Diclofenac

[JoLou12]

My back has gone into spasm, can I take diclofenac with pred? In the past I would only have to take a couple over a few days and my back would easy up quite quickly. They were prescribed last year before I got PMR. Thank you for any advice.

[PMRpro Ambassador]

Drug advice for patients:

"Using prednisone together with diclofenac may increase the risk of side effects in the gastrointestinal tract such as inflammation, bleeding, ulceration, and rarely, perforation. Gastrointestinal perforation is a potentially fatal condition and medical emergency where a hole forms all the way through the stomach or intestine. You should take these medications with food to lessen the risk. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Your doctor may also be able to recommend medications to help protect the stomach and intestine if you are at high risk for developing serious gastrointestinal complications. You should seek immediate medical attention if you experience any unusual bleeding or bruising, or have other signs and symptoms of bleeding such as dizziness; lightheadedness; red or black, tarry stools; coughing up or vomiting fresh or dried blood that looks like coffee grounds; severe headache; and weakness. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor."

Really it isn't advisable to use NSAIDs together with pred and definitely not for any length of time but doctors do use them together. They must be taken together with food and possibly using ranitidine or omeprazole as well which will help reduce the risk to the gut. They are both available OTC.

Have you tried using Voltaren gel? Does it work for you? That reduces the amount getting into the GI system so less effect on the stomach.

You have my sympathy - there I was thinking how good my back was after a few weeks of therapeutic massage and I got out of bed 2 mornings ago and OUCH!! Luckily I had a pain clinic appointment yesterday so I can move - but I'm sitting on a hot water bottle!

[JoLou12 in reply to PMRpro]

Thank you so much for your reply. I will avoid the diclofenac based on this information and try and cope with rest and paracetamol for now. I will also send hubby out to get me some Voltorol gel which I’ve never really used before, so fingers crossed that will help. Like you my back has been good for ages but yesterday I had an hour long MRI and think I put it out trying to get off the table! Hope yours eases quickly too, kind regards, so good to know we have this amazing forum x

[PMRpro Ambassador in reply to JoLou12]

I had a pacemaker check on Tuesday and I have a rather sneaking suspicion it was the combination of the position being a bit flat and the electrics going on!

[SheffieldJane in reply to JoLou12]

When my husband’s back goes into serious spasm the GP has prescribed Cocodamol and Diazepam. This does the trick within 30 minutes. He has been on the floor in agony and just about to give a speech, in the past.

[JoLou12 in reply to SheffieldJane]

Thank you, I think I have some diazepam but I need to check the date on it! Definitely worth a try tonight!

[piglette]

Have you tried Tramadol?

[JoLou12 in reply to piglette]

No never, I always got on so well with diclofenac that I never asked for anything else, thanks though, I will ask doc if no better by Monday.

[piglette in reply to JoLou12]

It is just that Diclofenac is an NSAID and is a drug contra indicated with pred.

[JoLou12 in reply to piglette]

Thank you x