MIXING PRED WITH IBUPROFEN AND OMEPRASOLE

[Mary63]

Saw my GP this morning for advice on knee flare up 11 weeks after total knee replacement. Advised I should go back to taking ibuprofen as that works well for my knee pain. Prescribed double dose of omeprasole which she assured me would not result in any gastric reflux. Took first with quite a bit of food but still have reflux. Pain not much improved.

I think I’m right in saying pred should be taken a few hours away from NSAIDs?

Would ranitidine be a better stomach protector, if omeprasole does not help?

[jinasc]

Any NSAIDs are not recommended at all with PRED.

Ranitidtine is a much better stomach protector.

One of the side effects of Omeprasole is muscle aches and pains just like PMR.

Why are you having a knee flare up after a total knee replacement?

I would be asking for an immediate appointment with the Orthopaedic surgeon who did the replacement.

I only ask because about 10 years ago a friend had a knee replacement and then had trouble, he went back to the surgeon and it was something to do with the 'cement' (I think that was the word used) and it had to be done again.

[fmkkm in reply to jinasc]

Hi,

I was actually going to ask this question. Why is it bad to take ibuprofen when you are on prednisone?

[piglette in reply to fmkkm]

The two are contra indicated, ie they affect each other. It is like taking grapefruit with statins.

[DorsetLady PMRGCAuk volunteer in reply to fmkkm]

Because they are both liable to cause stomach problems.

I used Ibuprofen gel when I was on Pred - but sparingly and only once a day (okayed by pharmacist) - but tablets taken regularly are not a good idea.

As jinasc says your knee problem should be addressed by the surgeon - do you still have release paperwork - it should tell you on that who to contact if you have problems.

[Mary63 in reply to DorsetLady]

Thanks. I have just dug them out.

[HeronNS in reply to Mary63]

I do take aspirin occasionally for headaches, although I try not to. Have been using the tried and true method of eating a little plain full fat yoghurt at the same time (as I do with my calcium at bedtime) and feel this helps line the stomach along with whatever other snack I might also eat at the time.

[piglette]

My GP offered me an NSAID with pred, when I asked about mixing the two she said she had forgotten there was a problem and offered me something else.

[PMRpro Ambassador in reply to piglette]

Facepalm ...

[PMRpro Ambassador]

Maybe - PPIs just don't work for some people, about a third I think. I was on a week long course of iv NSAIDs and used ranitidine and was fine.

However - that is just covering up a potential problem. Take it to the surgeon - there are a few reasons you could have problems,

[Mary63]

Decision made. Thanks.

[Pippah45]

I am allergic to Ibuprofen but GP suggest I use some stuff called Movelat - any chemist has - and rub it in.

[Mary63]

Thanks Pippa. Tried the rub in stuff. Does not work for me at the moment. Thanks though.

[Hidden in reply to Mary63]

I realise you have made a decision to contact surgeon(?). But in the meantime perhaps you need to build antacid up before you take ibuprofen. Also try the gastric resistant pred if you haven't.

I had ppi for 15years for aspirin and since I tapered off last year i still get reflux occasionally. I also take ibuprofen occasionally for other ongoing issues and always line my stomach with antacid and food prior to ibuprofen. I do have a pack of ppi left and had to take one twice. I try and get the 12hour nurofen so it needs that protection across the 12 hours but at least its fewer pills to take. A tiny, tiny, tiny bit of capsaicin cream might be an alternative but if you put too much on it can burn and you can't take it off. Water makes it burn more. Hence the tiny's.

[Mary63]

Yes I have contacted surgeon, and hope I will hear back soon .

I was on omeprasole and ibuprofen and food to try to line stomach for 8 weeks post op. And then gave ibuprofen and omeprasole up. It’s only 3 weeks ago but I can’t remember the details. I was convinced that far from helping omeprasole was making reflux worse.

Tried ibuprofen omeprasole and food again today. Knee pain maybe slightly easier but reflux dreadful. . In case my theory on omeprasole is correct I am going to give ibuprofen a go tomorrow, taking it with a meal.

Thank you all for your advice

[HeronNS in reply to Mary63]

Did you taper off the omeprazole? Stopping it abruptly can lead to rebound acid production.

[Mary63 in reply to HeronNS]

I did taper thanks.

[Purplecrow]

Hi Mary, about 6 months after my TKR, i still had pain around my new knee. Returned to surgeon, and after xrays and exam, he told me it was soft tissue pain, and not the knee appliance. I found it helpful to use ice pack and topical rubs. I expect my pain was due to the healing process, post trauma of the surgery. Took about a year to remit.

I used nsaids with yogurt for tummy protection.

Good luck, Jerri

[Mary63 in reply to Purplecrow]

Or should I say thank you

[Mary63]

Thank ypu