Does anyone here take an NSAID or Cox 2 Inhibitor?

[LorrieC]

I take 15 mg of meloxicam daily. I am Stage 3a (newly diagnosed) and my doctor said it is OK to take. I called a pharmacist and she confirmed this. I stopped taking it for a week on my own and I could barely walk. I need to exercise and get moving, but I can't unless I take meloxicam. I am thinking of cutting down to 7.5 mg on my home. I am planning to see a nephrologist soon and I am sure he will advise me, but I wanted to know until I get my appointment.

[lowraind]

From meds.org:

Functional renal failure

NSAIDs, by inhibiting the vasodilating effect of renal prostaglandins, may induce a functional renal failure by reduction of glomerular filtration. This adverse event is dose-dependant. At the beginning of the treatment, or after dose increase, careful monitoring of diuresis and renal function is recommended in patients with the following risk factors:

• Elderly

• Concomitant treatments such as ACE inhibitors, angiotensin-II antagonists, sartans, diuretics (see section 4.5. Interaction with other medicinal products and other forms of interaction)

• Hypovolemia (whatever the cause)

• Congestive heart failure

• Renal failure

• Nephrotic syndrome

• Lupus nephropathy

• Severe hepatic dysfunction (serum albumin <25 g/l or Child-Pugh score 10)'

In rare instance NSAIDs may be the cause of interstitial nephritis, glomerulonephritis, renal medullary necrosis or nephrotic syndrome.

The dose of Meloxicam in patients with end-stage renal failure on haemodialysis should not be higher than 7.5 mg (half a 15 mg tablet). No dose reduction is required in patients with mild or moderate renal impairment (i.e. patients with a creatinine clearance of greater than 25 ml/min).

Sodium, potassium and water retention

Induction of sodium, potassium and water retention and interference with the natriuretic effects of diuretics may occur with NSAIDs. Furthermore, a decrease of the antyhypertensive effect of antyhypertensive drugs can occur (see section 4.5). Consequently, oedema, cardiac failure or hypertension may be precipitated or exacerbated in susceptible patients as a result. Clinical monitoring is therefore necessary for patients at risk (see sections 4.2 and 4.3).

[LorrieC in reply to lowraind]

Very interesting and thanks for the info. This confirms the pharmacist's advice. I will follow the nephrologist's advice whenever I get one. My dr's office was supposed to call me with an appointment, but I haven't heard anything yet.

[Northfields]

Is Meloxicam the reason why you have stage 3a? All my nephrologists consulted over the past 20 years have insisted no NSAIDs, not even one, even when I was at stage 3a. Your nephrologist will be able to advise the safest medicine for you.

Just as you experienced, other doctors thought NSAIDs were safe. One doctor offered me aspirin infusions for my migraines and refused to replace them with paracetemol infusions that my nephrologist approved as an alternative. You need permission from your nephrologist each time you want to take any medicine, as pharmacists and other doctors will regularly recommend alternative or traditional medicines or supplements that are harmful to your kidneys. Consulting the Internet or the prescribing information that comes with medicines will not give you a sufficiently precise answer.

[LorrieC in reply to Northfields]

I don't know whether Meloxicam was the cause, for I noticed a rise in creatinine and drop in GFR before I took it, but since then, it has decreased even more. From what I've read here, some nephrologists don't always give good advice. This is a wait and see. Thanks.

[BBland in reply to LorrieC]

I am also stage 3a. My Dr ( GP ) and Nephrologist told me absolutely no NSAIDS. I've been stable now since first diagnosed in Aug of 2017.

My advice is to listen to the folks on here . They are very knowledgeable and very caring. You are safe here and they will be very honest with you.

As with everyone, I'm praying for my kidney community.

God bless.

Bonne'

[LorrieC in reply to BBland]

Bonnie,

I stopped taking the meloxicam three days ago. I don't feel the effects for about a week. I am presently using Voltarin gel on my knee and they can't be used together. I think I am better off getting cortisone injections in both my knee and foot. Thanks.

[Bassetmommer NKF Ambassador]

Do your research, consult with your doctor and also nephrologist. Tell them what each is saying. Make sure they know of all the drugs you take. Be careful stopping any medication without your doctor's approval as you can experience worsening in symptoms.

[LorrieC in reply to Bassetmommer]

I will feel better after seeing a nephrologist, for I am leery of my new doctor being he said to avoid salt but I could have cheese! I tried cutting sodium today, but it seems everything has sodium. I read where adults can have 2,300 or 2,500 mg per day, but kidney patients should limit sodium to 1,500 mg. Is that the number you follow?

[Bassetmommer NKF Ambassador in reply to LorrieC]

See my reply in your next question about apps.

[Jonquiljo in reply to LorrieC]

The new sodium numbers coming out are 1500 mg or less for everyone. That means starve to death, or wait for our western diet to change.

When it comes to “kidney patients” there still is a lot of disagreement in the literature as to what a kidney patient really is. In most countries, their kidnet associations tend to give the standard 1-5 scale. That’s done for simplification, and it actually is a lot more complicated.

Remember the “old” blood pressure classifications. Well, they just dropped those down about 10-15 mm Hg for all categories. If I remember correctly, “normal “ is now less than or equal to 120/80. So as we all grow older, all these ranges go up or down (probably sideways too). Ask your Dr’s because all of this “again” is a lot more complicated than it is made out to be.

[Tissybell]

Nephrologists recommend staying away from nsaids if you have CKD. Minvsays to avoid herbs, and contrast dyes for imaging and Bactrim.

[CatOnACloud]

Well, you sound like my mama! Same thing. CKD-3a, but arthritis so bad, and at 74 she has nothing the can take that isn’t an NSAID to help. Meloxicam keeps her moving and significantly reduces her pain. I was not supportive, but it’s better than taking naproxen, ibuprofen, and the cox-2 inhibitor Celebrex. She’s taking the 15mg a day, and her eGFR has been steady, so…I think she’d ignore me if I told her to reduce it. But if you can, try the 7.5mg, give your body a chance go acclimate, see how you do. Obviously it’s very nice to have a nephrologist’s advice but then not every stage 3 pt can get in to see one!

My experience was drastic—I finally was told my renal colic (pain!) was caused by taking NSAIDS. Once cut, it went away. However, in my old age of 50, I find I have to take an ibuprofen here and there as they’ve given me nothing else. So hard when you need new joints but are too sick to get em! But it’s the ACL & knee damage I need an ibuprofen for occasionally to bring down swelling. But they are definitely poison for the kidneys (and liver) those nasty NSAIDS. Best of luck, stay informed