Combo pred and NSAID: I am on 5mg prednisone for... - PMRGCAuk

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Combo pred and NSAID

Nolsie profile image
10 Replies

I am on 5mg prednisone for the last month, having tapered down from 25mg since Nov 2019. I take the full dose at 7am but found that I have stiff shoulders and hands in the morning since I've been on the 5mg. I have been adding 60mg of arcoxia (NSAID) every 2nd day which helps a lot with the morning stiffness.

My question: is it better to address the inflammation with the combo of pred and arcoxia or should I increase the prednisone temporarily to a higher dose (6.25mg) and leave the arcoxia?

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Nolsie profile image
Nolsie
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10 Replies
SheffieldJane profile image
SheffieldJane

Alternatively, you could try waking at 2 am to take your 5 mgs. Then go back to sleep. Some people find that this is effective. The body releases the inflammatory substance at this time and you can sometimes head the symptoms off at the pass. (Cytokines is the name I think). No doubt someone will correct me if it isn’t).

Our aim is to reach our lowest most comfortable dose of Pred. I am not familiar with Arcoxia - be careful if it is a non steroid anti inflammatory. Combined with Pred they can cause internal bleeding.

PMRpro profile image
PMRproAmbassador

As you say Arcoxia is an NSAID, in particular it is a Coxib, a selective Cox2 inhibitor. It is not sold in the USA - the FDA turned down Merck's request to market it as a successor to their drug Vioxx (which was banned in 2004 because of its record of doubling the risk of stroke and heart attack) until further safety information was submitted. It is available in 80 other countries.

If it were me and 1mg more pred meant I didn't have to take a pain killer of any sort that would be my choice.

Hi Nolsie

It really is a decision that needs to be taken by a Doctor/Specialist. I was prescribed Meloxicam for bone pain behind my knees post chemo & still take it when necessary but it was issued by my GP & approved by the Consultant.

The main concern is the risk of stomach irritation, so a PPI & plenty of Plain Yogurt is essential & take it once a day & best taken with a meal.

You may fare better on a small increase in your dose of Pred rather than adding another Big Boy into the Mix......

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer

Really NSAIDs should not be taken with Pred - both can affect stomach - and I think if you read the patient information leaflet it tells you that.

Better to stick to Pred alone, so up that if necessary.

piglette profile image
piglette

Are you saying you have dropped 20mg since last month? If that is correct I would be amazed if you did not have some aches and pains.

PMRpro profile image
PMRproAmbassador in reply topiglette

Well done piglette - didn't pick that up! I do hope it is a typo!

piglette profile image
piglette in reply toPMRpro

It is the sort of drop a lot of rheumies would love!!

Thelmarina profile image
Thelmarina in reply topiglette

That’s what I was thinking!

Nolsie profile image
Nolsie

Thank you so much for all the sound advice. The arcoxia was prescribed by my rheumatologist. And sorry, my mistake, I was diagnosed in Nov 2018.

I will increase the pred and leave the arcoxia.

Thelmarina profile image
Thelmarina

Thank goodness, although it still feels like hare rather than tortoise!

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