Ibuprofen and pred

[Casia]

My doc says it’s ok to occasionally take ibuprofen with pred as I’m on a low dose (4 mcg). I’ve found taking 200 mcg ibuprofen helpful very occasionally if going on a journey and dong a lot of walking. Does anyone have any advice or experience with this as I understood you really shouldn’t take both ? Btw thanks so much to you all for your input and support on this site. It’s great and very comforting.

[SheffieldJane]

Hi Casia, It is because both medications are very harsh on your stomach, so you get two attacks on it. Apparently either could cause a stomach bleed. I am not sure at your doses and in the absence of anything but good results. You could talk to your pharmacist about the combination, the frequency and the doses. Always coat your stomach with yoghurt or similar.

[Casia]

Thanks for that . That’s good advice about talking to the pharmacist . I don’t seem to have any tummy issues with pred but agree that the ibuprofen can have an affect there. Best, Casia

[DorsetLady PMRGCAuk volunteer]

I took ibruprofen capsules and used gel (both occasionally) whilst taking Pred for GCA. Not for the GCA but for osteoarthritis without any problems - was taking a PPI (Omeprazole) though.

As Jane says check with pharmacist.

[Casia in reply to DorsetLady]

Thanks DorsetLady. That’s very helpful.

[PMRpro Ambassador]

My rheumy put me on a week's course of a high dose NSAID recently for a back problem. I was terrified (particularly as I also take an anticoagulant) but he said I needed either a PPI or ranitidine as well and I would be fine although I do have to point out that the NSAID was given as an infusion.

Small amounts occsionally are probably fine if you are careful. I used to use topical ibuprofen gel when skiing before I was given pred and found that while it did not a lot for the PMR in general, it did help the post-exercise muscle soreness greatly.

[Casia in reply to PMRpro]

Thanks PMRpro. Very interesting what you say about the gel. I’m finding that my PMR stiffness has virtually disappeared in the mornings but after walking for more than half an hour I get hip pain ( not symmetrical) and will try the gel. I do wonder if the hip pain is PMR, muscle strain or arthritis or a combination .

[PMRpro Ambassador in reply to Casia]

I'd lay odds the hip pain could be trochanteric bursitis - unilateral, exacerbated by exercise (are stairs worse?) and often found with PMR.

[Casia in reply to PMRpro]

I think you may be spot on but would that show raised ESR and CRP and should it be treated with pred?

[PMRpro Ambassador in reply to Casia]

No, it may not show a raised ESR/CRP and while pred is a good approach it would not be by raising the oral dose but often by a local steroid injection. One is sometimes enough, sometimes you need a second a few months later. It isn't an injection into the joint, that is different, but into the soft tissue over the most painful area (found by pressure over the area, where does the patient squeal loudest ) At least, that is how my rheumy-trained GP and the rheumatologist go about it...

[Casia in reply to PMRpro]

Thanks so much. I will discuss with my gp and suggest a rheumatologist appointment. Enjoy the rest of your Saturday.

[peace_lover]

I occasionally use Ibuprofen tablets when I’m have an unshakable headache or migraine and analgesics are not touching it. The change of tablet usually does the trick. However I am always hesitant as I have indigestion problems and now take Ranitidine after years of being on Omeprazole. I usually have an idigestion flare up after taking Ibuprofen. The topical gel, on the other hand, I find quite useful for arthritic joint pain or muscle pain, although useless for PMR pain, and doesn’t seem to cause digestive problems.

[Casia in reply to peace_lover]

Thanks for that peace_lover . I will definitely try the gel for hip pain.

[peace_lover in reply to Casia]

Just realised I actually use Voltarol gel more then ibuprofen as it is more effective and less sticky,but the principle is the same!

[schmuppy]

I actually supplement 10 mg of pred with some advil every few days, usually when ive eaten too much of a triggering food. It helps mitigate that last bit of stiffness and actually lasts quite a while. But I'm always aware of the potential for stomach issues

I avoid dairy religiously so I take with a bit of rice cake.

[Casia in reply to schmuppy]

Thanks schmuppy!

[GOOD_GRIEF]

My doctor said if I use an NSAID, not to take it within 4 hours of a pred dose (before or after).

[Lochy]

I have been using naproxen and paracetamol combo some days when my knee pain is bad. If I know I’m doing a fair bit of walking I’ll take one of each mid morning with food. Takes a few hours to work but when it does it’s great! I’m currently on 10mg of Pred, splitting my dose 4mg at night 6mg in morning. My pain free time, from all niggles, is about 1pm until about 9pm. Stiffness sets in again usually because I’ve been sitting for a while!

Experimenting is worthwhile but I don’t take them daily.

[Casia in reply to Lochy]

Thanks Lochy. Good to get your experience .