Allowable NSAIDS

[RickHow]

Hi. I have stage 3 CKD (changes between 3a and 3b with each blood test). I also have cancer treatments (Keytruda). The Keytruda has caused pleurisy in the lungs. Mild but causes chest discomfort and mild shortness of breath with stair climbing, etc. My PCP today diagnosed the pleurisy but was in a predicament. NSAIDS should be avoided with CKD. But he was not familiar enough with the Keytruda implications to know the proper thing to do. For "normal" pleurisy he would prescribe NSAIDS. Or some steroid medication (steroids are not allowed with Keytruda). So since I have an appointment with my oncologist soon he just left it up to her judgment. We can't stop the Keytruda. Steroids would cancel the Keytruda effectiveness. So this leaves NSAIDS. Anyone know of any NSAIDS (over the counter or prescriptive) that are not too harmful to the kidney. For now, short term until appointment, I'm taking Ibuprofen. Short term won't damage the kidney. Advice?

[Catpuss66]

I didn’t think you were allowed any NSAIDS at all with stage 3 . How much pain are you in? Are you in the Uk? If you are I would ring the oncologist secretary and speak to her she will speak to the consultant and get back to you. In the US sorry Not much help there. Hope it get sorted soon

[Bassetmommer]

HI Rick,

Sorry you are going through so much. NSAIDS are not good for CKD, that is true. Ibuprofen is ok, if it works for you. I would ask your doctor how long he thinks you need to be on the NSAIDs and if he can recommend something else. But unfortunately, there are few pain meds that for long term use that are ok for CKD.

[RickHow in reply to Bassetmommer]

Thank for your interest. I'm taking the ibuprofen until Thursday when I have the appointment with oncologist. I am hoping for one of 3 options. That she says take the ibuprofen for 2 or 3 weeks and see if the pleurisy clears. Or she will prescribe some low dose steroid that will not influence the effectiveness of the cancer medication. OR best of all there is some medication, we do now know about, that could help the pleurisy and not bother the cancer med. I'm not a highly religious guy. But I sometimes joke the "powers that be" decided to give me CKD. They saw that it was not debilitating enough so said, lets add some cancer to the mix. Then they saw that was not debilitating enough, this guy (me) is too tough. Let's add in some pleurisy. lol.

[Bassetmommer in reply to RickHow]

HiRick

Your sense of humor is going to see you through this. I wish you the best.

[WYOAnne]

Sorry for all of your health problems!

I have had a transplant and have gotten the OK to take NSAIDS on a short term basis from my nephrologist over the years. I believe 2 weeks was the longest I was allowed to take them.

Keep us posted! Prayers....

[RickHow in reply to WYOAnne]

thanks

[Celtic]

Hi Rick, I wondered whether a one-off steroid injection (Depo Medrol) would interfere a bit less with the Keytruda than a course of oral steroids? Perhaps a phone call to Macmillan would give you the answer or at least some advice re a possible NSAID that would be gentle on the kidney?

I know how you feel about having what must feel like the kitchen sink thrown at you with regard to all the health problems as hubby is fighting prostate cancer that has spread to the bones on top of shingles damaged nerve pain around his eye, a respiratory virus, not to mention the side effects of the Radium infusions.

Good luck with the Keytruda and hope you soon get relief from the pleurisy pain.

[RickHow in reply to Celtic]

and good luck to your husband.

[Uckle]

National Kidney Foundation reccomends Acetaminophen for pain . Availble at Amazon.

Best wishes

[RickHow in reply to Uckle]

yes I take that for the mild cancer pain. I try to avoid my oxycodone if possible. But it does not act as an anti-inflammatory. And pleurisy is inflammation. Thanks for your concern.

[cmumbles]

So sorry,looks like your stuck between a rock and a hard place. NSAIDS caused my ckd, took for 30 years. I won't take them or steroids. Not a good person to give you advice. I use Rumalaya Forte which is made by Himalaya Herbs, it has reduced my sed rate to nil and keeps my horrible arthritis pain under control. But it could be the wrong thing for you. Really sorry.

[RickHow in reply to cmumbles]

thanks so much for your concern.

[Bet117]

Rick,

Hang in there and speak to your doctors about what they feel is the best course of action for you.

None of this is fun, nor in the plan, but you rock and roll with it.

Stay positive and know that it will pass.

I send you all of my support and warmest thoughts at this time.

Bet

[RickHow in reply to Bet117]

Thanks Bet, appreciate your concern.

[Bet117 in reply to RickHow]

No thanks ever needed, Rick!

"One moment at a time, one day at a time and folks in your corner!"

Standing strong behind you!

Bet

[HealthBuddyMelissa]

Ask your Nephrologist to work with your Oncologist to properly dose you for any meds that will effect your kidneys. NSAIDS are damaging to the kidneys. If you can take Tylenol and have relief I would do that. If your pain is really bad get in touch with your Nephrologist and ask him to give you advice on possibly taking a lower dose NSAID if that will not cause too much damage. You can try some alternative medicine such as meditation or guided imagery to see if it possibly can help. Most importantly make sure they are monitoring your kidneys regularly to be sure the damage is not worsening and to possibly dose alter the meds. The steroids may actually help relieve some of the pain too but again will probably have to be dose altered for your kidney disease.

[RickHow in reply to HealthBuddyMelissa]

Thanks for your concern. Yes Tylenol could do a little for the discomfort but it is not an anti-inflammatory. Pleurisy is inflammation of the lung. We will see what the oncologist says on Thursday. I find my kidney doctor visits virtually useless. Blood tests and urine tests results and a "see you next time" is about all she does. Every 6 months. I get the same tests every 3 weeks at oncologist. And as we all know, basically for the kidney you really do all the basics (diet, exercise, water) yourself and without an obvious problem of kidney (tumor, stones, etc.) they don't add a heck of a lot at early stages 1,2,3.

[HealthBuddyMelissa in reply to RickHow]

True Acetominophen is not anti-inflammatory though some say it does have mild effects on inflammation. There are dosing options for kidney patients which of course I can not tell you but the info is easy enough to search for. Ask your doctor to dose you for renal insufficiency so you can get some kind of relief. If doctor does not know how ask them to consult a pharmacist.

[Hidden]

Hi Rick

I have stage 4 CKD and it was caused by a mixture of very very high calcium levels for which I had a Parathyroidectomy and continued use of diclofenac an NSAID. The diclofenac used to make my very bad gout bearable but sorry to say although its an amazing drug its done my kidneys in so to speak. I had a tumour removed from one kidney just for good measure so that realy pissed my kidney off and its taken umbrage and doesnt work so well. Anyway, sorry I cant be of any help but anyone else by chance reading this please please be aware that although diclofenac does indeed help greatly with pain and inflamation it realy isnt any good for you. I am NOT any kind of medical expert just a ckd sufferer might I add.

[RickHow in reply to Hidden]

Hi. I know how difficult gout can be. My elderly father had gout that would come and go. He had a "bout of gout" about every 3 months. They tried diflofenac but it did not help him too much. Then the doctor tried prednisone. Was amazing. He would take it for 5 days and it knocked out the gout. So he did not have to take it every day, like your experience.

Best of luck to you and your battle.

[medway-lady]

I recently had Shingles and had Pregabalin for pain relief for 6 months it worked well. My function is 20%.

[RickHow in reply to medway-lady]

thanks for that important information

[medway-lady in reply to RickHow]

Prednisolone is also used in Rheumatoid which I have and it does reduce inflammation it does wearl off though and taken at a high dose is not good for the bones. I've had it when the kidneys first crashed at high dose and it didn't work to get function back.

[RickHow]

Thanks. I can't take it thought. It is a steroid. The medicine I take for cancer (keytruda) can not tolerate steroids. The steroid counteracts and makes the keytruda not work.