Celecoxib soho

Celecoxib consumer information

Qiu W, Su Q, Rutledge AC, Zhang J, Adeli K. Glucosamine-induced endoplasmic reticulum stress attenuates apolipoprotein B100 synthesis via PERK signaling. Morrison BW, Daniels SE, Kotey P et al. Rofecoxib, a specific cyclooxygenase-2 inhibitor, in primary dysmenorrhea: a randomized controlled trial. Obstet Gynecol. PVC catheters and peripheral heparin locks. Additional flushes should be given when stagnant blood is observed in catheter, after catheter is used for drug or blood administration, and after blood withdrawal from catheter. An increase in the incidence of background findings of spermatocele with or without secondary changes such as epididymal hypospermia as well as minimal to slight dilation of the seminiferous tubules was seen in the juvenile rat. These reproductive findings while apparently treatment-related did not increase in incidence or severity with dose and may indicate an exacerbation of a spontaneous condition. Similar reproductive findings were not observed in studies of juvenile or adult dogs or in adult rats treated with celecoxib. The clinical significance of this observation is unknown.

Am J Kidney Dis

Bone and joint disease called Kashin-Beck disease. Early evidence shows that taking glucosamine hydrochloride along with chondroitin sulfate reduces pain and improves physical function in adults with a bone and joint disorder called Kashin-Beck disease. The effects of glucosamine sulfate on symptoms of Kashin-Beck disease are mixed when the supplement is taken as a single agent. Drink water. A lack of water in your body can make your uric acid levels rise even higher than they already are. Drinking water will help your body stabilize uric acid to a normal level. Celecoxib is used to treat pain or inflammation caused by many conditions such as arthritis, ankylosing spondylitis, and menstrual pain.

Before taking celecoxib

CELEBREX in breast milk. It is also found in seashells, or it can be made in the laboratory. Glucosamine hydrochloride is one of several forms of glucosamine. This drug may rarely cause serious rarely fatal bleeding from the stomach or intestines. Do not use celecoxib just before or after heart bypass surgery coronary artery bypass graft, or CABG. Concomitant use of CELEBREX and pemetrexed may increase the risk of pemetrexed-associated myelosuppression, renal, and GI toxicity see the pemetrexed prescribing information.

Cmax and 10% in AUC

Mizuno H, Sakamoto C, Matsuda K et al. Induction of cyclooxygenase 2 in gastric mucosal lesions and its inhibition by the specific antagonist delays healing in mice. Gastroenterology. Talk to your healthcare provider if you are considering taking NSAIDs during pregnancy. You should not take NSAIDs after 29 weeks of pregnancy. During concomitant use of CELEBREX and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. Celecoxib has not been studied in patients under the age of 2 years, in patients with body weight less than 10 kg 22 lbs and in patients with active systemic features. Patients with systemic onset JRA without active systemic features appear to be at risk for the development of abnormal coagulation laboratory tests. In some patients with systemic onset JRA, both celecoxib and naproxen were associated with mild prolongation of activated partial thromboplastin time APTT but not prothrombin time PT. When NSAIDs including celecoxib are used in patients with systemic onset JRA, monitor patients for signs and symptoms of abnormal clotting or bleeding, due to the risk of disseminated intravascular coagulation.



Celecoxib forms and strengths

Use: For the relief of the signs and symptoms of ankylosing spondylitis. They remove waste products and extra fluid and flush them from your body as urine. When your don't work right, wastes build up in your and make you sick. Food and Drug Administration. WebMD does not endorse any specific product, service, or treatment. These side effects are an inconvenience rather than a disabling condition, and usually subside with continued treatment or a temporary reduction or cessation of dosage. If persistent, a cessation of dosage is indicated. Treating rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, juvenile arthritis, menstrual pain, or pain. It may also be used for other conditions as determined by your doctor. Patients on long-term treatment with celecoxib should have their hemoglobin or hematocrit checked if they exhibit any signs or symptoms of anemia or blood loss. Celecoxib does not generally affect platelet counts, prothrombin time PT or partial thromboplastin time PTT and does not inhibit platelet aggregation at indicated dosages. Bensen WG, Fiechtner JJ, McMillen JI et al. Treatment of osteoarthritis with celecoxib, a cyclooxygenase-2 inhibitor: a randomized controlled trial. Mayo Clin Proc. WebMD User Reviews should not be considered as medical advice and are not a substitute for professional medical advice, diagnosis, or treatment. Never delay or disregard seeking professional medical advice from your physician or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences may be a helpful health information resource but they are never a substitute for professional medical advice from a qualified healthcare provider. Drospirenone: Nonsteroidal Anti-Inflammatory Agents may enhance the hyperkalemic effect of Drospirenone. Drink plenty of fluids as directed by your doctor to prevent and tell your doctor right away if you have a change in the amount of urine. Read the Patient Information Leaflet provided by your pharmacist before you start using this medication and each time you get a refill. If you have any questions, ask your doctor, diabetes educator, or pharmacist. Shake the oral suspension liquid well just before you measure a dose. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one. H2-receptor antagonist, or a proton pump inhibitor should be administered as necessary. Patients should be counseled to avoid or minimize consumption of alcohol during NSAID therapy. Three or more alcoholic drinks per day during NSAID use may increase the risk of gastrointestinal ulceration and bleeding. Patients should also be advised to promptly seek medical attention if they experience symptoms that could indicate serious GI tract ulceration or bleeding such as epigastric pain, dyspepsia, melena, and hematemesis. Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.



Side effects of celecoxib

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Farxiga only for the indication prescribed. Do not take NSAIDs right before or after a heart surgery called a “coronary artery bypass graft CABG. What is the treatment for rheumatoid arthritis? Wu YL, Kou YR, Ou HL, Chien HY, Chuang KH, Liu HH, Lee TS, Tsai CY, Lu ML. Glucosamine regulation of LPS-mediated inflammation in human bronchial epithelial cells. Take Diflucan for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antifungal medication. Diflucan will not treat a viral infection such as the common cold or flu. Stumpf JL, Lin SW. Effect of glucosamine on glucose control. This may increase the risk of bleeding when taken with other drugs that also may cause bleeding. When celecoxib capsules were taken with a high fat meal, peak plasma levels were delayed for about 1 to 2 hours with an increase in total absorption AUC of 10% to 20%. Under fasting conditions, at doses above 200 mg, there is less than a proportional increase in C max and AUC, which is thought to be due to the low solubility of the drug in aqueous media. Celecoxib is a nonsteroidal anti-inflammatory drug NSAID. Celecoxib works by reducing hormones that cause inflammation and pain in the body. ACE inhibitor such as benazepril Lotensin enalapril Vasotec lisinopril Prinivil, Zestril quinapril Accupril ramipril Altace and others. Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? Get medical help right away if any of these rare but very serious side effects occur: signs of kidney problems such as change in the amount of urine unexplained stiff neck. Use: For the management of acute pain. Follow your doctor's instructions about any restrictions on food, beverages, or activity. Potential pharmacokinetic interaction increased plasma celecoxib concentrations with drugs that inhibit CYP2C9. 1 Caution is advised. clomipramine



Uncontrolled over many years

Learn all preparation and usage instructions from your health care professional and the product package. Helin-Salmivaara A, Virtanen A, Vesalainen R et al. NSAID use and the risk of hospitalization for first myocardial infarction in the general population: a nationwide case-control study from Finland. JIA in patients 2 years and older. Cardiovascular safety outcomes were also evaluated in the CLASS trial. Kaplan-Meier cumulative rates for investigator-reported serious cardiovascular thromboembolic adverse events including MI, pulmonary embolism, deep venous thrombosis, unstable angina, transient ischemic attacks, and ischemic cerebrovascular accidents demonstrated no differences between the celecoxib, diclofenac, or ibuprofen treatment groups. Until more data are available, a selective COX-2 inhibitor remains an appropriate choice for patients at low cardiovascular risk who have had serious GI events, especially while receiving a prototypical NSAIA. See 17 for PATIENT COUNSELING INFORMATION and Medication Guide. NSAIDs, including celecoxib can lead to new onset of hypertension or worsening of preexisting hypertension, either of which may contribute to the increased incidence of CV events. GFR and celecoxib clearance. During concomitant use of CELEBREX and digoxin, monitor serum digoxin levels. Some medical conditions may interact with ketorolac. Unexplained bleeding of any kind. vistaril in the philippines vistaril



Use of celecoxib

Your doctor can prescribe a glucagon emergency injection kit to use in case you have severe hypoglycemia and cannot eat or drink. Be sure your family and close friends know how to give you this injection in an emergency. Use of NSAIDs, including celecoxib, during the third trimester of pregnancy increases the risk of premature closure of the fetal ductus arteriosus. Avoid use of NSAIDs, including celecoxib, in pregnant women starting at 30 weeks of gestation. If you use this medication long-term, your blood will need to be tested often. Visit your doctor regularly. White WB, Faich G, Whelton A et al. Comparison of thromboembolic events in patients treated with celecoxib, a cyclooxygenase-2 specific inhibitor, versus ibuprofen or diclofenac. Am J Cardiol. Do not self-inject heparin if you do not fully understand how to give the injection and properly dispose of used needles, IV tubing, and other items used to inject the medicine. Thus, results of the DST should be interpreted with caution in these patients. NSAIDs work well to relieve pain, decrease fever, and reduce swelling and caused by an injury or disease. Some NSAIDs help reduce heavy menstrual bleeding. AUC 0-24 at 200 mg twice daily. The effects of celecoxib on labor and delivery in pregnant women are unknown.



Celecoxib uses

Reginster JY, Deroisy R, Rovati LC, et al. Long-term effects of glucosamine sulfate on osteoarthritis progression: a randomised, placebo-controlled trial. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication not have serious side effects. If you miss a dose of celecoxib and you are taking it regularly, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. Do not use this medication when you have low blood sugar hypoglycemia. Use the lowest effective dosage for the shortest possible duration. Farxiga is only part of a treatment program that may also include diet, exercise, weight control, regular blood sugar testing, and special medical care. Follow your doctor's instructions very closely. Correct volume status in dehydrated or hypovolemic patients prior to initiating celecoxib. order generic naproxen online canada naproxen



High over many years

Avoid the use of celecoxib in patients with advanced renal disease unless the benefits are expected to outweigh the risk of worsening renal function. If celecoxib is used in patients with advanced renal disease, monitor patients for signs of worsening renal function. Das A Jr, Hammad TA. Efficacy of a combination of FCHG49 glucosamine hydrochloride, TRH122 low molecular weight sodium chondroitin sulfate and manganese ascorbate in the management of knee osteoarthritis. For certain conditions such as it may take up to two weeks of taking this drug regularly until you get the full benefit. If you are taking this drug "as needed" not on a regular schedule remember that pain work best if they are used as the first occur. If you wait until the pain has worsened, the medication may not work as well. Discuss lifestyle changes that might benefit you with your doctor. Ju Y, Hua J, Sakamoto K, Ogawa H, Nagaoka I. Glucosamine, a naturally occurring amino monosaccharide modulates LL-37-induced endothelial cell activation. CycloSPORINE Systemic: Nonsteroidal Anti-Inflammatory Agents may enhance the nephrotoxic effect of CycloSPORINE Systemic. Nonsteroidal Anti-Inflammatory Agents may increase the serum concentration of CycloSPORINE Systemic. CycloSPORINE Systemic may increase the serum concentration of Nonsteroidal Anti-Inflammatory Agents. Management: Consider alternatives to nonsteroidal anti-inflammatory agents NSAIDs. Monitor for evidence of nephrotoxicity, as well as increased serum cyclosporine concentrations and systemic effects eg, hypertension during concomitant therapy with NSAIDs. Gislason GH, Rasmussen JN, Abildstrom SZ et al. Increased mortality and cardiovascular morbidity associated with use of nonsteroidal anti-inflammatory drugs in chronic heart failure. Arch Intern Med. You can get from having damaged kidneys. This information should not be used to decide whether or not to take celecoxib or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about celecoxib. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to celecoxib. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using celecoxib. CELEBREX should never be used right before or after a heart surgery called “coronary artery bypass graft” CABG. How is chronic kidney disease diagnosed? Imagawa K, de Andrés MC, Hashimoto K, Pitt D, Itoi E, Goldring MB, Roach HI, Oreffo RO. The epigenetic effect of glucosamine and a nuclear factor-kappa B NF-kB inhibitor on primary human chondrocytes--implications for osteoarthritis. If you are prescribed this drug on a regular schedule not just "as needed" and you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Lifestyle changes are an important part of your treatment. Taking these steps can help slow down kidney disease and reduce your symptoms. where to astonin



What are the possible side effects of celecoxib

For OA, the dosage is 200 mg per day administered as a single dose or as 100 mg twice daily. In patients who have demonstrated allergic-type reactions to sulfonamides. General: Celecoxib metabolism is predominantly mediated via cytochrome P450 CYP 2C9 in the liver. Co-administration of celecoxib with drugs that are known to inhibit CYP2C9 should be done with caution. Significant interactions may occur when celecoxib is administered together with drugs that inhibit CYP2C9. EKG Changes: Reversible flattening, isoelectricity or inversion of T-waves. Certain other drugs can cause unwanted or dangerous effects when used with Diflucan. Patients should be informed that celecoxib is a sulfonamide and can cause serious skin side effects such as exfoliative dermatitis, SJS, and TEN, which may result in hospitalizations and even death. Although serious skin reactions may occur without warning, patients should be informed of the signs and symptoms of skin rash and blisters, fever, or other signs of hypersensitivity such as itching, and seek immediate medical advice when observing any indicative signs or symptoms. Capsule shell for the 150 mg potency contains: Gelatin and Titanium Dioxide.



How to use celecoxib

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high. Pediatric patients: Oral clearance increases in less-than-proportional manner with increasing weight; clearance predicted to be 40 or 24% lower in pediatric patients weighing 10 or 25 kg, respectively, than in a 70-kg adult. Singh G, Triadafilopoulos G. Epidemiology of NSAID induced gastrointestinal complications. J Rheumatol. It is unknown if this medication passes into milk. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company. Take the smallest dose of NSAIDs that you need. This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. This list is not complete and many other drugs can interact with fluconazole. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all your medications and any you start or stop using during treatment with Diflucan. Give a list of all your medicines to any healthcare provider who treats you. Use: For the relief of the signs and symptoms of rheumatoid arthritis. generic name for rifampicin cream



CELEBREX in breast milk

Patients should be informed that celecoxib can lead to the onset of new hypertension or worsening of preexisting hypertension, and that celecoxib may impair the response of some antihypertensive agents. Patients should be instructed on the proper follow up for monitoring of blood pressure. The concomitant use of celecoxib with other NSAIDs or salicylates is not recommended. Olsen AM, Fosbøl EL, Lindhardsen J et al. Cause-specific cardiovascular risk associated with nonsteroidal anti-inflammatory drugs among myocardial infarction patients--a nationwide study. PLoS One. Teichman JMH 2004. Acute renal colic from ureteral calculus. New England Journal of Medicine, 3507: 684-693. Dosages may range from one to four times per day, depending on how long each drug stays in your body. Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal. Pediatric: Use with caution in pediatric patients with systemic-onset juvenile idiopathic arthritis JIA; serious adverse reactions, including disseminated intravascular coagulation, may occur. idiz.info topamax



What conditions does celecoxib treat

Ketorolac is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using ketorolac at home, a health care provider will teach you how to use it. Be sure you understand how to use ketorolac. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions. The daily recommended dose of Celecoxib Capsules in patients with moderate hepatic impairment Child-Pugh Class B should be reduced by 50%. Lithium Toxicity: The likelihood of toxicity increases with increasing serum lithium levels. Do not stop taking any medications without consulting your healthcare provider. Sulfonamide "sulfa" allergy: The FDA-approved product labeling for many medications containing a sulfonamide chemical group includes a broad contraindication in patients with a prior allergic reaction to sulfonamides. There is a potential for cross-reactivity between members of a specific class eg, two antibiotic sulfonamides. However, concerns for cross-reactivity have previously extended to all compounds containing the sulfonamide structure SO 2NH 2. An expanded understanding of allergic mechanisms indicates cross-reactivity between antibiotic sulfonamides and nonantibiotic sulfonamides may not occur or at the very least this potential is extremely low Brackett 2004; Johnson 2005; Slatore 2004; Tornero 2004. In particular, mechanisms of cross-reaction due to antibody production anaphylaxis are unlikely to occur with nonantibiotic sulfonamides. T-cell-mediated type IV reactions eg, maculopapular rash are less well understood and it is not possible to completely exclude this potential based on current insights. What Is Celecoxib and How Does It Work? Your condition may get worse when exposed to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Wear protective clothing when outdoors. Ask your doctor if you should use along with this medication.



What should i avoid while taking celecoxib

Call your doctor for instructions if you miss a dose of heparin. What happens if I overdose? What is rheumatoid arthritis RA? Reduce dosage by 50% in patients with moderate hepatic impairment; not recommended in patients with severe impairment. INDOCIN in patients with advanced renal disease. Tell your doctor right away if you have any serious side effects, including: signs of low potassium level in the blood such as muscle cramps, weakness, irregular heartbeat. Initially, 200 mg daily as a single dose or in 2 equally divided doses. 1 If no response observed after 6 weeks, increase to 400 mg daily. 1 If no response observed after 400 mg daily for 6 weeks, response is unlikely; consider alternative therapies. Brugada Syndrome may pre-exist and be unmasked by lithium therapy. Brugada Syndrome is a heart disorder characterized by abnormal electrocardiographic ECG findings and risk of sudden death. Patients should be advised to seek immediate emergency assistance if they experience fainting, lightheadedness, abnormal heart beats, or shortness of breath. Patients should always ask their doctors for medical advice about adverse events. Tell your healthcare provider about all of the medicines you take, including prescription or over-the-counter medicines, vitamins or herbal supplements. NSAIDs and some other medicines can interact with each other and cause serious side effects. Do not start taking any new medicine without talking to your healthcare provider first. clozaril



Medicine to treat problems

GI bleeding may be increased. Celecoxib is contraindicated in the setting of coronary artery bypass graft surgery CABG. Risk of MI and stroke may be increased with use following CABG surgery. NSAIDs are contraindicated for the treatment of peri-operative pain in the setting of coronary artery bypass graft CABG surgery. Two large clinical trials of a COX-2 inhibitor for the treatment of pain in the first 10 to 14 days following CABG surgery found an increased incidence of myocardial infarction and stroke. Concomitant use of corticosteroids with CELEBREX may increase the risk of GI ulceration or bleeding. If traveling across time zones, ask your doctor about how to adjust your insulin schedule. Take extra insulin and supplies with you. Dougados M, Behier JM, Jolchine I et al. Efficacy of celecoxib, a cyclooxygenase 2-specific inhibitor, in the treatment of ankylosing spondylitis: a six-week controlled study with comparison against placebo and against a conventional nonsteroidal antiinflammatory drug. Arthritis Rheum. This medication must not be shared with others. What are complications of rheumatoid arthritis? Celecoxib may cause premature closure of the ductus arteriosus. Dr. Janet Woodcock, director of the FDA's Center for Drug Evaluation and Research, said in an agency statement. " professionals and patients can be assured that these FDA-approved have met our rigorous approval standards. Crofford LJ, Wilder RL, Ristimäki AP et al. Cyclooxygenase-1 and -2 expression in rheumatoid synovial tissues: effects of interleukin-1β, phorbol ester, and corticosteroids. J Clin Invest. NSAIDs should interrupt dosing for at least five days before, the day of, and two days following pemetrexed administration. protopic-ointment



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Celecoxib ingredients


It may harm them

Importance of seeking immediate medical attention if signs and symptoms of a cardiovascular event chest pain, dyspnea, weakness, slurred speech occur. Kurumbail RG, Stevens AM, Gierse JK et al. Structural basis for selective inhibition of cyclooxygenase-2 by anti-inflammatory agents. Nature. Consult your doctor before -feeding. Kimmel SE, Berlin JA, Reilly M et al. Patients exposed to rofecoxib and celecoxib have different odds of nonfatal myocardial infarction. Ann Intern Med. There is some concern that taking glucosamine hydrochloride and acetaminophen Tylenol, others together might alter how well each works. But more information is needed to know if this interaction is a big concern. amitriptyline soho

General information about celecoxib

Adams ME. Hype about glucosamine. ASA Derivatives: Nonsteroidal Anti-Inflammatory Agents may enhance the nephrotoxic effect of 5-ASA Derivatives. In the setting of CABG surgery. Patients should talk to their health care provider before they use over the counter analgesics. Please refer to the for information on shortages of one or more of these preparations.

Celecoxib warnings

Serum levels should be determined twice per week during the acute phase, and until the serum level and clinical condition of the patient have been stabilized. McGettigan P, Henry D. Cardiovascular risk and inhibition of cyclooxygenase: a systematic review of observational studies of selective and nonselective inhibitors of cyclooxygenase 2. JAMA. 2006; 296; 1633-44. Rest the joint. It's a good idea to rest until the pain lessens. Most people having an acute attack of gouty probably won't want to move the joint much anyway. Raise the joint if you can on a pillow or other soft object. Beirne JP, Cairns SR. Cholestatic hepatitis in association with celecoxib. BMJ. order azathioprine in canada online

Celecoxib adult dosage

Anticoagulant activity should be monitored, particularly in the first few days, after initiating or changing celecoxib therapy in patients receiving warfarin or similar agents, since these patients are at an increased risk of bleeding complications. The effect of celecoxib on the anticoagulant effect of warfarin was studied in a group of healthy subjects receiving daily 2 to 5 mg doses of warfarin. In these subjects, celecoxib did not alter the anticoagulant effect of warfarin as determined by prothrombin time. However, in post-marketing experience, serious bleeding events, some of which were fatal, have been reported, predominantly in the elderly, in association with increases in prothrombin time in patients receiving celecoxib concurrently with warfarin.

Ott E, Nussmeier NA, Duke P C et al. Efficacy and safety of the cyclooxygenase 2 inhibitors parecoxib and valdecoxib in patients undergoing coronary artery bypass surgery. J Thorac Cardiovasc Surg. This medicine may cause stomach bleeding. Daily use of alcohol while using this medicine may increase your risk for stomach bleeding. This medication passes into milk. While there have been no reports of harm to nursing infants, consult your doctor before -feeding. Store heparin at room temperature away from moisture and heat. If you have a history of ulcers or take large doses of or other medication, limit beverages while using this drug. nexium

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