Skip to main content

Advertisement

SpringerLink
Log in

Use of a Once-Daily NSAID in Treatment of Cyclic Vomiting Syndrome

  • Clinical Practice: Clinical Vignettes
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

ABSTRACT

Cyclic vomiting syndrome (CVS) is a rare disorder characterized by episodes of intense vomiting and nausea separated by symptom-free periods. We report the case of a 71-year-old man who presented with a long history of poorly controlled CVS whose symptoms resolved with the addition of a once-daily dose of meloxicam, a semi-selective non-steroidal anti-inflammatory drug (NSAID). This is the first report of symptom alleviation in a CVS patient using a once-daily NSAID, as well as one with selectivity to COX-2 inhibition. This is important due to both the increased compliance seen with once-daily medications, as well as the decreased gastrointestinal effects seen with selective COX-2 inhibitors compared to nonselective NSAIDS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1

Similar content being viewed by others

REFERENCES

  1. Fleisher DR, Gornowicz B, Adams K, Burch R, Feldman EJ. Cyclic Vomiting Syndrome in 41 adults: the illness, the patients, and problems of management. BMC Med. 2005;3:20.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Abell TL, Adams KA, Boles RG, et al. Cyclic vomiting syndrome in adults. Neurogastroenterol Motil. 2008;20:269–284.

    Article  CAS  PubMed  Google Scholar 

  3. Tack J, Talley NJ, Camilleri M, et al. Functional gastroduodenal disorders. Gastroenterology. 2006;130:1466–1479.

    Article  PubMed  Google Scholar 

  4. Hejazi RA, McCallum RW. Review article: cyclic vomiting syndrome in adults — rediscovering and redefining an old entity. Aliment Pharmacol Ther. 2011;34:263–273.

    Article  CAS  PubMed  Google Scholar 

  5. Lee LYW, Abbott L, Mahlangu B, Moodie SJ, Anderson S. The management of cyclic vomiting syndrome: a systematic review. Eur J Gastroenterol Hepatol. 2012;24:1001–1006.

    Article  CAS  PubMed  Google Scholar 

  6. Pareek N, Fleisher DR, Abell T. Cyclic vomiting syndrome: what a gastroenterologist needs to know. Am J Gastroenterol. 2007;102:2832–2840.

    Article  PubMed  Google Scholar 

  7. Olden KW, Chepyala P. Functional nausea and vomiting. Nat Clin Pract Gastroenterol Hepatol. 2008;5:202–208.

    Article  PubMed  Google Scholar 

  8. Hejazi RA, Reddymasu SC, Namin F, Lavenbarg T, Foran P, McCallum RW. Efficacy of tricyclic antidepressant therapy in adults with cyclic vomiting syndrome: a 2-year follow-up study. J Clin Gastroenterol. 2010;44:18–21.

    Article  PubMed  Google Scholar 

  9. Pasricha PJ, Schuster MM, Saudek CD, Wand G, Ravich WJ. Cyclic vomiting: association with multiple homeostatic abnormalities and response to ketorolac. Am J Gastroenterol. 1996;91:2228–2232.

    CAS  PubMed  Google Scholar 

  10. Sunku B. Cyclic vomiting syndrome: a disorder of all ages. Gastroenterol Hepatol. 2009;5:507–515.

    Google Scholar 

  11. Li BU, Lefevre F, Chelimsky GG, et al. North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition consensus statement on the diagnosis and management of cyclic vomiting syndrome. J Pediatr Gastroenterol Nutr. 2008;47:379–393.

    Article  CAS  PubMed  Google Scholar 

  12. Capone ML, Tacconelli S, Di Francesco L, Sacchetti A, Sciulli MG, Patrignani P. Pharmacodynamic of cyclooxygenase inhibitors in humans. Prostaglandins Other Lipid Mediat. 2007;82:85–94.

    Article  CAS  PubMed  Google Scholar 

  13. National Institutes of Health. Meloxicam. Available at: http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601242.html. Accessed April 11, 2012.

  14. Hawkey C, Kahan A, Steinbrück K, et al. Gastrointestinal tolerability of meloxicam compared to diclofenac in osteoarthritis patients. Br J Rheumatol. 1998;37:937–945.

    Article  CAS  PubMed  Google Scholar 

  15. Engelhardt G. Pharmacology of meloxicam, a new non-steroidal anti-inflammatory drug with an improved safety profile through preferential inhibition of COX-2. Br J Rheumatol. 1996;35:4–12.

    Article  CAS  PubMed  Google Scholar 

  16. Chaiamnuay S, Allison JJ, Curtis JR. Risks versus benefits of cyclooxygenase-2-selective nonsteroidal antiinflammatory drugs. Am J Health Syst Pharm. 2006;63:1837–1851.

    Article  CAS  PubMed  Google Scholar 

  17. Silverstein FE, Faich G, Goldstein JL, et al. Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis: the CLASS study: a randomized controlled trial. JAMA. 2000;284:1247–1255.

    Article  CAS  PubMed  Google Scholar 

  18. McCormack JP, Rangno R. Digging for data from the COX-2 trials. CMAJ. 2002;166:1649–1650.

    PubMed Central  PubMed  Google Scholar 

  19. Edwards KR, Rosenthal BL, Farmer KU, et al. Evaluation of sumatriptan-naproxen in the treatment of acute migraine: a placebo-controlled, double-blind, cross-over study assessing cognitive function. Headache. 2013;53:656–664.

    Article  PubMed  Google Scholar 

  20. Vismari L, Alves GJ, Muscará MN, et al. A possible role to nitric oxide in the anti-inflammatory effects of amitriptyline. Immunopharmacol Immunotoxicol. 2012;24:578–585.

    Article  Google Scholar 

  21. Dave M, Amin AR. Yin-yang regulation of prostaglandin and nitric oxide by PGD2 in human arthritis: reversal by celecoxib. Immunol Lett. 2013;152:47–54.

    Article  CAS  PubMed  Google Scholar 

  22. Bombardier C, Laine L, Reicin A, et al. Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. N Engl J Med. 2000;343:1520–1528.

    Article  CAS  PubMed  Google Scholar 

  23. Claxton AJ, Cramer J, Pierce C. A systematic review of the associations between dose regimens and medication compliance. Clin Ther. 2001;23:1296–1310.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors wish to thank our colleague Greg Brisson, MD, for suggesting we write this case report. We also wish to thank our patient, SS, who graciously gave his time to fill in all the details of his story.

Conflict of Interest

The authors declare that they do not have a conflict of interest.

Author information

Authors and Affiliations

  1. Feinberg School of Medicine, Northwestern University, 1913 W. North Ave, Chicago, IL, 60622, USA

    Mahesh K. Vidula BS, Anil Wadhwani BA, Kaleigh Roberts BS & Lyle L. Berkowitz MD, FACP

  2. Northwestern Memorial Hospital, 1913 W. North Ave, Chicago, IL, 60622, USA

    Lyle L. Berkowitz MD, FACP

Authors
  1. Mahesh K. Vidula BS
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anil Wadhwani BA
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kaleigh Roberts BS
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lyle L. Berkowitz MD, FACP
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lyle L. Berkowitz MD, FACP.

Additional information

Mahesh K. Vidula, Anil Wadhwani and Kaleigh Roberts contributed equally.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vidula, M.K., Wadhwani, A., Roberts, K. et al. Use of a Once-Daily NSAID in Treatment of Cyclic Vomiting Syndrome. J GEN INTERN MED 29, 543–546 (2014). https://doi.org/10.1007/s11606-013-2624-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11606-013-2624-9

KEY WORDS

Search

Navigation