Naproxen? Advice on duration?

[hawker955]

I was diagnosed in 2008, started with naproxen/paracetamol/sulphasalazine but the in 2009 with Humira that worked quickly and fantastically well.but I still take naproxen twice daily for on-going wrist and other pain. As I assume we all do, I have blood tests every few months to check liver and kidney function and all okay so far. However at my last routine check with the rheumatologist commented that I should not continue with the naproxen at 500mg twice daily because it is not really intended for long-term use! I feel rather miffed and disappointed that I am told this after eight years not at the beginning,okay, my blood results are good but by the time I've sustained kidney damage, it is too late, kidney pathology generally being irreversible! It is the first time I've felt let down. I still take them now and again because I refuse to take opiates and originally was given naproxen because it is the safest anti-inflammatory to o'e's stomach, especially with omeprazole as well. So my question is this: Has everyone been told this about naproxen? ie Short-term-use only!

[helixhelix]

There does seem to be a bit of a gap between theory and practice re long term use of NSAIDs. I always believed that they should be used long term as a last resort when nothing else works because of the risks to heart and kidneys and my rheumy said the same. So I worked with her to get doses of DMARDs to the level that I no longer need to use NSAIDs permanently, hence being on 3 DMARDs. I still have NSAIDs prescribed as needed, but only use them a few days a month and my GP raises eyebrows if I use more than a box every couple of months.

However, there do seem to be a few people on here who do take them permanently. Often to deal with OA pain, as that can be intractable. But if you have annual cardiovascular checks, don't take blood pressure medications, and are under 65 then the risks are not that high. So I think it does as ever come down to personal choice between pain management, quality of life and acceptance of risk.

[Simba1992]

Naproxen is very hard on the stomach. 500mg twice a day for along period can do very bad damage even when taken with omeprazole that also has its own side effects. I know it's hard to wean off it. When my inflammation decreased I started taking tumeric with selenium and reservitol and need nw only occasionally 250mg of naproxen. Cod liver oil, Astaxenthin and strong D3 suppliments help to calm inflammation and pain. Good luck😊

[PFKAAde]

I don't have the figures but as bad as long-term NSAID use is / can be long term PPI use is the thing that has encouraged me to stop taking that combo. For me it has been Diclofenac / lansoprazole but apparently all of the 'oprazole' class of medications were only ever intended for short-term use and have a whole raft of problems associated with long-term use. Including dementia, but in no way limited to it.

As helix says it's the balance thing again. But if any med causes more problems than it solves - that's the answer, for me.

I haven't tried the turmeric thing but really should.

Ade

[earthwitch]

I guess it depends on the disease. For spondyloarthritis, full doses of NSAIDs are the first line treatment for as long as you are able to take them without significant side effects. Spondy however doesn't respond to DMARDs in the same way as RA does. I wonder if you need to be asking your rheumatologist whether your meds need reviewing, given that you still have ongoing pain. If the pain isn't inflammatory any more but is the result of damage, then could you ask if there is any surgical solution to it?

[cathie]

I don't know about naproxen but I've tried turmeric with black pepper. I'm not sure if it works but the peppers supposed to boost it

[hawker955]

Thanks, my main complaint is that I wasn't told this at the beginning nor at any subsewuent routin check-ups. I was told all he risks associated with Humira: unpasteurised food/dirty salads etc but not about the NSAIDs. So I got a surprise at my latest appointmen to be advised not to stay on them long-term. What have the last eight years been if not long-term?

[hawker955]

Food-poisoning etc can be treated but treating toxic kidney damage from long-term use is rather more difficult and too late by the time blood tests pick it up!

[nomoreheels]

In a word no! Not for the reason they are prescribed anyway. I've taken various NSAIDs over the years, 6 different ones since diagnosed with RD but they've always formed part of my treatment. They've all become less effective over longer-term, all except for etoricoxib (Arcoxia 90mg) which I currently take? I have annual cardiovascular reviews to ensure I'm ok to continue taking them nightly, my BP is fine & I've taken omeprazole concomitantly for the last 8 years. The main reason for taking them nowadays is to tackle inflammation caused by OA but they also have effect on my RD inflammation.

I think lengthy prescribing of NSAIDs is generally accepted as not ideal but in a chronic condition of an inflammatory condition where inflammation can result in damage then it's a given that NSAIDs are commonly repeat prescribed. It's recommended checks are taken of renal function, cardio & as long as there are no known gastro problems, & that they still work effectively then I shouldn't think there is any reason for them not to be prescribed.

If your Rheumy's insistent that you shouldn't take them & there's no other reason I'd ask if you could be prescribed a different NSAID.

About 3 years ago I did have a registrar tell me to only take my etoricoxib when absolutely necessary but I suffered for it? When at the next appointment my Rheumy questioned my inflammation I told her why & she wasn't best pleased. She told me he should have asked her & she would have requested my GP perform the tests I've mentioned above & if all's well I could continue on them.