Pain medication.

[GazzaD57]

Dors anyone know if i have to be careful what pain medication i take if I'm on Apixaban and Metaprolol? 

[BobD Volunteer]

Normally paracetamol is fine but if you have AF you must never take Ibuprofen or any similar . regardless of what drugs you may be on since Ibruprofen is know to be a cause of AF. Codeine should also be fine in small doses. 

[Ialla in reply to BobD]

My EP also said that low dose codeine is the safest choice.  Here in the US it is by prescription, but I have bought it over the counter in the UK.

[Finvola]

Anything aspirin based or any of the anti-inflammatories normally shouldn't be taken with Apixaban (which I take).  My GP advised paracetamol for mild pain and prescribed co-codamol for toothache.

[cassie46 in reply to Finvola]

I have a lot of joint pain and my doctor prescribed Solpadol (30mg Codine/500mg paracetamal) same as Co-Codamol.   Since AF definately no Ibrupofen or any ati-inflammatary drugs. They do not work as well as anti-inflammatory meds.    Oh he did give me Tramadol once  when I had really bad pain but it sent me away with the fairies!

[CDreamer in reply to cassie46]

Ginger is a very powerful anti-inflammatory - I include 1/4 in of peeled ginger into a morning smoothie and also take at least 1gm of Glucosomine daily (on advice of arthritis Dr) and have found this has greatly reduced the amount of inflammation and therefor pain.

I don't take any meds.

[CDreamer in reply to CDreamer]

Should read painkillers! Loads of meds but no painkillers.

[angell1950]

I take apixaban and dr prescribed co-codamol for me : it works well to easy pain and safe with apixaban 

[ILowe]

The golden rule is that those on anticoagulants do NOT take NSAIDs except under strict rare medical supervision. 

But, the BNF says, chapter 10, "The selective inhibitors of cyclo-oxygenase-2, etoricoxib and celecoxib are as effective as non selective NSAIDs ... Short term data indicate that the risk of serious upper gaxtro-intestinal events is lower with selective inhibitors."

Check the INR interactions if you go down this route.

health.clevelandclinic.org/...

we advise they take a PPI (proton pump inhibitor) as well for stomach protection, since most bleeds are from the gastrointestinal (digestive) tract,” .

So, there are selective NSAIDs that can be tried, with a PPI for stomach protection.