Iboprofen

[Mugster]

Currently in hospital after a knee replacement op. They want to give me ibuprofen as pain relief. I thought this was a no no for AF PATIENTS currently in NSR?

[Wightbaby]

Well, i should query that.....I have been told I can take paracetamol and cocodamol but NOT Ibuprofen!! They should know this...surely!!

[Finvola]

Anti-inflammatories are known to cause AF, especially in people over 55. I was told to avoid all of them too but that was because of Apixaban. My GP prescribes co-codamol if needed, otherwise I take paracetamol.

[10gingercats]

Sounds to me they do not have your notes to hand .i also recall being told not to take Ibuprofen.

[wilsond]

No!!! D0 not take it! I did a few years back,didnt know there was a problem and had a terrible AF attack.

Beggars belief that they even suggested it!!

I would love to do a national tv ad or programme about AF,in the hope of educating some of those meant to be looking after us!!

Im hoping you resisted the offer.....

[meadfoot]

Steer clear of them. I was told never to take them again after being diagnosed with arrhythmia. Before diagnosis I had been taking them daily for headaches and wonder whether they had triggered my af initially.

[Hidden]

I was told they were forbidden .....IF a patient was on Warfarin.

I had knee replacement surgery and it was never, not ever, offered to me and my consultant knew I was an AFer and on Warfarin.

I was kept on CoCodomol 30/500.

[BrettonLass]

I take Ibuprofen with no problems - my PAF is well-controlled and I'm usually in sinus rhythm. Ibuprofen has been prescribed for me several times without it causing any contraindication/interaction warnings to appear on my GP's screen.

[Mugster]

Dont think its in my notes. According to the nurses they routinely give ibroprofen to all orthopaedic patients including many with AF, pacemakers etc because it's an Anti inflammatory

[cassie46]

I have had arthritis for years and used to take Ibroprofen (possible caused my AF), we all know it is anti inflammatory but not suitable for people with AF. I have been prescribed Co-Codomol 30/500 for pain relief, not as effective but all that is available. When I had breast cancer surgery it was noted no Ibruprofen because of AF and was given a few doses of morphine after op then Co-Codomol. Which hospital is this, seems very odd to me to make such a statement.

Cassie

[icklebud99]

Absolutely NO NO NO do not take ibuprofen, there is a proven link it causes AF. Can also cause stomach bleeds if you are on anticoagulation so again. NO. Paracetamol seems to be ok but check with your cardiologist or EP.

[Mugster]

Thxs for all the replies. I did resist it. I told the recovery nurse I wanted to discuss it with s doctor b4 taking. Of course at this stage they are also giving me liquid Morphine so not an issue for pain relief.

Btw I am in NSR since my ablation last May but still a risk, especially at that point she thought I might have reverted to AF (looking at her monitor)

[Pammie9 in reply to Mugster]

This is not the first time I heard! It also happened to me when I had my two knee replacements. They did not check with me but just gave me ibuprofen. I said hang on, what’s this? When I told them I got AF, they were taken aback, told them to read my bloody files! They are too busy to check! We need to keep reminding them to make sure!

[jedimasterlincoln]

All NSAIDs (Nonsteroidal anti-inflammatory drugs) (Like Ibuprofen, Diclofenac and Naproxen) carry a risk of increasing your AF problems.

There was a study which I shared either as a post or as a response on here last year which showed that the risk of AF episodes on Ibuprofen was the higher of the three drugs mentioned above, about the same with Dicofenac but reduced with Naproxen. It also reduced further when you're on Naproxen longer than 12 weeks.

I think from memory the figures were in the hundreds for Ibuprofen, just under the 100s for Dicofenac and something like 14/16 for Naproxen out of all those tested.

I'll try to find it when I have more time. I've been on Naproxen for Osteoarthritis of the right knee (Cricket Injury) for a few years now, but in the "early days" I was on Ibuprofen very regularly (I was football coaching back then) and I did wonder if this was a factor in the AF (as well as energy drinks to get me through 12 hour shifts and 10 day stretches).

Of course one massive NO NO NO is the contraindication that NSAIDs have with those on anticoagulants such as Apixaban and Warfarin. They present a higher risk of Gastro-intestinal bleed which is why you should always have a PPI (Proton-pump inhibitors) prescribed like Omeprazole to limit the production of stomach acid (when not on anticoagulant) and they should be avoided at all costs when taking an Anti coagulant.

When I am on anti-coagulants I'm given 30mg-60mg Codeine to take when needed (I take it regularly on and around active days)

Post knee replacement you should be given Paracetamol, Codiene and Oramporph. You should take the paracetamol and Codiene regularly (you can take it together) and use the Oramorph for breakthrough pain outside of your normal dose times.

If that doesn't work you can take your Paracetamol and Codiene 2 hourly (ie Take the Paracetamol at 6am, the Codiene at 8, more paracetamol at 10, Codiene at 12 and so on until the max dose per 24 hours is reached) with the Oramorph between times (usually 4-6 hourly)

With that in mind, you shouldn't necessarily need the anti-inflamatories. Keep the joint moving, ice for no more than 20 minutes every hour if inflamed (frozen peas or crushed ice cubes in a freezer bag applied to the joint wrapped in a teatowel)

Good luck!

[Profound15]

Just to emphasise the point about ibuprofen I took two just before Xmas after being in nsr for three months and I ended up in afib. Had to end up in a&e to get me back. Spoke to my cardio last week and he advised paracetamol or codeine. Probably affects most of us but not all like anything else. My take on it is if you have the vagus nerve link don’t take it.

[Hidden]

Good news is that I had a knee replacement in May & am now walking a mile or two a day without even thinking about it. I have a matching pair now, the other one was done in 2016.

Setting aside AF, there are now conflicting views on Ibuprofen and although it was prescribed this time, (wasn’t diagnosed AF until July 2018) they advised me not to take it as it can increase the risk of post op bleeding/bruising. Suggest you don’t take it as it’s not recommended any way with many AFMeds or anticoagulants.

I’m lucky that I seem to have quite a high pain threshhold and after only 24 hours on OxyContin, I transferred to a regime of codeine 15 or 30mg depending on the pain, with 2 x 500mg paracetamol in between. I would recommend this rather than co - codamol as it kept the pain at bay better taking something every 2-3 hours. I was off all painkillers this time at about 6 weeks. Last time I still required painkillers at night for several months, though in other respects both recoveries were similar and have changed my life. How lucky we are to live in times where this surgery can be done.

Just saw Jedi’s reply above & have to disagree over the Oramorph which is likely to ‘send you away with the fairies’, make you dizzy, miserable & sick & stop you doing your exercises. Where I had my op they wouldn’t send anyone home on it anyway.

I got up & walking with sticks as soon as I could and did every exercise as planned, trying to increase the range of movement a little each time. (Don’t worry if you can’t even get your foot off the floor for some exercises, just try & it will gradually improve each day. Also try to increase the distance you walk each day.

Hope this is helpful

Pat x

(female age 64)

[Sandyc2705]

I have PAF and had no episodes for nearly a year when I started to include ibruprofen in my pain management for a prolapsed disc in my neck

I had two episodes in two weeks and the ibruprofen was the only thing I had changed

No ibruprofen since and touch wood no more episodes

[Barb1]

Every time that I am in hospital ( 2 hip replacements, sepsis, spinal surgery) they try and give me an NSAID and I have to explain why I can't take it. This has been going on from 2012 until just before Christmas for me. Whenever I am given medication to take or an IV drip, I ask what it is and have stopped some mistakes being made. What worries me is if I was not aware enough to make the staff aware.

[Mugster]

Worrying isn't it. How do we get them to change policy?

[Ianc2]

Unfortunately it usually involves m'learned friends..