Short term ibuprofen

[Twopies]

I have a lot of non-pmr pain, Tylenol isn’t cutting it, 1/2 tramadol makes me very ill with nausea and wooziness. My doc suggested I take a 5-7 day course of ibuprofen, providing the pharmacist said it was ok to do so while on prednisone. The pharmacist said yes, 5-7 days would be ok, but at the least hint of stomach upset, I’m to stop it immediately. He also said to take it with food. Has anyone tried this? Thanks.

[PMRpro Ambassador]

My rheumy uses 1 or 2 week-long courses of NSAIDs but ALWAYS with stomach protection alongside it - I don't take anyhting routinely, never have. I've done it for infusions of high dose something or other (no idea what, just it is an NSAID) and more recently 2 weeks of ibuprofen. No problems.

[Twopies in reply to PMRpro]

Stomach protection? You mean coating? My husband takes coated ibuprofen but it contains dye to which I am allergic. I looked up the ingredients in the non-coated kind which is dye free.

[PMRpro Ambassador in reply to Twopies]

No - a PPI or H2 antagonist to reduce stomach acid. Omeprazole is the most commonly used PPI, there are others. Used to be ranitidine for H2 antagonists until it was withdrawn, now famotidine or cimetidine usually.

[Dontwannabesick]

I occasionally resort to a combination of Ibuprofen and paracetamol when my back and hip become too painful. I have Lanzaprozol to protect my stomach. I used to have Naproxen for my arthritic spine, but GP won't prescribe it now because I'm still on 1.5 mg Pred. No ill effects from Ibuprofen so far, but it has helped me keep moving during the day, and sleep better at night. I only use it for a week at the most. To be honest, as soon as pain eases I forget to take it!

[PMRpro Ambassador in reply to Dontwannabesick]

I find that paracetamol does nothing for me on its own - except as as an infusion. But taking 1x400mg ibuprofen plus 1 paracetamol tablet works far better than just the ibuprofen alone.

[Pawscat11 in reply to PMRpro]

I totally agree with this and do the same some mornings with breakfast if my bursitis is particularly bad. It takes the edge of. I do not take omeprazole or any equivalent. I have not had any stomach issues in the 3 years of pred so do not want to add any more pills than necessary.

[Twopies in reply to Dontwannabesick]

You mean you take them at the same time? (I’m assuming paracetamol and Tylenol are one and the same). Thanks. (I haven’t purchased the ibuprofen yet, hoping that will do the trick—or at least help more than the Tylenol alone).

[PMRpro Ambassador in reply to Twopies]

Yes - and paracetamol is acetaminophen, Tylenol

Ibuprofen is supposed to be used with a flooding dose of 800mg and then topped up with 400mg doses. I find I can manage on less iboprofen by adding the paracetamol You still have to observe the max doses in 24 hours though

[SusanEleven]

Tylenol/paracetamol has never worked for me to reduce the pain of my osteoarthritis and other non-PMR pain. Quirk of my body I guess. Luckily a mere 200mg ibuprofen will give me eight pain-free hours. In rare instances I'll need 400mg. I use them sparingly, always with food per my pharmacist, and spaced a few hours apart from my prednisone.

[Twopies in reply to SusanEleven]

Thank you; I took 200 mg 2 hours ago; have some relief for first time in a month.

[SusanEleven in reply to Twopies]

I’m glad you’ve found some relief.

[HeronNS]

For what it's worth: I haven't taken it for more than a day or sometimes two, but aspirin is allegedly harder on the stomach than ibupfofen (I believe this is why ibuprofen is more popular now) and I take aspirin for headaches. I'm very careful. I never take it near my pred time, and always eat something with some substance - e.g. bread - and have a full glass of water. I don't lie down for at least an hour after taking aspirin. Have been known to "go to bed" in a comfy chair in order to stay upright. Nowadays I also often have a little bit of yoghurt which we know helps us tolerate pred. In my life I've had two serious stomach bleeds and so if anyone would be at risk it would be me, but because I'm so careful this has not caused me problems since being on pred. But, as I said at first, I've never had to take anything for several days in a row. And, yes, a single dose of acetaminophen along with the nsaid does seem to help, although like PMRpro I do find it generally useless on its own.

[Twopies in reply to HeronNS]

So do you take them together? I can try ibuprofen and Tylenol together if needed?

[HeronNS in reply to Twopies]

I usually alternate, but it is possible to take them at the same time because they work through different pathways. I looked it up one time. You could take one medication and then take the other a couple of hours later rather than both at the same time, or waiting the full time you would wait between doses of a single med. So if you were planning to wait eight hours between doses of ibuprofen, for example, you could take acetaminophen maybe three to five hours after the ibuprofen, depending how you are feeling. Also you don't have to worry about stomach if you take acetaminophen near your pred time.

[Twopies in reply to HeronNS]

Got it, good, thank you!

[Alebeau]

How many mgs of Pred are you on?Maybe increase to reduce pain?

I went through a stage where I was taking Tylenol 3 Tramadol and then Dilaudid. Dilaudid worked the best.

However, in hind sight I should have just increased the pred as that was what worked best.

Have not had a pain killer since.

Slow reduction after that is essential to remain pain free.

Anyway, just wanted to share my experience and BTW I am also now taking Leflunomide which sems to be working quite well as I am now approaching 7 mg and still no pain.

Good luck.

[Twopies in reply to Alebeau]

It’s not pmr pain, it’s post surgical pain; it was the surgeon who suggested ibuprofen. Glad you’re pain free. I do the slow reduction, I’m reducing to 6 1/2.

[Alebeau in reply to Twopies]

Oh, my apolgies for the mistake.Yes, post surgery pain is difficult. I remember taking all the Tylenol 3's for a very minor hernia operation.

Good luck