Hi

Hi, I've been on Etoricoxib (Arcoxia) for the past year, as prescribed by my rheumatologist. I've recently moved house and switched doctor surgeries. I have just phoned to request my repeat prescriptions and I got told "the doctor has decided this is a high risk medication and won't issue you it". I've had to make an appointment for next week, but I'm really worried because this is the only medication that gives me any relief from my arthritic pains. Can GP's actually refuse to prescribe something recommended by a specialist? And can they really expect me to go from 60mg daily to nothing at all? I'm really worried and my anxiety levels have gone through the roof. Please can anyone help me?

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  • It's really annoying that your appointment is next week, especially if you are now without pain relief. I think that the sooner you & your GP get on the same page, the better. In my experience, GPs are willing to work WITH patients once they get to know us but for now you're left wondering what the hell is going on. Have you contacted your rheumy department to put them in the picture and perhaps to ask for whatever is the next best NSAID in their opinion? I would do that straight away so that you know their views ahead of GP appointment.

    Best case scenario is that this new GP is a responsible prescriber who wants to double-check that this really is the best painkiller for you. I'd set out to have a very sensible discussion with him or her and to at least consider that they may have a point, they may have real concerns about the drug which they want to run by you. I'll admit I do try to manipulate doctors (maybe that's not quite the right word) by being ultra-reasonable & really putting on my Sunday-best attitude. I mean, I know I'm responsible and sufficiently un-confused not to take an overdose by mistake for example, but doctors don't know this till they meet us.

  • Call your rheumatologist's secretary & tell her what the GP said..

    I had this with Leflunomide & there is a form the Rheumy will send to your GP explaining he would like the GP to write the prescription, but he(the Rheumy) will take the responsibility of overseeing your treatment.

    My GP at the time was complete wimp.....I don't know if it is a technical requirement.....but he's history now.....so it's water under the bridge.

    Hope you get it sorted asap!

  • It's good that the GP knows about the risks of Entoricoxib. He/she may not have read the most recent research that showed that all NSAI have very similar risks, it's just that the more recently developed ones were tested more rigorously initially.

    However, the GP may want to try you on a different NSAI - had you tried others before? If you haven't - there are a large number of them!

    Or the entoricoxib may not be on the list of drugs preferred by that area because of a decision by a committee based on efficacy against cost.

    The GP is only advised by the consultant and does not have to follow their recommendations, so you may need to explain about which ones you have previously tried, and what problems you had, so go prepared with a list.

  • However irritating, the GP is doing the responsible thing by wanting to see you before prescribing. It's quite possible that they have yet to get any paperwork from your old practice or the rheumatologist so it would be very lax of them to prescribe NSAIDs without knowing you, your disease and your cardiovascular risk. Long term use of NSAIDs is not ideal, so unless there is no other option GPS will avoid it.

    I take arcoxia, and have done for quite a while and agree it's pretty effective! I used to take it all the time, and had similar discussions with my GP. Luckily my RA is now much better controlled, so I only need it now and then. If you are still needing it all the time have you had a conversation with your rheumy as to whether you can get your RA under better control? Perhaps your other meds could benefit from being reviewed too?

    If you are desperate you could call the surgery back and ask for a week's supply as an emergency measure before your appointment. Sometimes they'll do this.

  • My rheumy appt is on 21st so hopefully they will have some more answers

  • I had exact same reaction a year ago, but I persisted and got etorcoxib in the end x

  • Sometimes conversations with receptionists aren't always clear & of course they're not medically qualified to discuss specifics. It could be that it's a blanket warning on etoricoxib but the initial prescriber, be it GP or Rheumy, should be the person who decides if a patient continues taking a med so in your case your Rheumy.

    On Friday I received a call for a med review, when I saw the doctor it was specifically for etoricoxib. I'm prescribed 90mg & there's recently been a Government alert sent to GP's for this on 90mg or 120mg requesting that their doctor review patients & advise them cardiovascular & other events may increase the longer it's taken & that the safest recommended dose is now 60mg. It may be that your new doctor will recommend he/she be performs a full CV check or apply the QRISK to calculate your 10 year (or less) risk before adding etoricoxib to your repeat list, or possibly suggest trying an alternative NSAID. If it's of interest I posted today about the changes healthunlocked.com/nras/pos...

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