Is anyone coming off Diclofenic?

[shasmac]

I mentioned my concern about recent research published about Diclofenic at my last RA clinic appointment about 5 weeks ago and it was agreed that I would gradually reduce the dose over 4 weeks and now I've been off them for a week completely. Now I'm having new, sharp stabbing pains in my ankles and wrists...the first since the RA was brought under control last summer. I've never had a flare since then and hoped that was it under control (denial, I know). Has anyone else stoppedDiclofenic and if so, how did you get on and is there an alternative as I'm getting worried that a flare is heading my way! Going on holiday on Friday so thinking about going back on them until I get back. Clinic seemed to be leaving it up to me wither to take them or not.

I'm obviously not looking for medical advice...just personal opinions and experiences to help me decide. I'll call the clinic tomorrow but I think they'll tell me to do what I think best?

[Hidden]

Hello

There are quite a few NSID you can take have you been given a replacement for the Diclofenic ??.

When I was in the early days of my problems it took a while for GP and Hospital to find the right medications for me.

because the medications given were causing tummy problems etc. I was left with one medication a Cox 2 inhibitor.

so all I can advise is to have words with Clinic tomorrow, I hope they get a good medication match for you if that is the case

Hopefully they will also give you something for your flare up

All the best

BOB

[earthwitch]

yes there are alternatives. As Bob says, there are a huge list of other NSAIDs that you could try instead. They all have slightly different composition, so you may have to try a few different ones before you find one that you tolerate well and that works for you. Did you actually discuss the risks in detail with your doctor? Some groups of people are likely to be more at risk than others. I know I did really well on diclofenac (until it finally got to my stomach), but at the time I did check out risk factors for the more serious side effects and for me it seemed that the risks were worth taking for the benefits. If I had a lot more risk factors it might have swung the other way.

There are also other types of meds for inflammatory arthritis besides the NSAIDs as well - all the long list of DMARDs, in various combinations, and also all the biologics. So if you don't have good disease control, then be sure to ask what else you can try.

[oldtimer]

Diclofenac won't control a flare, only the DMARDs or steroids do that - but it can be replaced by another non-steroidal anti-inflammatory to control some of the pain and inflammation if you do have a flare. I take meloxicam, which suits me, but there are lots out there. Evidence suggests trying one for two weeks will tell you if it is OK for you. But all of them have risks as well as benefits of course.

[mistymeana]

I had to stop diclofenac as it gave me really bad stomach problems. I was given a cox 2 inhibitor instead and find I can tolerate that quite well. I'd recommend you speak to your GP or rheumy to see if they'll prescribe it for you to keep inflammation down.

[emmajj1971]

There are lots of othere u can take, diclofenac although very affective is not a good one to be on long term. Your Dr can also give u meds to protect your stomach whe putting u on any other meds. I did find diclofenac more affective than any if the others but the risks are to great.x

[earthwitch]

Just a thought. If you have done very well on diclofenac in the past, then its possibly worth asking at your next appointment if there is any possibility that you have a form of spondyloarthritis (eg PsA). The reason I'm saying that is that NSAIDs are the first line treatment for spondyloarthritis and can really bring it under good control, but as other folk have pointed out, aren't nearly so effective with RA. In the same way, DMARDS (in the right combination) are the first line treatment for RA but aren't anywhere near as effective for spondyloarthritis, and in fact usually only MTZ or SSZ are used in spondyloarthritis, and then only if peripheral joints are a big problem. The other reason for suggesting that is that spondyloarthritis seems to be very underdiagnosed in the UK, (confirmed by recent research that seems to suggest that diagnosis rate is quite a bit higher in the US than in the UK).