My orthopedist prescribed a one month course of daily Meloxicam (Mobic) for my shoulder pain. Mobid is an NSAID like Ibuprofen, Advil, Alleve, etc. Both my primary doctor and EP were concerned because I'm on the blood thinner, Xarelto. The pharmacist said the combination OK as long as long as it wasn't taken daily for over a couple of months. I am aware of the online warnings . What I'd like to know is if anyone here in the same position and what are you doing for pain while on thinners?
Jim
I take CoCodamol ....codeine/paracetamol...for pain relief. NSAIDS are really not advised at all. My husband went into fast AF after just a few days on Naproxen. I caught this on my Kardia device as he felt something was going on (!). Stopped taking them and no more problems.
I think I'm correct in thinking that the main problem with the NSAIDs is that they can promote arrhythmia s regardless of whether you are taking anticoagulants
The problem we face is that a consultant in one field may not be aware of drug interactions in another. I take Apixaban and both my cardiologist and GP warned against anti-inflammatories for back pain. I was prescribed co-codamol high dose for short term use.
The problems with NSAID's are twofold for people with AF - they actually cause AF and they increase the effectiveness of anti-coagulants, with potential bleeding problems. Having said that, some members do use NSAID's for chronic pain. I would be guided by a physician aware of both AF and the need to treat pain short term.
On the day i was diagnosed with afib my cardiologist asked if i ever took NSAIDs, yes i said regularly for neck pain. Never take them again i was told as they are contraindicated for people with arrhythmia. My later cardiologist asked and said exactly the same thing.
I am now on Xarelto too but never taken another NSAID from diagnosis back in 2009.
Never mind any contra indications for anticoagulants. NSAIDs have been shown to be a CAUSE of AF so must be avoided.
I’d be concerned because you have AF, the anticoagulants is just another layer - NO!
I also take CoCodamol for a torn muscle in the shoulder and warned by cardiologist not to take nsaids.I don't find these alternatives help very much so am having a cortisone injection soon that should do the trick.
NAISDs we’re definitely the cause of my gastric issues 16/17 years ago and is now thought it may have been the cause of my Afib which started about 16 years ago too. All it took was a 2 week very high dose of Nurofen following dental surgery in hospital and prescribed by consultant. When GP found out some months later he went ballistic and said the damage was now done! I now have NAISDs written on the red allergy band any time I’m at hospital and always state it on any form I have to indicate allergies. Paracetamol or Paracetamol and codeine is my go to these days if needed and recommended by GP and pharmacist if NSAIDs a problem. Have been on Apixaban anticoagulant for 5 years. xxx
Maybe you can take CBD instead.
I have used CBD extensively in the past for inflammation. Worked great for me. My friend also used THC ( indica) in gel and chocolate infused form for post surgical pain, and it also worked...and he did not feel any euphoric or "high" effects. Of course CA eat being *consult your physician* ...and, it is legal here in Canada, but may not be where you live
And as far as drug interactions and questions in general, our Pharmacists are the oracles of all things medicinal, for both patients and doctors. It is what they do for a living, so they are highly trusted. Again, maybe not where you live, and I can only speak for ours. We can walk in for a chat, or call them.
NSAIDS can be tricky even without AFIB or any other medical issue. When I was in my 30's I had wrecked my shoulder playing squash. The doc prescribed 400mg of Ibuprofen *as needed* ...it caused cluster headaches( Google it) and being that I'd never had a headache in my life, I was at a loss. Once I stopped taking them, it stopped and never returned.
Avoid nsaid's. I have been on co-codamol for the last three months with my shoulder injury. I found that if I take the full dose for about five days then slowly come off them for another few days my pain is manageable without them. The trouble is sleeping. I am now just talking them to get some sleep. I have just had the results of my MRI scan. Arthritis, a torn tendon and lots of loose bodies floating around. It's the loose bodies that impinge the joint and the pain is of the chart. Go look with your treatment.
Hi Jim, I am on sotalol and apixaban and have just been diagnosed with polymyalgia having suffered shoulder pain. Blood tests revealed high inflammation markers. I have been told no to NSAID and have to have steroid treatment on with diazapam to relax muscles
A doctor said it was OK for me to take Tramadol for severe neck pain and I am on Xarello. It certainly helped with the pain which was almost unbearable without the Tramadol however it really made me spaced out in a strange and not pleasant way. I had to stop after three days as it effected my Sleep Apnea episodes , using Cpap I record 3 a night whilst on Tramadol it was almost 20 episodes an hour so had to stop fortunately my physiotherapist managed to get the pain under control having 3 sessions a week,
I too have problems with tramadol. Doc prescribed co-codamol for bad pain. Panadol for intermediate pain but try very hard to only take anything when absolutely necessary.
I take Tramadol 50 mg for my hip pain. It was prescribed by my surgeon post op after I had the right hip replaced . I did not need it much for that but now the pain in the left hip is very bad and my next op isn't till Sept. I find it works better than Paracetamol with opium powder which my GP prescribed prior to the op. My body does not get on well with Paracetamol and it does not work much for the pain. I only take the Tramadol two or 3 times a week and never more than one capsule a day. The only side effect I have noticed is mild nausea when it starts to come on and later on a feeling of bloatedness and wanting to burp. But I get this worse with Paracetamol.
I am so sorry you are going through this. Pain is very debilitating. Good luck
Thank you. Yes pain is debilitating but I used to be a dancer before I retired so I am used to skeletal pain. I am looking forward to having my left hip replaced as the right one has been successful and the recovery was far less trouble than I expected. It left me with one leg longer than the other which will be corrected in the next op and I will have to get used to being able to walk correctly again. I have limped for a long time now! Like you I try to limit painkillers and it would be a reliefto take them more often but they are all poison for the body.
You can be confident that your orthopaedic specialist knows of the potential risks involved in your short term use of meloxicam. I would imagine he has a lot of experience of the use of this drug in patients taking anticoagulants.
Have you, however, considered other possibilities such as coping with the shoulder pain until the bursitis heals naturally or using topical treatments such as heat / ice pads or anaesthetic or anti-inflammatory gels?
I have no medical training so I cannot offer any advice except from what I have read and my general advice to trust you doctors. I know that meloxicam is a highly regarded newer anti-inflammatory that achieves its effects somewhat differently from older drugs. The evidence for its use along with anticoagulants isn't clear cut so, far as I can read. Usually, these drugs are given along with a PPI drug such as omeprazole to protect the gastric lining from erosion. Again, from what I have read, the evidence for this combination seems strong.
In the end, it is you who have to deal with your shoulder pain. When I had this, I was not taking rivaroxaban and I was able to use occasional naproxen. Frankly it didn't do much for me. I was also given diazepam for the muscle spasm, but, again, without much success. In the end the shoulder healed naturally but, if I recall, it took over a year.
Steve
I use a homeopathic cream called TOPRICIN for knee, back, and shoulder pains. Works well for me ... might not work for everyone.
I won't take NSAIDs .... If you do, I recommend drinking plenty of water as they are terrible for the kidneys.
My cardiologist and I decided that my use of NSAIDs precluded using a thinner, so I’m just relying on my aspirin for that aspect of my afib treatment.
I am in PAF have chronic lower back pain and have taken Diclofenac for years and following a TIA 18 months ago I am on Apixaban and Omeprazole. The Danish study of people wth AF on short term use NSAIDS has caused some Drs to be cautious about NSAIDs but after experimenting with various pain relievers I am back on Diclofenac, pain-free and bleed-free. It works for me. It's all about quality of life surely and I and my Drs agree this is ok. I say 'if it works - go for it'. Good Luck!
Personally, I wouldn't touch them. I use paracetamol or once, I've used co-codamol when I needed something with more oooomph.
Thank your all for sharing your opinions and experiences.
My initial concern was not that NSAID's were pro-arrhythmic, but of the increased bleed risk when taken in combination with a thinner. In my case, pain -- especially neck pain -- is an afib trigger, so I have to weigh the risks of a drug that has the potential to be pro-arrhythmic, to the benefits of reducing a primary afib trigger, not to mention the benefits of helping my neck/shoulder rehab so I can improve the quality of my life.
Going back to the risk of bleeding, professional opinions seem mixed with short term use.
For now, with my EP's blessing, I've decided to give the Meloxicam a short trial while discontinuing the Xarelto. If I need a longer term solution, I will discuss other combination approaches with my doctors. Arguably, I could have continued both the Mexloxicam and Xarelto short term. As to switching to a different class of drugs such as opiates, I do plan to having that discussion as well with my orthopedist.
I forgot to mention that I am also on a strong PPI, Dexilant, which also can figure into the equation.
Jim
NSAIDs cause internal bleeding with blood thinners. Been there !!!
I ended up in the hospital by ambulance after taking an NSAID (Naproxen) with my Eliquis. Don't take a chance.
I have rheumatoid arthritis as well as AF (lucky me!!). So I’m on NSAIDs and rivaroxaban and experience no problems. Hope this is helpful.
I'm in persistent AF and have been for some time now. It's probably permanent.
Early on, when it had just gone persistent and I ended up for a day in hospital getting rate control sorted etc. I spoke to the hospital pharmacist about Ibuprofen because it is the ONLY pain killer that can stop a migraine for me. She said provided I took them with food and didn't do them very often it would be OK.
So I use them for migraine. But I usually only need 2 tablets at the start to sort it out. Paracetamol does nothing to help and Paracetamol and Cocodamol make me feel ill. I only get a migraine every few months normally, although I've had a few more recently but I think I know why. So I don't need to take many Ibuprofen a year. But some are pretty essential.
I have taken 2 to 4 Advil every day for neck and knee pain and for TMJ I am also on blood thinner! My cardiologist never told me to stop nor did my EP and I have been doing this for 4 years! I do not seem to have problems with the combo but will certainly talk to my EP and my Cardiologist now!
I’m on warfarin and am warned against NSAIDs so when my back is very bad (slipped discs) I turn to Cocodamol but it makes me feel very sick. If I have an unshiftable headache I will sometimes take 1 paracetamol 1 nurofen and a cup of strong coffee. Works a treat but I do this very rarely.
Blood thinners
stomach ulcer and blood thinners 
Blood thinners and diarrhoea
