My rheumatologist has changed my inflammatory medication MELOXICAM to NAPROXEN for pain relief . ( Have been on Meloxicam for years ) .
Is anyone else on Naproxen ? Do you find it effective ? How long does it take to work ? I've read the accompanying leaflet and wonder how people have found the side effects, if any ?
Naproxen was an early NSAID for me, for another condition, before RD diagnosis. Unlike meloxicam it's quick acting, within a couple of hours I would say. I had no side effects whatsoever but it did stop working so well me so it was changed to another. Meloxicam was the third NSAID I tried following my RD diagnosis, I didn’t have any side effects from that either. The best NSAIDs I’ve found have been COX-2's. My current one, etoricoxib, I’ve been on around 10 years.
I hope you find naproxen helps you, & you don't have any side effects either. Probably stating the obvious but you are coprescribed a PPI aren't you, omeprazole or similar? Again, you may know but taking NSAIDs with food helps mitigate tum irritation.
Thanks for your reply nomoreheels . I've just started taking it , this am , so hoping it will be the "magic bullet" 🙄. Yes , I'm taking a PPI - lanzoprasole ( which I've been taking for years , for all the medication I take ). I was interested in your comment on taking a Cox-2 as I thought they had been disqualified years ago because of the problems they caused - heart ???
I notice in the accompanying leaflet that taking naproxen with MTX and paracetemol was not encouraged, although my rheumatologist didn't say anything to the contrary . I asked my chemist , who looked a bit confused at the question , and he said both were fine . I do wish there was some agreement on taking various medications together .
You're sort of right about COX-2's, insofar there is a connection with cardio events. In fact when this was last reviewed about 5 years ago my GP called me in to discuss it & I agreed to reducing my dose to 60mg from 90mg with the caveat that I could increase it back to 90mg if needed. I do have history of heart disease on both sides so have annual cardio reviews, & an echocardiogram performed for something unconnected revealed no issues at all with my heart I'm pleased to say. The FDA however, like us, have removed rofecoxib from the market. You may remember the brand name Vioxx? The manufacturer voluntarily withdrew it due to increased cardio risk when taken long term. The FDA retained celecoxib but have also removed etoricoxib whilst we still prescribe it.
I think I'm right in saying what you've been told is relative with all NSAIDs & MTX but we're monitored so any problems will be flagged up. I think it's more related to high dose MTX though, but of course the warning is just MTX & NSAIDs! Either way it's all about quality of life isn't it so as long as we're not at risk I’m happy taking them. I do hope it is the “magic bullet” for you. Oh, & I also take paracetamol (in the form of cocodamol), so that’s the 3, MTX, NSAID & paracetamol.
Thank you , for replying again , nomoreheels . I've been on one medication or another since my introduction to Rheumatoid Arthritis in 1989 and have settled mainly on MTX and sulfasalazine. Plus meloxicam , doxycycline , amlodipine , accrete and a statin - also codeine and paracetemol when needed . Despite joint replacements and ulnar drift of fingers , making my hands look like flippers , I've never been considered bad enough ( or good enough )for a biological.
Yes I remember the fuss about Vioxx which is why I questioned your Cox-2 . Of course you're absolutely correct to say that we're closely monitored and most things should be picked up . I get 2 monthly blood tests and they often go up and down like a yo-yo but in the end they even out . Most of the time I feel really well apart from some stiffness and at the moment a painful hip . Hence the change to Naproxen .
If I get given something new I always read the accompanying paper and then wonder why most of the stuff I take is contraindicated. In the end I take whatever it is and settle down until the next blip .😁
I relate to your comment of not bad enough (or good enough) for a biological. It's been discussed, though not at length, with a couple of Rheumys (actually one was a registrar), but not yet been seriously considered. Like you I’ve been on double therapy with MTX/SSZ, but also MTX/LEF, both additions had to be discontinued though so I remain on monotherapy MTX with prednisolone as I can't go higher than 17.5mg (injecting). It is frustrating, I'd rather dump the steroids having been on them so long & considering bone health.
I see you've had knee & elbow joints. I take it these were both related to RD? Has your ulnar drift been connected to RD or osteoarthritis, I believe both can have the effect. Asking as my main hand issues are OA related, I’ve no cartilage in my DIP joints. I have been offered the joint replacement op but I’m holding off until, or sometime before really, it becomes an insurmountable problem. Thankfully no ulnar drift but it could potentially be an issue. Have they suggested a realignment op at all? Like me you must have grip issues.
Hi , again , nomoreheels . I'm not sure whether RA or OA was responsible for my knee and elbow replacement . Both were a mess by the time they were done . My elbow had a subchondral cyst as well and the parts were sent off to labs as experimental bits ( my only claim to fame ) . The surgeon who did my elbow is apparently well known for his Hand/Elbow work and he did do a good job , although , unfortunately , I contracted an infection during the op which ended in a long drawn out hospital stay . Fortunately, the joint was saved .
I still see him now for checks on my elbow and he looks longingly at my hands and fingers and asks if I would like him to do something with them . I know he'd do a good job but I'm not so gung-ho about ops as I once was . We have discussed it as I'd love more strength to do everyday things but , strength , he says is something he can't give me . They don't hurt and I can do most things I guess , although holding things and picking up things can be problematical. But cosmetically they're really ugly .
We're both off now for our fifth jabs . So a rather "meh" day to look forward to tomorrow.
I hope lots was leant from your unneeded bits! “Looks longingly at your fingers”, I bet he does, & would probably do an equally good job on those as he did your elbow. I'd think in your place though it would be a considered decision for me too.
Hope you're both ok after spring booster jabbing. It was Moderna for me & I was fine, just the slight soreness & raised redness around the site which I was prepared for, advised by the one who jabbed. All was well after 4 or 5 days.
I was changed to naproxen from Diclofenac when I moved to a new area and GP, they wouldn’t prescribe it. I’ve not found it works as well as the diclofenac and I get indigestion too from it so don’t take it all the time now.
Sorry to hear that naproxen didn't work for you , Kitty . Were you told why your new rheumatologist didn't like diclofenac ? I have a feeling that I was given diclofenac originally, years ago . Then I think my rheumatologist changed it to Meloxicam because it was new .
I've been on it for years but I guess all rheumatologists have their own pet drugs . Just hoping naproxen works for me , although I have read that diclofenac is superior to most of the others.
It was my new GP, something to do with the heart I think. I’d been on it since diagnosis 30 years ago so I think that worried them🙄 but my rheumy has never been concerned about it. Naproxen does help, just not as good as diclofenac and the tablets are huge 😁
They are huge aren't they ? Horse pills come to mind . 😄
I was taken off Naproxen by my Consultant due to my age (75) and the heighten risk of stroke/heart attack. Instead I take max Paracetamol a day.
Thanks , Jackie . That’s somewhat worrying . I did read the accompanying blurb and there was a note about there being a slightly greater risk of stroke/heart attack but when I questioned my friendly chemist he said this applies to all NSAIDs . As I’m 80 now , I think I’ll speak to my GP about it and probably the rheumatologist, when I see him in 3 months time . ( sigh 😌- nothing is ever easy , is it ? )
I had a discussion with my rheumatologist about NSAIDs ( non-steroidal anti-inflammatory drug-s). He pointed out that, for me, it is often a decision whether to give NSAIDs or straight onto prednisolone. Both have disadvantages, but reduction of inflammation is often required. I'm also elderly and now the GPs are not happy with me using NSAIDs, so it requires negotiation....
Thanks for your reply . It is difficult to decide what is for the best . I've been on the NSAID Meloxicam for probably 30 years without a problem . I'm not sure why this rheumatologist decided to change unless he thought Naproxen was superior . I'll certainly discuss it with my GP as various people have questioned it .
I have tried naproxen and diclofenac (daily for about 6 years). I got ‘toxicity’ all the time. Tons better now I’ve stopped taking them. I take Amitriptyline 20mg every night at 7pm. That has helped tremendously. I can honestly say N&D didn’t make any difference at all except making me feel ‘icky’. Also they rot your internal organs with long term use. Yay! Give them a go, but I wouldn’t bother… *I appreciate we all react differently to things, so your call obvs.
Thanks for that CripLady . I was given Amitryptaline after an episode of shingles . It worked very well for me and at a rheumatologist appointment she decided that I should continue with . Recently, however with my hip problem , my GP has suggested I go back to paracetemol and codeine as they would be more effective with the kind of pain I am experiencing. I'll hang onto the Amitryptaline when I decide that paracetemol/codeine aren't as effective.
Good luck with it. Yeah, different meds for different types of pain I suppose. Maybe take both?? Cocodamol was also not good for me (my body is obviously very fussy 😆). If I am in severe pain now I take paracetamol. I also find ‘deep heat’ works really well for me. Try a few things.
Have you ever tried Amitryptaline with paracetemol ? I was wondering if I could take both . I get paracetemol and codeine on prescription rather than co-codomol , so that I can mix and match .
I can't see any reason (but check with a pharmacist) not to take paracetamol and amitriptyline together as they work in different ways - the amitriptyline on the nervous impulses taking the pain signals and the paracetamol by blocking the receptors that tell us we have pain. I wouldn't take codeine with amitriptyline without advice from a pharmacist as they may well interact - although it works in the brain to block pain appreciation it has so many other effects.
Thanks old-timer, I think I'll do as you suggest and check with my pharmacist.
Do still check but I take amitriptyline with cocodamol, same dose as if I was taking it without the codeine, 500mg per tablet.
Taking both has never caused any issues; but I take paracetamol extremely rarely. It’s there for emergency use only.
I was given Naproxen about a year ago. First time was by a GP based in our local hospital A&E think I took 250mg three times a day. That worked really well, with no side effects, it was really good and took care of the pain I was in - I had a sacral insufficiency fracture although at that point it was undiagnosed.
Fast forward a couple of weeks, I had three private MRI scans and a definite diagnosis of fractured sacrum and nerve pain from lumbar discs.
My GP then prescribed a stronger dose of Naproxen - I think perhaps 500mg twice a day so it wasn’t that much more really along with Omeprazole as a ‘tummy protector’.
It worked but no better than the lesser dose and I very soon developed the worst diarrhoea I have ever had in my life - worse than when I had meds I had to clear my bowels for a barium enema. My heartbeat was up to 100 and I felt absolutely dreadful. The doctor said to stop the Naproxen and to double up on the omeprazole which I did. Eventually the diarrhoea stopped when I stopped the omeprazole.
So I’ve had mixed experiences with the Naproxen - I suspect it was the omeprazole that upset my gut rather than the Naproxen either that or it was the change of dose but I stopped both naproxen and omeprazole for good.
You’re right, the information in Patient Information Leaflet is very scary.
Thanks F&N , I've only been taking naproxen since Thursday and already finding it helpful . I've been taking lansoprazole for years after finding that omeprazole was ineffective. I suffer from IBS (D) so I'm used to the D bit and so far it hasn't got any worse . I'm due a blood test with MTX profile at the end of this month so I'll be interested to see if these have been affected by the addition of naproxen .
Yes, I’ve had IBS since the 1980s and alternate between D + C but boy was this unbelievable - I could feel it gurgling vertically - presumably down through my large intestine. I’ve never felt anything like this before or since. It was unbelievable.
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