Alternative to naproxen

[Chris_O]

Alternative to naproxen

Hi

I’ve been taking naproxen for some years now for RA, but I also have CKD ( chronic kidney disease). After going for my six monthly checkup with the RA specialist, she has suggested I stop naproxen and switch to co-codamol, which I reluctant to do.

Has any one been in the same situation, and been prescribed an alternative anti inflammatory?

Chris_0

[helixhelix]

The safest anti-inflammatory is ibuprofen, would yiur consultant be ok with yiu taking that I wonder?

I hate co-codamol as I end up constipated.

[Chris_O in reply to helixhelix]

Hi

Thanks for the reply. I need to have a conversation with my GP about the alternatives.

I have used co-codamol and ibuprofen in the past, but both don’t seem to do much for me. The only thing that did help with pain was Zapain ( 30 / 500 mg Codeine phosphate paracetamol), but it works so well I fall asleep, and it’s addictive!

Chris_0

[Hidden]

Co-codamol used to block me up (overshare) and made my brain fuzzy 😵‍💫. I take amitriptyline now every day at 7pm, and that seems to work a treat. Naproxen I took for years, and it did bugger all. I take paracetamol occasionally, but usually deep heat works on any poorly bits.

* I also take 1000mg of Sulfasalazine every day (breakfast and teatime).

[Chris_O in reply to Hidden]

HiThanks for the reply.

I need to have a chat with my GP about a replacement for naproxen, but looking at Google for replacement nsaids all seem to give warnings about not using these with someone who has CKD.

Anyway I’ve got some suggestions now that I could use.

Chris_0

[Cutes]

Hi Chris, I was interested to read your post. After a hospital admission, 3 weeks ago, for a very bad flare up in my right wrist and hand, I have been put on Naproxen. (I had had to temporirly. stop my Imraldi injections and methotrexate due to being on anti biotics for an ear infection. The hospital thought this might have been what triggered the flare up. I have also been put on diuretics, as well as my usual BP medication. I'm not too convince the Naproxen are doing much. I restarted the methotrexate and then the anti TNF injectoin on Friday and Sunday and also started the diuretics on Friday. Since Monday am, I have been experiences nausea on and off and particularly after eating. I am wondering if that be due to re-starting the arthritis meds, or possibly the diuretic and maybe the Naproxen, although I have now been on the latter for 3 weeks and haven't experienced nausea until the last few days. Have you experienced any nausea with Naproxen. As for you finding an alternative, I see someone else recommended amitriptiline (probably spelt wrongly); I understand that is supposed to be quite effective and would certainly help with sleep. Best of luck with it all.

[Chris_O in reply to Cutes]

Hi

Thanks for the reply. I’ve been on naproxen for some years, but I’ve always taken omeprazole with them to counteract any stomach upset, which do seem to work for me. I have tried reducing my dosage of naproxen last year and found that I couldn’t without getting some pain, so I’m still on the original doseage ( (500 mg per day ). One point I’ve noticed about naproxen is that it does not work immediately, but the effects start to be felt after about one to two weeks. With the tablet form of methotrexate some people experience nausea and upset stomach, since I changed to injections I’ve not had any problems with it.

I need to chat to my GP about naproxen but now I’ve got a few suggestions from the forum. Hope that you solve your nausea problem.

Chris_0

[Cutes in reply to Chris_O]

thanks Chris. Yes I too currently take Omaprozole. This am I tried skipping the Naproxen and still got nausea mid am, so will probalby take one again this evening. Having talked to an ex nurse friend today, she reckons the most likely culprit is the newly prescribed diuretic. I have had methotrexate and anti TNF for many years and although I used to get nausea when on the higher doses methotrexate, i.e. before I started the Anti TNF, I am now only on a very low dose. Therefore, I think it's fairly unlikely to be that, especially as the nausea didnt start until 3 days after re-starting it, although it is possible I suppose, given I have had a month's break from it and the Anti TNF due to the recent infections. I have a blood test next week for the new diuretic, so will try and hold out 'til then, to see if that shows up anything untoward.

[Langers2]

My stomach can't take ibuprofen or any drug in that family, including naproxen. I take celecoxib which hasn't aggravated my stomach at all....maybe that could be an alternative for you x

[Chris_O in reply to Langers2]

Hi

Thanks for the reply and suggestion. I need to talk to my GP and I’ve now got a list of alternatives that I can suggest.

Chris_0

[Chris_O]

Hi

Thanks for the reply. I really don’t want to change to co-codamol as the low strength doesn’t affect me very much, and the high strength send me to sleep. It also makes me constipated, and reading the notes supplied with it, it’s addictive ( that’s the codeine ). When I first started with RA my GP prescribed Zapain ( 30 / 500mg, codeine phosphate paracetamol) which worked very well as a pain killer, but the side affects !

Naproxen is described in the literature as a ‘anti inflammatory painkiller’, so the anti inflammatory affect is the main thing that is useful in RA. Co-codamol is only described as a painkiller, not so much an anti inflammatory.

So I’m looking for an anti inflammatory drug to replace naproxen ( one which is easier on my kidneys ).

Chris_0

[Chris_O]

Hi

Just had a review with my RA specialist ( different one to last time ), and they never suggest a change to methotrexate and hydro chloroquine, I wish they would! Perhaps I should take the initiative and suggest something else? On the subject of naproxen, I have been only taking half dose per day for several week days and seem to manage ok. But as I said, last time I reduced naproxen to nil, I started to get aches.

Chris_0

[Kags1068]

Hi Chris

As you mentioned earlier, naproxen is an anti-inflammatory and co-codamol is a painkillers, so both work differently and can be taken together.

I have stage 3a/b CKD so understand the difficulties with anti-inflammatories, but they have always seemed to help me a lot. I do take 5 DMARDs (pred, Humira, MTX, Cyclosporin and Hydroxy), but unfortunately still need the anti-inflammatory. I had been taking Meloxicam 15mg since about 2000, but my new(ish) rheumy wasn't happy with those, and after accepting that I needed something, switched me to Arcoxia/Etoricoxib 90mg daily. He felt this would be a better choice with kidney issues. I've been on it a few months now, and I've been ok - no obvious side effects. Kidneys seem to be stable too.

Hope you can find one that works for you.

Good luck xx

[Chris_O in reply to Kags1068]

Hi

It sounds like your problems with CKD are similar to mine. I need to arrange a GP appointment ( can’t till March cause she’s on hols ) and suggest I swop to the anti inflammatories you mention. Thank you for the advice.

Chris_0

[Kags1068 in reply to Chris_O]

You are very welcome. So glad you found it useful. Hope your appointment is early and not late March!

Also, hope your doc OK's the change as it's really difficult when they help a lot. You can even start on a smaller dose (60mg I think) and build up if necessary. As you know, it's best for us to stick to lowest dose possible.🙄

Best wishes x