Pain relief?

[Plavers]

I'm 74 with ET JAK 2 , I also have Arthritis in my hips. My Physiotherapist advised using a Pain relieving gel - but I said they contain Ibuprofen and I'm not allowed that as I'm on Apixaban. He said ask a Pharmacist as 'they will know'. I'm not so sure about that as some Haematologists don't know about MPNs. Any advice please gratefully received. Paul

[DougyW]

I always trust the pharmacist to know about drug interactions more than any doctor. That is their area

[Plavers in reply to DougyW]

Thanks Dougy I've obviously got trust issues.

[hunter5582]

Checking with the pharmacists is the best idea. I know that some of the NSAID topicals come with a Monitor/modify treatment warning. this does not mean that you cannot combine the medications but does mean you need to be cautious and monitor your response. Like all decisions we make with meds, it is a risk/benefit assessment. Is the potential reduction in pain worth the degree of risk?

[Plavers in reply to hunter5582]

Excellent advice as always, thank you Hunter

[EGMumma]

My doctor prescribed ibuprofen gel and I am on warfarin. He said that it doesn't get absorbed into the blood stream. To be honest it didn't work too well. I rely on regular paracetamol for my osteoarthritis pain.

[ainslie in reply to EGMumma]

I suspect some will get in to the bloodstream

[lizzziep]

I’ve got severe knee arthritis, I take co-codamol, prescribed by GP, I can take up to 8 a day but I usually take 4, two in the morning, two mid-day, it takes the edge off the pain. It can be addictive so I try to keep usage down. You could also try acupuncture or steroid injections.

[Plavers in reply to lizzziep]

Thanks for your reply Lizzie, I’ve been prescribed Co-codamol in the past but like you I don’t want to come dependent on them. Steroid injections have worked in the past, but now my GP surgery see the answer as MSK and physiotherapy. The only thing is it hurts.

[lizzziep in reply to Plavers]

I know - my knees are VERY painful. I don’t walk much but I do go to aqua fit 4 times a week and do pool walking when I have the time. I’d be stiff as a board if I didn’t. Most of the aqua class (male and female) go because of their joints.

[RedCardRob]

Good question as I think my 70 year old hips are starting to show signs. As others have commented, the pharmacist is also up to date with "mixtures" of medication you can take and can advise more on application of them.

[Spanelmad]

I have sero neg arthritis and Et , I take celexicob and exalt ( blood thinner). You can be prescribed a nasaid if you need it but you need to be aware that it could cause bleeding.Your gp should refer you to a rheumatologist .

[Minify]

I am on Apixaban and occasionally use Diclofenac gel. Hematologist said ok, as minimal amount absorbed, and my use is infrequent.

[Jamesxyz]

Sure check.

But my understanding is that it's pretty much does not get in the blood.

Howeever it didn't do much for me in terms of releif.

[TLJ-1]

As noted, pharmacists (at least those with a Pharm.D. degree) are generally much more knowledgeable than most physicians about drugs, their interactions, and their side effects. However, a physician specialist will know more about the drugs in their particular field of expertise but increasingly less about all other drugs. However, most pharmacists will not know of our particular problems with MPNs. But on to your particular issue: not very much of any drug administered topically gets into one’s bloodstream. So it should pose no problem to use a gel with ibuprofen or one with diclofenac (the one I use) even though we may be taking apixaban (mine too). I just hope your chosen remedy works for you.

[Plavers in reply to TLJ-1]

Thanks TLJ it’s off to the Pharmacist for me.