Is there any pain meds for arthritic pain while on Eliquis?

[donsgirl58]

What medication can I take for arthritic pain (besides extra strength Tylenol) while on Eliquis 5 mgs for A-fib, along with Diltiazem 120 mgs per day?

[jedimasterlincoln]

I have been on ibuprofen for years.... and only recently did someone on here mention none steroidal anti-inflammatories as being an AF trigger. Something I had never heard before or since.

Naturally though, whilst on any anti coagulant, I have been unable to take this or my naproxen for my osteoarthritis due to the risk of GI bleed. The best they could suggest was Codeine phosphate but this is not an ideal option.

They have suggested Tramadol but I want to avoid that if I can due to its side effects.

[donsgirl58 in reply to jedimasterlincoln]

Hi and thanks for your reply. Why is Codeine phosphate not an "ideal option", possible addiction problems?

[jedimasterlincoln in reply to donsgirl58]

Well yes, it is an opiate (body breaks it down and makes it into morphine) in essence but in terms of inflammatory pain it's not going to reduce swelling (and therefore pain) only treat the nerves (neurogenic) pain.

It can also make some people quite dizzy/unwell and constipated.

I tend to use cold treatments like frozen peas and cold packs on my knee when I'm out of options.

[donsgirl58 in reply to jedimasterlincoln]

Ice packs and extra strength Tylenol every 6 hrs is my go to treatments. I have also heard some good reviews on Biofreeze gel which can be bought on Amazon, or directly from the Biofreeze web site.

[Amcech in reply to jedimasterlincoln]

Tramadol has been known to cause irregular heart rhythm. Take it very carefully and as a last resort.

[donsgirl58 in reply to Amcech]

Hi Amcech.....thanks for you input, but I think I will continue to push through my aches and pains minus the synthetic opioids.

[Hidden]

Off topic I know, but a Watchman allows AC to be stopped, a ppi like omeprazole offers protection against GI bleeding with NSAID gels, and pace and ablate can be effective if ablation fails. I suppose it depends whether OA has a greater impact on your quality of life than your AF. Something to discuss with your cardio or EP perhaps?

[donsgirl58 in reply to Hidden]

Hi Oyster...Thanks for your reply. At present, my OA is having a greater impact on the quality of my life, especially since I am convinced that a protracted revision surgery of a failed total knee replacement, coupled with dehydration and stress was the cause of the initial A-Fib event shortly after the surgery. Because the symptoms of the two events that I experienced were completely different, my EP suggested I have a Medtronic Linq recorder implanted as extra protection. So far, thankfully, I have not had to forward any adverse recordings. There are some ongoing studies examining the possibility of discontinuing Eliquis meds and relying on the Linq recorder solely. My hope is that will be approved as the only protection against future A-fib events sooner, rather than later.

[Hidden in reply to donsgirl58]

Bit of a minefield really, stopping AC with low AF burden. Consideration of factors like CHAD2VASC2 score, left atrial size, LASC score and left atrial appendage configuration can come in to play. I suspect that prospective studies will not be conclusive, as will be opinions between the medics. I get the impression here that many feel more comfortable continuing AC once PAF has been diagnosed, not least because it will very likely return unless secondary to something treatable like thyrotoxicosis, and clot formation can occur in a week, sometimes less, so asymptomatic or silent AF could be a problem.

I take your point about the Medtronic recording events, but I wonder if you are notified as well as Cardiology ; if just the latter, then events at weekends, Christmas break, holidays in Patagonia, might lead to a delay.

[donsgirl58 in reply to Hidden]

To continue regarding the Linq monitor. This instrument is not only residing subcutaneously in my left chest, but also a base unit that sits on my night table which is responsible for monitoring from 11 pm to 7 am, usually during sleep. In addition, if I was out of the house shopping, visiting or whatever while out of the house and I experience any symptoms, I carry a key fob that I would place over the linq monitor for a few minutes and begin recording the symptoms. When I arrive home I would place the fob on the base unit & it will transmit whatever was recorded while I was experiencing "symptoms." This information is immediately sent to the EP's office, recorded and a cardiac tech will call me to validate that I transmitted the information. I know this to be true because I panicked one day and transmitted one or two harmless PVC's to the office, and within an hour received a phone call inquiring as to how I was feeling. I have no immediate plans for a holiday in Patagonia, but if I do, my "watchdog" will come along. It's also immune to power failures & adaptable to all foreign types of electricity.

[Hidden in reply to donsgirl58]

Does the system automatically send recordings of AF , which it detects automatically and of which you may be unaware? I am uncertain how well it works when patients are completely asymptomatic. Do you anticipate the 27 minute recording time before overwriting will be a problem for you?

[tinhouse in reply to donsgirl58]

Eliquis protects against stroke as a result of the AFIB it doesn't stop AFIB events happening. I was told I couldn't take anything but Tylenol, however I do take a Celebrex once in awhile for bulging discs in the back.

[Polski in reply to Hidden]

Sorry, I don't follow this Oyster. I thought an NSAID gel was for external use on the joint etc, and very little is absorbed into the blood stream, so why would omeprazole be needed?

[Hidden in reply to Polski]

healthline.com/health/diclo...

The absorption of NSAID in gel form, is very minor compared to oral intake. However with regular and extended use, I believe accumulation can occur, which might explain adverse effects. Though not documented, it must be tempting to exceed the prescribed dose of the gel, particularly if it is not working well and you believe it to be safe. One could see how problems might arise with undiagnosed peptic ulceration PU.

There are a few cases of gastrointestinal haemorrhage after using NSAID gels reported. The link above is to a list of side effects and doesn’t really give any indication of how common they are. For short courses, at the prescribed dose, I imagine they are safe in the absence of a known history of PU. As ever, the pharmacist can advise.

[donsgirl58]

I understand the base unit next to my bed would serve as my alarm system while asleep and unaware of any true AF irregularities as it will communicate with the implanted monitor. My second and last AF episode presented with no symptoms whatsoever until my rate was determined in the ER. That was exactly the reason the system was determined to be of importance to me .... I would feel asymptomatic, but perhaps I was actually in AF. As for "recording time," my results go immediately to the EP's office at the same time as the transmission. In the one case that I received a call due to my sending a transmission, the 30 mns it took to get a call back, was just to see if I was experiencing true AF due to the transmission I sent in error for a couple of PVCs. I'm very confident that if a transmission of a true AF event was received, I would hear from them immediately. Incidentally, if a transmission is received in the middle of the night and the office is closed, the transmission would be automatically sent to my EPs phone at his home and I would hear from him personally.

Having this monitor has alleviated many of my concerns of having another AF event and the real reason I would really like to get permission to discontinue taking Eliquis.

[Hidden in reply to donsgirl58]

Amazing. I had not realised you were in the US!

[Tudee]

I have severe arthritis in both hands and rt hip, as I wish to stay away from analgesia, I have found Castor oil hot packs very effective, I am virtually pain free in my hands now. I use Holland and Barrett Pukka organic, hard pressed, hexane free castor oil, it’s a life saver and cuts inflammation. It has been used for centuries in Asia.

.

[Buffafly in reply to Tudee]

My MSK suggested heat treatment with a wheat bag or similar as I have the same problem as posted, told I can't have a hip replacement until there is no movement in my hip 😢

[Polski in reply to Buffafly]

(Have you sought a second opinion on this? - I'm interested as I have osteoarthritis in the hip too. I'm not seeking help now, but I didn't think it had to get that bad . . .)

[Buffafly in reply to Polski]

Seen two different MSKs and now having physiotherapy (as in given exercises to do at home) and all looked at old x-rays and said not too bad and wouldn't order a new one. The sad thing is that I was offered a hip replacement seven years ago before I had an operation on my spine (degenerative scoliosis) but my hip pain improved after the other op and now the criteria are much stricter. Unfortunately the OA in my lumbar spine is getting worse and I'm regularly getting a nerve trapped which is agonising, all a bit complicated. I'm thinking I might see my old surgeon privately if things get worse. I think they should take into account how limited my painkiller options are, paracetamol only 🙁

I don't know if different areas have different rules maybe?

[Zabadak]

Your question about pain meds and Elquis. If you are on an anticoagulant there is a higher risk of gastric bleed with diclofenac or other nsaids. Also diclofenac is now not recommended for people with heart issues. I miss being able to use that as a top up. But it’s not just about the Anti coagulant. My friend does not have AF but her Gp refused to give her diclofenac , and she has been forced to take tramadol.

[Maclan]

I know very little about drugs and there side effects however my GP prescibed amitriptlyne for pain relief (carpal tunnel syndrome) while on Apixaban which took away the pain but made me manic and paranoid so I couldnt continue with the treatnent I'm not sure if it's an anti inflammatory though

[Hidden in reply to Maclan]

arthritisresearchuk.org/art...

Amitryptilline is a powerful antidepressant with unpleasant side effects at the doses needed to treat depression. It is not much used now for depression, since the advent of better tolerated meds. It is not an anti inflammatory.

I believe that it is still used at lower doses as an add to analgesics for rheumatological conditions.

[eleanor--1941]

Hello,

I have Osteoarthritis from head to toe.30yrs now.

I was prescribed the strongest Co.Codamol,I refuse opioids.To get the benefit I was advised by my doctor,must take full dose.30/500,whether I think I need them or not.

2 capsules, (they act faster,)every 4hrs a day,total 8 daily.People keep away from these,, as they get the name of severe constipation,I make sure I eat plenty of fresh fruit,veg,wholemeal etc and have fibre sachets on prescription,which help a lot,if needed.Best thing I have done,worth a try.

Hope you keep better soon.

Eleanor,X