A lot of people have said in the forum that ibuprofen "doesn't do anything" for PMR, but I use it to supplement my pred. I've been up to 15mg for a month (my doc only ever had me at 10mg, so that was a mistake for sure), and after 18 months of dealing with the PMR, it's abated pretty well, but I still sometimes take Advil (ibuprofen) when I get up in the morning and feel a bit of extra stiffness - it knocks it right out. I'm walking well, and taking stairs much better. But I don't take Tylenol at all - I found that Tylenol, while it does mask pain, also seems to cause other symptoms. Ibuprofen is also metabolized in the liver but not as hard ON the liver as Tylenol is, so you can absolutely never take Tylenol while drinking alcohol, if you are so inclined. I'd rather have a glass of wine or a scotch than deal with the Tylenol, particularly since it's not helping inflammation.
Ibuprofen isn't a treatment for PMR - prednisone is that treatment. But if you need to "top off" with some Advil (ibuprofen) every once in a while, then why shouldn't you?
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I used to take Brufen 600mg tds and co-codamol 6 hourly for slipped discs. Only ever reduced the pain and never eliminated it. It did however wreck my stomach, and more than 2 doses now will mean I need a PPI. (With all the side effects they bring for me).
And my son is allergic to Brufen.
Apart from that, Brufen is not recommended for use alongside pred. And it has, I believe some long term cardiac implications.
OTOH, paracetamol (Tylenol) works for me, without side effects (that I am aware of) But other son gets unequal pupil size with P’cetamol.
You do still need to be careful with the NSAIDs (which include ibuprofen) as both they and pred can be hard on the stomach and in some people lead to gastric bleeding. One lady was told to use ibuprofen for her PMR symptoms - after only 3 doses she was in A&E with a gastric bleed.
And as Soraya says, there are other long term effects with ibuprofen in the cardiovascular and renal realms.
I agree, before I was diagnosed when I just thought I was really , really sore and Ill and
didn’t know what might be wrong, I was taking Ibuprofen on a very regular basis. As a result I developed stomach ulcers , sadly then compounded by being prescribed Alendronic Acid.
I think it’s more that an additional anti- inflammatory whilst you are on Pred is just a double whammy on your digestive system. I agree, without Pred, Ibuprofen is probably the one painkiller that might help any residual aches and pains.
My PMR friend had taken just 3 doses as instructed by her GP - no pred at all. Coffee grounds gastric bleed - not pleasant for her or the staff in A&E.
I’ve taken other pain meds along side Pred for other issues. I always discuss with my Pharmacist for Contraindications for any new or change of Pain Meds, a lot of it is to do with gastric issues.
Some of us cannot take ibuprofen or any other one in that family of drugs. They are too hard on the stomach lining and can cause bleeding. I take Tylenol. My physician says that I could take up to 4,000mg of it before it starts to be detrimental to the liver.
I do trust my doctor, I have found him very reliable for the over 15 years I have gone to him. He is not a fuddy duddy old man. He is in his lete 50s and keeps up with all the present studies. Even so I check his advice and always found it verifiable for me.
I didn't know this before but I guess pred itself can in some cases damage the liver so basically it's not a good idea to add in other meds with the same potential if one can avoid it.
My GP cites the 4,000, but says 3,000 max because it is also an ingredient in so many over-the-counter drugs and other things affect the liver with my condition.
You are right that other pain killers can make a difference to our pain with GCA/ PMR because it is a complement drug working on the neuralgic or muscle pain which is not part of the PMR , but pain affecting other parts of the body from other causes or a side effect of medication.
You are also right that the drug originally if choice by doctors was always Ibuprofen . It is more effective than Paracetamol and without the same addictive side effects of Codeine.
However , doctors are now aware that in some cases , despite being more reliable in masking the pain , Ibuprofen is not appropriate for many types of condition of patients.
This is because it does have an effect on the stomach similar to aspirin irritating the gastric tract and increasing stomach bleeds and potential for ulcers.
If you have ever been diagnosed with gastric reflux , gastritis , IBS and ulcers you will be told to stop taking it immediately and Paracetamol is usually the drug you are left with.
If you are taking certain types of drugs that also affect the gastric tract like steroids you are also advised not to take ibuprofen to prevent extra trauma on the stomach.
As a low grade NSAID , it should only be used with other NSAIDS under advisement , and Paracetamol is preferred with certain blood pressure and heart issues too.
It is considered that the impact of Paracetamol on the liver ( unless your function is reduced) is far less than the possible effect of ibuprofen on the stomach.
Obviously , from experience most of us found ibuprofen more effective in the last , but with our already sensitive system on PMR or GCA that is not the best drug in the long run.
If paracetamol does not dull all of your pain in other parts of the body other alternatives are available ( preferably not Codeine, steer clear if you can ) but it will need to be on prescription with GP advice.
When I was 1st diagnosed with GCA & PMR early 2017, I had been taking Advil around the clock for about a month before for my unrelenting headache. Steroids resolved that. But, I was forbidden to take NSAIDs like Advil.
I'm on 4 mg/day of Prednisone now. I take Advil as needed for rather minor aches 'cause I'm not going back now that my hair is returning. And my rheumy said that the pain in my legs going down my legs when I walk wasn't PMR. So, I assume it's steroid withdrawal pain.
I'm always mindful that other than bleeding, these drugs are hard on the kidney. It's a little complicated to explain. But, whether it's Tylenol (acetaminophen) or Advil (ibuprofen) you must be hydrated. Read labels for many combination drugs contain acetaminophen. Our liver can only metabolize 4000mg of Tylenol per day. And a man who took ibuprofen tried to sue the manufacturer when he developed renal failure from it.
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