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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by manic666 on December 29, 2009, at 7:32:41
i saw him last week when i went to reniew my scripts, an i asked if i could have a arthritis med arthrotec my sister,s take. he said sure///i told him the jiont pain i get plus the weight gain an headaches.i said can i go on escitalopram,he said no/// but you can have genetic citalopram. he said just try an up the sertraline for a month an see if you come good.If not we will try citalopram. i cant stand the 150mg sert so im droping back to 100mg, what mg of citalopram is same as 100 sert.after all that he forgot to script the arthrotec ,so i have to go back today, does my head in.do you think i should go for the citalopram????? should it be a smooth straight change over
Posted by Justherself54 on December 29, 2009, at 8:57:28
In reply to i can swap meds at gp saw new doc, posted by manic666 on December 29, 2009, at 7:32:41
I can't remember the swapover dosage of citalopram, but I'm sure someone will chime in on that. You should have no problems switching over. At least you won't have to go through all the withdrawal symptoms having to come off Zoloft before trying citalopram. Good luck Manic..hope this works out better for you.
One thing tho..if you start the arthrotec and citalopram at the same time and find yourself running to the loo at breakneck speed, it's most likely the arthrotec!
Good luck Manic..hope it works well for you!
Posted by Phillipa on December 29, 2009, at 10:30:34
In reply to Re: i can swap meds at gp saw new doc, posted by Justherself54 on December 29, 2009, at 8:57:28
Oh really causes urination or defecation? Phillipa
Posted by Justherself54 on December 29, 2009, at 11:17:28
In reply to Re: i can swap meds at gp saw new doc » Justherself54, posted by Phillipa on December 29, 2009, at 10:30:34
Royal sharts!
Posted by manic666 on December 29, 2009, at 12:54:05
In reply to Re: i can swap meds at gp saw new doc, posted by Justherself54 on December 29, 2009, at 11:17:28
same old crap at the english gp, i can swap but i have to start at 10mg of citalopram.i will save some sertraline , how do i get out of the start up sh*t.he is saying i must give the 150mg sertraline a month ,to make sure im not going through a blip,thats fair enough i can sruggle through that . but how can i do a swap from 150mg if it fails to 10mg of citalopram without getting nuked
Posted by Justherself54 on December 29, 2009, at 15:37:39
In reply to Re: i can swap meds at gp saw new doc, posted by manic666 on December 29, 2009, at 12:54:05
Hey Manic. I can't say for certain as I've been on so many meds and done changeovers, but this is what I think is correct. I went down by 50 mgs. Zoloft every 3 to 4 days. Then when I was down to 50 mgs. a day of Zoloft, I started the Celexa and dumped the Zoloft.
I wish my memory was better. I hope someone else chimes in as perhaps you can do it faster.
Posted by manic666 on December 30, 2009, at 4:52:14
In reply to Re: i can swap meds at gp saw new doc, posted by manic666 on December 29, 2009, at 12:54:05
hey babe carnt you remember the ciratopram dose you started on.i would like to thank you to. I read your post on arthrotec just as i was about to take 2 tabs,i went for 1 instead , 1 hour later i had a volcanic eruption in my guts, sort of like a bubbleing monster, i managed to contain it .////// but i think you saved me from a night on the shitter , thanks
Posted by Justherself54 on December 30, 2009, at 6:42:20
In reply to Re: i hope someone post,s a med change route, posted by manic666 on December 30, 2009, at 4:52:14
I'll rack what's left of my brain to try to remember..if I can't I have to put a call in to my pdoc when he's back on the 4th and I'll ask him. I'll leave a note on my computer to remind me!
I had to give up on the arthrotec and tried Aleve..it was way easier on the bowels. Another word of warning with arthrotec..don't ever, ever, break wind on it..you may get a surprise!
Posted by manic666 on December 30, 2009, at 7:31:03
In reply to Re: i hope someone post,s a med change route, posted by Justherself54 on December 30, 2009, at 6:42:20
NOW you tell me.///////
Posted by West on December 30, 2009, at 14:55:23
In reply to Re: i hope someone post,s a med change route, posted by manic666 on December 30, 2009, at 7:31:03
Glad to hear your making some headway. GPs are a usually a total pain in the *rs*, I can definitely sympathise.
The doses aren't equivalent. What I would probably do is take the citalopram plus the sertraline to make up a proper dose and then complain you're getting worse, so hopefully he puts you up to a proper dose of citalopram (20mg)
Either that, or point out the dose equivalence is wrong, but then you run the risk of getting his knickers in a twist.
Posted by Phillipa on December 30, 2009, at 19:57:16
In reply to Re: i hope someone post,s a med change route, posted by West on December 30, 2009, at 14:55:23
Got to google this athrotec? Phillipa
Posted by Phillipa on December 30, 2009, at 20:04:25
In reply to Re: i hope someone post,s a med change route, posted by Phillipa on December 30, 2009, at 19:57:16
Side effect should go away in a few days per article? Phillipa
Medications and Drugs
Rheumatoid Arthritis Slideshow
Pharmacy Editor: Jay W. Marks, MDGENERIC NAME: diclofenac and misoprostol
BRAND NAME: Arthrotec
DRUG CLASS AND MECHANISM: Arthrotec is a combination of diclofenac and misoprostol. Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) similar to ibuprofen (Motrin; Advil), naproxen (Naprosyn), and others. Diclofenac, like other NSAIDs work by inhibiting the production of prostaglandins. Prostaglandins are a related family of chemicals that are produced by the cells of the body and have several important functions. They promote inflammation, pain, and fever, support the function of platelets that are necessary for the clotting of blood, and protect the lining of the stomach from the damaging effects of acid. Prostaglandins are produced by the enzyme cyclooxygenase (Cox). There actually are two Cox enzymes, Cox-1 and Cox-2. Both enzymes produce prostaglandins that promote inflammation, pain, and fever. However, only Cox-1 produces prostaglandins that support platelets and protect the stomach. Diclofenac blocks both Cox enzymes and reduces prostaglandins throughout the body. As a consequence, ongoing inflammation, pain, and fever are reduced. Since prostaglandins that protect the stomach and support platelets and blood clotting also are reduced, NSAIDs can cause ulcers in the stomach and promote bleeding. Misoprostol is a synthetic (man-made) prostaglandin that stimulates secretion of mucus in the gastrointestinal tract. Mucus protects the lining of the stomach from acid. Misoprostol has been shown to reduce the frequency of ulcers of the stomach caused by NSAIDs. Arthrotec was approved by the FDA in December, 1997.PRESCRIPTION: Yes
GENERIC AVAILABLE: No
PREPARATIONS: Tablets (diclofenac/misoprostol): Arthrotec 50 (50 mg/200 µg) , Arthrotec 75 (75 mg/200 µg) .
STORAGE: The tablets should be kept at room temperature, 15-30°C (59-86°F).
PRESCRIBED FOR: Arthrotec is used for treating signs and symptoms of rheumatoid arthritis or osteoarthritis in patients at risk for developing ulcers from NSAIDs.
DOSING: For osteoarthritis the recommended dose is Arthrotec 50 given three times daily. Patients who cannot tolerate this regimen may be treated with Arthrotec 50 or 75 twice daily. The recommended dose for treating rheumatoid arthritis is Arthrotec 50 given 3-4 times daily. If this regimen is not tolerated, Arthrotec 50 or 75 twice a day may be used. Taking Arthrotec with food may reduce stomach upset. It is recommended that Arthrotec not be taken with alcohol because of the increased risk for ulcers.
DRUG INTERACTIONS: (Please also see the monographs for diclofenac.) Diclofenac is generally used with caution in patients taking blood thinning medications (anticoagulants), such as warfarin (Coumadin), because of the increased risk of bleeding. Patients taking lithium can develop toxic blood levels of lithium because diclofenac may inhibit the elimination of lithium from the body by the kidney. Side effects from methotrexate and cyclosporine also may be increased by diclofenac. Diclofenac may reduce the effectiveness of antihypertensives because it causes or worsens high blood pressure.
PREGNANCY: Since misoprostol can cause abortions, Arthrotec should not be used by women who are pregnant. Avoid pregnancy for 1 month or 1 menstrual cycle after discontinuing Arthrotec.
NURSING MOTHERS: Arthrotec is not recommended for use by nursing mothers.
SIDE EFFECTS: Arthrotec has the side effects of diclofenac and misoprostol. The most common side effects are stomach pain, diarrhea, dyspepsia, nausea and flatulence. Diarrhea and abdominal pain may resolve after 2-7 days. Magnesium containing antacids worsen diarrhea caused by misoprostol. Taking Arthrotec with food and avoiding antacids containing magnesium may reduce the occurrence of diarrhea. Serious side effects include gastrointestinal ulcers and bleeding; liver dysfunction; severe skin reactions. Severe bronchospasms may occur in patients with aspirin-sensitive asthma. Like other NSAIDS Arthrotec may cause heart attacks and strokes; accumulation of fluid and worsen heart failure; cause or worsen hypertension and kidney failure.
Posted by manic666 on December 31, 2009, at 5:50:07
In reply to Re: i hope someone post,s a med change route, posted by West on December 30, 2009, at 14:55:23
so if im on 150mg sertraline an he gives me 10mg of, citalopram, what about 10 mg of cita an 100mg of sert at the same time. go back later an get 20cita an 50mg sert. then what
Posted by West on January 1, 2010, at 15:29:06
In reply to Re:west, posted by manic666 on December 31, 2009, at 5:50:07
Posted by West on January 1, 2010, at 15:32:11
In reply to Re:west, posted by manic666 on December 31, 2009, at 5:50:07
Hi Manic, why not stay on the 50mg Sertraline until you see him again (of you have enough), at which point you can say you're still feeling depressed, then hopefully he should put you up to 30mg citalopram, then you can stop the sertraline?
Posted by manic666 on January 2, 2010, at 6:45:29
In reply to Re:west, posted by West on January 1, 2010, at 15:32:11
its 150mg im on not 50mg i have to give a month to see if it levels me.
Posted by West on January 2, 2010, at 7:23:14
In reply to Re:west, posted by manic666 on January 2, 2010, at 6:45:29
> its 150mg im on not 50mg i have to give a month to see if it levels me.
I do realise that, what I meant was that the 50mg was the final dose to take with the citalopram, and when you drop it, you go up to 30mg.
Will you have enough medicine (if you have to wait a month before raising citalopram's dose)?
Posted by manic666 on January 2, 2010, at 7:53:19
In reply to Re:west, posted by West on January 2, 2010, at 7:23:14
thats what i have to work out, wait till i get a script for sertraline.then go to the docs to change i drop to 100mg an take it with the 10 citaloram he gives . after a week ask to go up 20mg an drop the sert to 50mg or 75, .next 30mgcit 25mg sert ,than just citalopram ,does that sound cool.
Posted by West on January 3, 2010, at 11:17:25
In reply to Re:west, posted by manic666 on January 2, 2010, at 7:53:19
> thats what i have to work out, wait till i get a script for sertraline.then go to the docs to change i drop to 100mg an take it with the 10 citaloram he gives . after a week ask to go up 20mg an drop the sert to 50mg or 75,
That would be ideal (50mg), but didn't you say you'd have to wait a month?
next 30mgcit 25mg sert ,than just citalopram ,does that sound cool.
Absolutely.
W
Posted by manic666 on January 3, 2010, at 12:09:19
In reply to Re:west, posted by West on January 3, 2010, at 11:17:25
i do have to wait a month, but then i get a new repeat sertraline script,without seeing the doc, so a week after that i can go to the doc an say lets try the citalopram. he say,s ok, an i have a near as a months sertraline to play with, do you see were im comming from buddy.im trying a month on his instrution at150mg instead od 100mg sertraline to see if that stop,s the dive in health.if not then change.
Posted by West on January 3, 2010, at 14:22:06
In reply to Re:west, posted by manic666 on January 3, 2010, at 12:09:19
I've got you now. So you'll have enough then if your repeat's for 150mg won't you. Yeah, I know it feels kind of sneaky but I would just play it out - he's got the dosages wrong, quite unprofessional.
This is the end of the thread.
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