in a class of medications called NSAIDS (Nonsteroidal Antiinflammatory Drugs). Many other NSAIDS are still used in treating musculoskeletal problems (some of these are naproxen, ibuprofen, diclofenac, Celebrex, and many others). In rheumatoid arthritis these medicaions may help in relieving symptoms but are not disease modifying.
You may find more information about NSAIDS on the website:
Meloxicam is a nonsteroidal antiinflammatory drug (NSAID). As is the case with other NSAIDS it can help with arthritis related pain and inflammation. In certain arthritic conditions (such as rheumatoid arthritis), it is generally used as an adjunctive therapy combined with a disease modifying agent (DMARD).
Tylenol (generic Acetaminophen) is commonly used as an adjunct for pain relief in patients with various forms of musculoskeletal pain. While acetaminophen is not an anti-inflammatory agent (like NSAIDS, including Celebrex), it does act on pain pathways. It is important for patients to inform their physicians of breakthrough pain that is requiring the use of any over-the-counter agents as there may need to be increased monitoring for certain possible side effects (increased liver function tests, etc).
It is also important to remember that combining different NSAIDS is not recommended, including over-the-counter agents such as ibuprofen (Advil, Motrin, etc) or naproxen (Alleve) with prescription NSAIDS (Celebrex, diclofenac, and many others).
Your/his story is not unusual although flares/remissions occur much less frequently in OA than in RA or other inflammatory types of arthritis. The triggers of the flares and remissions are not known for either type of arthritis. Patients often feel stress, weather, over exercise and diet are factors in the flares.
Osteoarthritis and osteonecrosis (avascular necrosis) are two diferent problems. Osteoarthritis occurs with when the cartilage wears thin and degrades. It is thought to primarily a cartilage problem although recently some investigators have raised the theory that collapse of bone at the cartilage interface may also contribute. Osteonecrosis occurs when the bone does not get enough blood supply and dies. This occurs most commonly after trauma to the joint. Patients with certain blood disorders, patients with lupus or who are taking high doses of prednisone are also at risk for osteonecrosis. The confusion comes when a joint is badly degenerated or “endstage”. A that point it is often impossible to distinguish between the two problems.