What strong painkillers can I take?

I was going to phone the asthma nurse - but the helpline isn't open until tomorrow.

I have fairly mild asthma, mostly well controlled. I've developed a cold overnight and my peak flow is down today. I'm not coughing which is my usual symptom but my chest feels a little tight. I'm using Salbutamol regularly to try and ward off an attack, can't double up on the preventer as I already take the max dose.

There is an added complication - I've recently had major abdominal surgery. I've been taking Diclofenac as the main painkiller since I left hospital just over 2 weeks ago. I know that if I am having an asthma symptoms I have to stop taking it as it can make the asthma worse, but I'm still in pain and I don't think I can manage with just paracetamol yet. If I get to the point where I am coughing it is going to hurt even more.

I have some cocodamol which I could take instead of normal paracetamol. Is there anything else I can take?

Thanks

14 Replies

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  • Unfortunately i think for anything else you'd have to see a doctor, i'm no expert by any means but i don't *think* there's anything else available without prescription

    Do you know from experience the diclofenac will worsen asthma symptoms or is that just what you've been told? I only ask cos medications affect everyone differently so you *may* be ok with the diclo although obviously if you know for certain it'll be worse then maybe you should stop taking it

  • Hi Jinglfairy

    My GP won't prescribe Diclofenac purely because I have asthma. He took it off my repeat prescription which potentially left me in pain for 6 weeks before the surgery. He only noticed that I was on it because I went to him with a chest infection and he asked what I was taking for the pain. He then gave me a lecture about it being contra-indicated for asthma. Luckily my surgeon seems to know a bit more about asthma and explained that she was happy to prescribe it for me but I mustn't take it on a day when I have asthma symptoms. After the chest infection was gone I was able to take Diclofenac as needed and have taken it 3 times a day since surgery 19 days ago without any problems.

    I'm worried about continuing it now that I do have symptoms in case I make the asthma worse.

    Guess I'll have to see how I get on today and call the out of hours number if needed.

    Thanks for your help.

  • Sounds a bit strange of your GP, my understanding was that asthmatics were either always affected by it, or were never affected by it! maybe i'm wrong about that, i just thought it was a common trigger! Also seems really odd that he gave YOU a lecture, it surely isn't your fault you were prescribed something!!! In *my* experience, i can take ibuprofen (also contra-indicated in asthma) even when my breathing is bad, as it has never affected me. but this is a personal decision.

    I think that the cocodamol is the best you're gonna get without a prescription unfortunately. can you try heat/ice packs maybe? I would rest and then go back to your GP (probably a good idea if the lungs are going downhill anyway) and explain the situation. i would try to avoid the GP that you saw before as they don't sound massivly helpful, and im not sure why they would leave you completely without pain relief! hope you feel better soon!

  • Also seems really odd that he gave YOU a lecture, it surely isn't your fault you were prescribed something!!! !

    That's pretty much what I said to him Soph. I've been on the Diclofenac for a couple of years and the asthma was only diagnosed in November, after a couple of months trialling using an inhaler - by him! I pointed out (in December) that he should have looked at my repeat prescription when he made the diagnosis for potential conflicts or asked me what else I was taking etc. he didn't particularly like me being so assertive about it. He still removed a long term painkiller and replaced it with 1 week with of cocodamol. What use is one week painkillers when it was still 6 weeks until my surgery. Plonker!

    I used the ventolin and then took the Diclofenac after checking my peak flow had improved.

  • I'm with Soph on this and a bit confused by what you've been told. I'm not a doctor but the advice/info I've seen is that some asthmatics (maybe around 15%?) are sensitive to NSAIDs and should never take them, but if you are ok with it then you're ok to take them. HOWEVER I have also been told that it's possible to develop a sensitivity to them even if you were ok before, so you do still need to be aware that they could cause problems at some point. I'd have thought though that if you have times when you take ibuprofen/diclofenac without asthma symptoms cropping up then you probably haven't developed one as presumably if you were sensitive it would always set you off?

    However, I'm no kind of expert so I'd agree that you should go back to a different GP for advice (mine is fine with me taking NSAIDs as I've said they don't affect my asthma, though pharmacy won't always give me OTC diclofenac) - but first I'd go with your original idea of ringing the helpline as they may have more ideas which you can take to the GP and more knowledge about painkillers with asthma.

    Good luck, hope you find something and are in less pain soon!

  • Hello!

    If your pain becomes unbearable in the mean time, please phone NHS Direct 0845 46 47 or NHS247 in Scotland I think.

    They will have health care professionals to advise.

    Be careful with any codeine based meds if you have had any surgery to your digestive tract as codeine can bung you up a bit.

    Take care

    Kate

    x

  • Be careful with any codeine based meds if you have had any surgery to your digestive tract as codeine can bung you up a bit.

    Thanks Kate. I was on codeine for several days in the hospital and was also given some in my take home meds so I know I'm ok to take codeine or cocodamol.

  • Hi Philomela,

    I'm guessing I'm one of the,ones that doesn't react. I have used Diclofenac almost daily since I was diagnosed and also in the months before diagnoses when I was having asthma symptoms. Once I started on inhalers the only time I have had symptoms was whilst I have a cold or chest infection or am exposed to a strong allergen. The mild things that were setting me off all summer seem to be ok but really strong stuff will set me off even when I am otherwise healthy.

    Like you say, if Diclofenac was a problem for me then I would have had symptoms every day. That gives me a lot more confidence to keep taking it. I'll still phone the nurse tomorrow to check what advice they have. And I'll bear in mind that it could become a trigger in the future. Hopefully once I recover from the surgery I won't be in constant pain and won't need to take daily painkillers - that was why I had surgery after all!

    Thank you :-)

  • Hi there,

    Just wanted to say I'm sorry you're going through that. I actually had chest surgery and then got pneumonia afterwards, and my surgeon's assistant kept insisting I should be in so much pain!!

    So I just wanted to say, if you have a cold and can't take the pain med they gave you, I think it would be perfectly reasonable to contact your doctor and explain the situation, as if you are in pain and can't cough right, or can't have a BM right, it can really mess things up.

    I try to take pain medication only as much as needed myself, but find sometimes doctors forget that treating pain IS important to healing.

    In the long run after my chest surgery I was able to get off the pain meds just fine, when my body healed enough. And all bodies heal at different rates anyways. But I will say I'm in the middle of an asthma attack right now, and that scar is still the spot that hurts when I cough. Oh, by the way, I don't know what you're allowed to use, but I was told it was O.K. to use a low level heating pad on my incision to help with pain. I'm not a doctor, but do you think maybe something like a hot water bottle might help in the meanwhile while you figure this out?

    Bee

  • Gosh Bee it sounds like you had a really rough time!

    I was cuddling a hot water bottle in bed last night but it caused all sorts of weird pains so I kicked it down by my feet which is where it normally stays. I did have a wheat bag on my wound yesterday afternoon, it had been heated up a couple of hours earlier so it was only warm really. It felt ok. The bottle was in a really good woollen cover but maybe it was just too hot?

    My consultant is very good when it comes to pain relief, the GP not so much! Hopefully I won't need regular painkillers after this and can go back to over the counter stuff which obviously I can get without having to beg my GP.

  • Thanks Stray. Maybe I'll find that I don't need so much preventer once I no longer need the daily Diclofenac. At the moment it's a balancing act, aside from when I have a cold the asthma is under control so not obviously effected by the Diclofenac. That really would be a bonus if once the surgery pain is done with I find that it not only fixed the problem it was meant to so I can give up painkillers but as a side effect I can reduce my inhalers.

  • Ginger, I'm glad you have a surgeon who cares :). It only takes one doc who gets it. I just say being sick is no fun (of course) but sometimes it just sucks. I hope you keep feeling better!

    Bee

  • Boots sell their own brand codeine + paracetamol, you could have a word with the chemist before buying them too :)

  • I actually did have a ""one off"" pretty bad asthma reaction to ibuprofene. It was actually when my asthma was at its best period at 14 but i had flu/chest infection and the nsaids made it so much worse i got carted off to hossie. But since then and despite now having severe asthma/lung failure i have often taken such meds (currently daily) and find they no longer effect me.

    Also a while ago my 4yr old tummy scars were really hurting just randomly one day. My physio said he thought it would be due to the weather. It got better the next day. And i thought all that sort of stuff was just old wives tales but im not old yet ;-)

    Hope things improve for you soon ginger.

    Rose xx

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