In the past if I ever got any muscular/body aches or pains I use to take an anti- inflammatory Voltaron EC. Usually one dose only was required and the matter resolved.
Currently I am on a low dosage of Ibrutinib which is maintaining my bloods at an acceptable level. Can I still take Voltaron EC or even stop Imbrutinib for 24hrs before taking one dose, Otherwise does anybody know of a simular anti-inflammatory which is compatible with Imbrutinib.
Cheers
I wish it was possible to take any anti-inflammatory whilst on Ibrutinib fossicker but I’m told this just isn’t safe. Not even ibuprofen. It’s causing me severe joint problems but I’m still on full dosage of I&V and don’t want to risk clearing out the malignancy.
I’ve been given topical anti-inflammatory gels but nothing systemic due to the anti-coagulant action of Ibrutinib.
You could ask your Consultant about temporary cessation in your circumstances. I’d be interested in the response.
Regards,
Newdawn
Hi Newdawn, I read your response with interest and would like to ask what are the risk of taking ibuprofen whilst on ibrutinib?
I have just begun to take ibuprofen for joint pain of my own volition as I was unaware this may be a concern 😳
Hi Suzan,
Obviously you must be guided by your own medical team but it’s been made clear to me by three separate haematologists that I must not take anti inflammatories whilst taking Ibruitnib. It represents a bleeding risk and if our platelets are already reduced, it’s an enhanced risk. This explains from the CLL Society;
‘Ibrutinib has a mild anti-coagulant effect essentially equivalent to 325mg of Aspirin. It is important that you provide a complete list of medications that includes any nutritional supplements or over-the-counter medications to your provider. Your provider or the clinical pharmacist assigned to your clinic will review your medication history and make recommendations on items to reduce or eliminate. Some common medications to avoid without provider approval are, aspirin or Non-Steroidal Anti-Inflammatory agents such as ibuprofen, naproxen, or diclofenac; and anti-platelet agents. In addition several herbal products can enhance the anti-coagulant properties of ibrutinib including Omega-3 Fatty Acids (Fish-Oil), Flaxseed Oil, Vitamin E, and Curcumin/Tumeric.’
cllsociety.org/2017/09/thin...
Discuss this with your doctor and please be careful about starting meds without their approval because unfortunately there can be serious interactions.
Best wishes,
Newdawn
Thank you Newdawn, this is really helpful x
Newdawn, thanks so much for this info. You mentioned non steroid anti-inflamitories being not advisable along with Ibrutinib. What about steroids like Prednisolone?
Prednisone seems to be given under medical supervision during Ibrutinib treatment for acute need and the difference is it’s a Corticosteroid as opposed to a nonsteroidal anti-inflammatory. This explains the mechanism of both;
medicinenet.com/corticoster...
I’m no pharmacological expert but it seems that the increased dangers with NSAID’s is the potential for bleeding. They can decrease the ability of the blood to clot and therefore increase bleeding. However, Corticosteroids are immune suppressive, not advisable longer term and are usually given during treatment under very close monitoring and more at times of urgency.
We may have members who are professional pharmacists who can give more detailed information on this.
Newdawn
Thanks so much Newdawn for quick reply. I've never been on Prednisone. I am on IB and months ago, while my specialist was abroad, woke up one morning suddenly unable to move all upper limbs and joints. All. Was prescribed Prednisone but did not take and prescribing Doctor, a Fellow in my CLL Specialists hospital continually advised and examined me, gracefully accepting my decision as he saw minor improvements. For some weeks could do nothing and was able to survive only with grown children's help as husband unwell. Slowly, slowly got better. Before I got better it was said I prob had Polymyalgia Rumatica. Now they wonder????
When my CLL Specialist returned he said he was glad I had not taken the Prednisone. I'd not asked him why as its obvious to me I should not take any extra meds unless absolutely have to. But when I saw your post wondered if there was another more specific reason.
I've noticed your joint problems and know how limiting this can be. How fatigue and pain becomes overwhelming. I've wished you good things often.
Hi Newdawn
Have you been told that topical ibuprofen is ok with Ibrutinib?
I’ve been googling it but couldn’t find anything other than this post.
I’m having joint pain from the tablets (I think) and neither paracetamol or codine is helping.
All the best.
Jamie
Jamie, while there is a concern that ibuprofen can suppress bone marrow production, there's a big difference in the small dose delivered internally from topical use compared to the oral dose. Topical use of ibuprofen should be quite safe, but if you have any concerns, ask a pharmacist.
Neil
Thanks Neil!
Hi Jamie, as Neil has indicated, topical applications are much safer as topical NSAIDs work locally, with systemic uptake limited to around 5%.
Obviously advise your doctor that you are using them but I’ve never been advised not to. If all else fails, a TENS machine can be effective. I use mine when my back pain becomes very severe.
Best wishes,
Newdawn
Thank you!
Hi. I am also on Ibruitnib on the Flair trial. I have been told the only pain relief I can take for back pain which I have been suffering from since my fall fracturing my spine over 2 years ago is paracetamol, if I take it regularly it is helpful.
June
I believe the problem with ibrutinib and using NSAIDS ( non steroidal anti inflammatory drugs)is with further inhibiting our clotting function. Most of us have low platelets and it certainly wouldn’t be advisable to to put another brake on the system. NSAIDS inhibit platelet function so you don’t want your low platelets being inhibited. That being said all of us are in unique situations and each case must be evaluated separately with risk/reward taken into account. I have been on 400mg venetoclax and 140mg ibrutinib for the past 11 months. I had hip replacement surgery 2 months ago and was permitted to take 200mg ibuprofen up to 4 times daily the month before my surgery. I couldn’t walk without it. My platelets were 130 before surgery. After surgery they were 47. I was then only allowed narcotics and acetaminophen. Instead of the usual aspirin regimen to prevent clots after the surgery I had to give myself lovonox injections twice daily for 5 weeks. Bottom line is that each of our situations are unique and you must discuss matters with your providers.
as others have noted, NSAIDs like ibuprofen are a no-no when on ibrutinib. i was warned awhile ago to avoid naprosyn as another in the NSAID family.
So what to do? Acetaminophen (Tylenol) is okay, according to my hemoc. If pain issues get too strong when using acetaminophen, then ask your hemoc about an Rx for something like celebrex. My doc prescribed it for back pain and it is a big help.
Covid - Paxlovid and Ibrutinib 
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one year off Ibrutinib. Still well....
