Medications causing mouth ulcers? - British Heart Fou...

British Heart Foundation

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Medications causing mouth ulcers?

EU95PTM profile image
29 Replies

Hi there, I’m on 9 different medications: Dapagliflozin, Bisopropolol, Aspirin, Clopidogrel, spironolactone, warfarin, atorvostatin, lanzrapole and ramipril and I’ve been taking them since late April following a HA. I’ve felt generally well apart from fatigue but in the last 6-8 weeks have developed really painful, recurrent mouth ulcers and my mouth seems super reactive to even the slighest trauma or rough textured food (eg toast). Eating and drinking is incredibly sore and even speaking isn’t comfortable, so my doctor prescribed a numbing spray (Difflam) but that provides only temporary relief and I have to use painkillers as well to get control of the pain. I’ve never had so many or so frequent ulcers in my life and no sooner does one go, another develops. Has anyone else had similar symptoms on these drugs? I’ve checked the patient information leaflets but none list mouth ulcers as a side effect.

I will be getting in touch with my GP again next week but wanted to know if anyone else has experienced the same and what the cause was?

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29 Replies
Anon2023 profile image
Anon2023

Hi. I feel for you as they must be very painful. My husband gets frequent mouth ulcers and they found that he had a vitamin b deficiency. Might be worth getting your bloods checked. It could also be caused by toothpaste as a lot of them contain Sodium Lauryl Sulfate which is really harsh. I think ultradex toothpaste doesn’t contain it and it is low abrasion, it’s available in Boots but is about £6 a tube. My sister had Bechets syndrome (I’m not suggesting you have this though) and she said the only thing to do with mouth ulcers was to rinse regularly with warm water with salt in it. I hope you get to the bottom of why you are getting them. Best wishes.

EU95PTM profile image
EU95PTM in reply to Anon2023

Thank you, that’s really useful suggestions

Anon2023 profile image
Anon2023 in reply to EU95PTM

No problem, let us know how you are getting on.

nellie237 profile image
nellie237

I'm not medically trained at all, but has your GP run any blood tests to try and find an answer?

EU95PTM profile image
EU95PTM in reply to nellie237

Not yet, but I’m having FBC, Lipids, HBA1C and Kidney function tested next week. Maybe that’ll throw up some ideas?

nellie237 profile image
nellie237 in reply to EU95PTM

Fingers crossed.🙂

Wooodsie profile image
Wooodsie

Hi, can I suggest he uses cordosile original to mouth wash day and night. Also, believe it or not, manuka honey rubbed on the ulcers is proven to get rid of them. Used together, hopefully he will get some relief.

I'm not qualified to say, but I haven't seen many people on here blame their medication for causing ulcers, I do get more than I used too, but never connected them with the tablets. Well worth asking the Dr, or even a good dentist,

EU95PTM profile image
EU95PTM in reply to Wooodsie

Thank you, I’m using a Colgate mouthwash currently but will look at others

Heythrop51 profile image
Heythrop51

I associate mouth ulcers with being run down. How are you on yourself? Feeling well, healthybalanced diet, exercise, fresh air, not overdoing screen time, etc.

EU95PTM profile image
EU95PTM in reply to Heythrop51

Yes, there has been stress in my life but I’ve been exercising with the cardiac rehab team 3 x per week and trying to keep active when my energy levels allow. Diet good with plenty of fish and chicken and veg/fruit with the odd treat here and there.

Mountwood profile image
Mountwood

Good morning. I have found a certain mouthwash very good for stopping a mouth ulcer from developing. I have some blocked salivary glands which I sometimes bite by mistake and a mouth ulcer will start to develop but Listerine stops it every time. Good luck.

EU95PTM profile image
EU95PTM in reply to Mountwood

I’ll take a look at this one. Thanks

Oldspider profile image
Oldspider

Possibly a Vit B12 deficiency. I need a large dosage to keep ulcers/lesions at bay. Maybe your gp could include a blood test for this. Nothing to do with meds in my case.

EU95PTM profile image
EU95PTM in reply to Oldspider

Didn’t know this but worth looking into. Thanks

Silvertail profile image
Silvertail

I have had mouth ulcers on and off most of my life, but Nicorandil gave me ulcers non-stop so I had to stop it. (It is listed as one of the side effects.) Strangely enough, I don't seem to get many any more. They are terribly painful - I do hope you can find the source of yours.

EU95PTM profile image
EU95PTM in reply to Silvertail

Thank you, I’m sorry to hear that you suffered too. It really feels so debilitating at the moment I really want to get some relief and respite.

Silvertail profile image
Silvertail

Hi again. I’ve just looked up side effects of dapagliflozin and one is thrush. That may be the culprit. I forgot to say I found Difflam to be the best thing I've tried so far and I've tried everything.

EU95PTM profile image
EU95PTM in reply to Silvertail

Ok, thanks. I thought thrush was for ‘down below’ but I guess it means for the mouth too. I will see what the symptoms of thrush are.

Silvertail profile image
Silvertail in reply to EU95PTM

Certainly can be in your mouth. I hope your doctor sorts it out for you.

Dixy profile image
Dixy

My husband had the same problem of huge mouth ulcers. He saw an Oral consultant in Maxillofacial who checked all his medication and had a biopsy (all clear). He said any medication which could cause a rash could cause mouth ulcers, basically a rash in your mouth. As he was on a lot of different medication which could not be stopped he said the only thing to do was treat the symptoms. He said tablet 1 could be reacting with tablet 2 or 3 or 4 . The permutations were endless and probably the cause couldn't be found. Eventually the symptoms eased but he still gets the odd one now and then.

EU95PTM profile image
EU95PTM in reply to Dixy

I’m sorry your husband suffered too but pleased it has improved for him. I do hope there is some respite for me soon too!

Dear EU95PTM

Welcome to your first, of what we hope will be many, posts on this forum.

While I found your post very interesting it is something that I have not suffered from.

But what I have had regularly is a shedding of the lining of my mouth so maybe that could be a precursor to ulcers ?

I contacted my Heart Nurse about it and was told that it is a common side effect of some of the medication and not to use a certain mouthwash I was using as it was to strong, Listerin Original { I like the taste }

It happens a lot less now { but has not fully stopped } pickled stuff can do it so can a very hot drink.

I have not a clue if this can help in anyway, but without answering your post I will never know.

Take care and please keep us informed.

EU95PTM profile image
EU95PTM in reply to

Thank you. I’m being really careful with food textures (only soft foods) and nothing acidic or salty or too hot. I’m hoping this will help.

Trecam profile image
Trecam

Hi, I had a severe allergic reaction affecting my whole mouth. In my case, it turned out to be caused by Ramipril. I had been taking it for a few months, so was not an instant reaction. The GP told me to stop taking it immediately and thankfully I have not had this issue since. I do hope you can find the cause of your mouth ulcers because I know how unpleasant this condition is.

EU95PTM profile image
EU95PTM in reply to Trecam

Wow, that sounds awful too. I really want to discover the cause but I’m not hopeful. Just spoke to a pharmacist who couldn’t offer any new suggestions.

edplayer profile image
edplayer

Hi, I feel for you because mouth ulcers are a total misery and as you say stop you wanting to smile, talk and, eat and can be hideously painful. I've had recurrent mouth ulcers all my life including before and after starting various heart medication. Dentists and Doctors mostly had advice to try things that just didn't work. A couple of years ago I decided to really work at finding solutions and I've had some real success at controlling them much more effectively. It sounds like quite a regime but its actually not much to do to reduce all that suffering.

Here is what works for me:

I take a high dose under the tongue Vitamin B12 supplement every day. This has been shown to be effective in a randomized, double-blind, placebo-controlled trial even when the subjects B12 levels were normal. You need to be patient and consistent though: the effect was shown over 6 months.

pubmed.ncbi.nlm.nih.gov/191...

During an ulcer outbreak I avoid eating any "sharp" or abrasive foods such as crisps, crusty bread or anything that might nick or scratch the lining of my mouth and trigger an ulcer.

When I have ulcers I use Gengigel Mouth Rinse and / or Gengigel Gel directly on the ulcer - its soothing and reduces healing times. These products aren't cheap but really help.

I always use an ulcer friendly toothpaste such as Squigle Enamel Saver Toothpaste. This is a flouride toothpaste that is SLS free and contains 36% Xylitol. Many suffers find this toothpaste helps and is at least much less painful to use when you have ulcers.

Twice a day every day, whether I have ulcers or not I wash my mouth for 2 minutes with about 20ml of Aloe Vera juice. This seems to promote healing of any minor nicks in my mouth lining before ulcers start to form. Personally I found swallowing the aloe vera juice had a greater effect. But read the label, use a quality product and don't exceed the dose.

Following this regime has hugely reduced my ulcer problem. I still get them but much less often, they are smaller and less painful and go away more quickly.

For me analgesic products like Bonjella are excruciating to apply, reduce pain for no more than 30 minutes at best and make the ulcers bigger and last longer. I never use them.

You can find some of these products from a great online store mouthulcers.co.uk which is also a source of good info about ulcers and many other products that might help.

Good luck!

EU95PTM profile image
EU95PTM

Thank you, I really appreciate this comprehensive reply. I’ll certainly be looking into your suggestions.

Rovelli profile image
Rovelli

Hello, I've just seen your post. Are you on the lanzaprole for acid reflux or hiatus hernia. I get mouth sores and ulcers from acid reflux, and when I was on the other "prole", omezaprole, my food sensitivities were even worse.

EU95PTM profile image
EU95PTM in reply to Rovelli

Thanks for you reply. The ulcers have cleared now and I think were triggered by stress. Corsodyl mouthwash really helped.

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