Which anti inflammatory for RA?: Ibuprofen and Naproxen... - NRAS

NRAS

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Which anti inflammatory for RA?

tazman3 profile image

Ibuprofen and Naproxen do not help. I've heard there is an alternative that can be prescribed, but can't remember the name of it. Anyone know?

23 Replies

Etoricoxib is the one I can no longer get.

Bessieboo1 profile image
Bessieboo1 in reply to J1707

I’ve been on Etoricoxib for several years now, can I ask why you are no longer able to get it? Xx

J1707 profile image
J1707 in reply to Bessieboo1

I was told it could no longer be prescribed as on list of drugs no longer available as not safe

Bessieboo1 profile image
Bessieboo1 in reply to J1707

WoW, no one has mentioned this to me, whereabouts do you live?

J1707 profile image
J1707 in reply to Bessieboo1

Birmingham. Neither my Gp or rheumatologist will give it too me . I’m allergic to ibuprofen and naproxen and they still won’t give it to me even though it works and I’m willing to take the risk. I would only use it if desperate

Bessieboo1 profile image
Bessieboo1 in reply to J1707

I wonder if they will stop mine sometime in the near future then!!!

J1707 profile image
J1707 in reply to Bessieboo1

I was offered steroids only

Bessieboo1 profile image
Bessieboo1 in reply to J1707

Gosh, that must be incredibly difficult for you, really sorry!!

If you would like support, information or just someone to talk to, our NRAS helpline is open every weekday from 9.30am to 4.30pm nras.org.uk/helpline/ 0800 298 7650. Or have a look at our website nras.org.uk. Kind regards.

tazman3 profile image
tazman3 in reply to Helen-NRAS

Thank you Helen, I appreciate your kindness.

There are two NSAIDs (the family of drugs that brufen and naproxen belong to) that are cox-2 inhibitors, meaning they work slightly differently to all the others: I think it’s one of those you’re likely thinking of. One is etoricoxib as mentioned by J1707, and the other is celecoxib. As I understand it, they’re not very widely used for a number of reasons, but there are members here that have done/do use them.

tazman3 profile image
tazman3 in reply to Charlie_G

I managed to get a phone consultation with a 'Physician Associate' at the GP surgery. He has prescribed Nefopam so I will see how I go with them. Anyone else tried this med?

Charlie_G profile image
Charlie_G in reply to tazman3

With the caveat that I’m not remotely medically qualified. So, nefopam is not an anti-inflammatory, it doesn’t have any anti-inflammatory action at all in fact, it’s ‘just’ a non-opioid painkiller suitable for moderate pain. It’s one of those drugs where we don’t know how it works, but the theory is it probably blocks pain signals in the central nervous system from reaching the brain. It’s only my opinion, but depending on why you’re in pain, I’d suggest it may not be the most appropriate or helpful option. If the pain is due to flaring, then contacting rheum and asking them for steroids would likely be a much more useful option. Personally, I’ve never had any benefit from any painkillers if the issue is active inflammation - the inflammation in the joints that’s causing the pain to begin with.

tazman3 profile image
tazman3 in reply to Charlie_G

Thank you for your reply. I understand it's not anti inflammatory, but needed something that I can take as and when needed. I recently weaned myself off Co-codamol after 25+ years on it. I had an accident in the gym, followed closely by a car accident which damaged my back and that's when the coco started.

I am still going through the start/stop of biologics, the last one being Tocilizumab infusions. Bloods not good with that so the next one will be Sarilumab. I just need to be able to control my pain, even if it doesn't go completely.

Got yet another blood test tomorrow for kidney function. If that's ok I will be starting the Sarilumab. I'm not getting excited as I always get disappointed when the drug doesn't work or suit me. So back to basics with fingers crossed!

I have had a few steroid shots which have really helped but I refuse to take oral steroids. I had them when PMR was suspected in the beginning. I was grateful when I was told I have RA so I could stop taking them.

Charlie_G profile image
Charlie_G in reply to tazman3

I’ve had several spells of several years each munching cocodeine, tramadol, gabapentin etc., for various reasons, and I suffer with constant chronic pain unrelated to my joints: I can empathise with your experience, and hope the nefopram takes the edge off. I do understand what you’re saying about pred, and I personally really don’t like taking it, but as it’s the only thing that ever helps me when things are really bad, it’s a case of weighing up which is the lesser evil at the time - I’m a single dad to a disabled teen, and at my worst I can barely walk or even cut my own dinner up, never mind deal with her appropriately 🤷‍♂️ I’ve had psoriatic arthritis (PsA) for 20 years, but only finally got my diagnosis in Jan of 2020. To date, I’m still not under control, although have finally seen some benefit since switching from adalimumab to etanercept (Benepali) a couple of months ago. Like you, I’m not holding my breath that it’s going to be ‘the one’, but all we can do is cross our fingers and try.

AgedCrone profile image
AgedCrone in reply to tazman3

You are so right…the longer you can manage without the oral steroids the better.I know it’s no fun going through the disappointment of a yet another failed drug…but I fortunately turned out not to be able to take steroids,& when I see the difficulties people have in stopping taking it,I am very grateful.

I hope you manage well on Sarilumab.

Good morning tazman3 - Naproxen didn't work for me either and Ibuprofen didn't work enough and not even Tramadol so I was prescribed Celebrex (Celecoxib) and that helped a lot! I took it last year for a few months while I was waiting for Kevzara to kick in. Maybe you could ask your rheumy about this med? All the best, Christine xx

I was prescribed Celebrex in 2004 when I was first diagnosed with RA , alongside Sulfasalazine. I was taken off it months later , something to do with it being banned in America I think. I have since taken Lodine (Etodolac) which is an anti inflammatory and works really well for me. It’s a slow release one. I’ve tried Naproxen but it didn’t work for me.

Ketoprofen

I’m taking Celecoxib alongside Sulfasalazine and works better for me than Naproxen,

If you want to know more about non-steroidal anti-inflammatory drugs have a look at the NICE guidleines:bnf.nice.org.uk/treatment-s...

I do like to know more than I need to so that I can take informed decisions about my treatment!

I take Diclofenac Acid (voltarol) a NSAID, and have done so for over 30 years. It works a treat for me, naproxen and others just don't do it.Many GPs will not prescribe Diclofenac now, but if what you have doesn't work it might be worth asking about.

There are quite a few in the NSAID group, so there are options. There may be an alternative for you, it depends on if you have any medical history determining if you shouldn’t be prescribed them. I've tried a few since diagnosis 14 years ago, some with success, others little. My longest serving & current one is etoricoxib. This is the COX-2 inhibitor the FDA discontinued for cardio reasons. I have heart disease on both sides but fortunately I’m ok, I still have annual cardiovascular checks though. Celecoxib, another COX-2 (still available in the US), was one of the 2 NSAIDs I was prescribed at diagnosis, that & nabumetone. Otherwise I've tried diclofenac, naproxen, meloxicam & ibuprofen, the latter before diagnosis.

You might find this helpful in understanding why not all NSAIDs are suitable for everyone cks.nice.org.uk/topics/nsai... Keep in mind though, we wouldn't be prescribed them if they weren't thought beneficial in our treatment of RD & it's co-diseases, sort or longer term. I hope the next you try works well for you.

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