About 8 months ago my hip pain ( totally different than pain when first diagnosed) became so bad my doc suggested I start Celebrex to ease pain and keep me mobile. I started a PPI at the same time to protect my stomach. Think I was on 9 mg. pred at the time, having started in 2018 and going through 2 flares. My hip pain vanished and I have been able to decrease my pred to 2.5 mg. I have felt like PMR is in remission for a few months, just don’t want to rush to the finish line. My question to you, after reading many cautionary tales, do you recommend I stop taking Celebrex while on prednisone? I know it’s not recommended, is hard on the stomach, can cause heart problems but oh my! I feel like my old self in all senses.
My doc has been running blood tests all along, checking kidney function etc as well as usual markers. Thanks for any research news or experiential stories.
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Evercurious
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So long as your doctor is aware and checking for all the usual interactions and you are taking stomach protection - like PPI - it's really a decision you have to make - you know the risks.
Thanks for your speedy reply, Dorset Lady. When I read about the risks my answer would be NO, but my PMR self feels so good and all since I started Celebrex, that I’m just not sure.
It's really a decision between you and them...we can give our opinion, but as my late husband used to say, "it's my pain, and I have to decide what I want to take for it"..
Thanks, DL. Guess I was looking to see if anyone else has been prescribed the same or if any new research would say definitively NO to combination. I knew Celebrex could cause heart problems, but just read one of those problems could be calcification of the heart valves.
But then reading about prednisone would cause one to reconsider, too.
Yes, she does. That’s why a PPI was added to the mix. Think she thinks being active outweighs the risks. Guess I was just wondering if anyone else has taken both for any duration or if there was newer research I hadn’t read.
It really seems to have made a difference in my PMRjourney.
There was an article in the BMJ recently saying PPIs should not be taken for any length of time, just a few weeks. I am not sure who did the research on that though as I know people who have been taking PPIs for years. I have never heard that being active stops contra indications though!!!
Hi,Evercurious, I have been taking Pred now for 3 years,at various doses, and have been on Celebrex for a while now. I do take Esomeprazole to protect the stomach, and ,although I do have breathlessness and bruising, my GP tells me I’m “breathing funny” and dismissed it! I never have any regular blood checks so I guess that means there’s no risk?
My pain is always worse without the Celebrex, so I suppose we take our chances??? It sounds like you have a more interested doctor,so, good luck!🤞
It is the way it is in Wales unless you keep them to the proper protocols. Regular monitoring blood tests and heart checks should be done at between 3-6 month intervals , irrespective of symptoms to ensure a combination of two strong medications are not causing any potential change in liver , kidney and heart function. Although a PPI is often needed for certain patients long term the PPI itself can also sometimes cause it's own side effects and may need adjusting or changing.
Any drug combination which involves a Moderate chance of causing additional symptoms through the effects of those drugs together on the body needs proper supervision and regular health checks.
If you have symptoms like " breathing funny" the GP should immediately order blood tests and checks , even if you have had similar tests recently.
Not to do that is against standard care guidelines.
I am in Wales , my surgery are not very up to date on knowledge , but they are on the ball about systematic testing while on drugs like steroids and NSAIDs.
I would suggest that you contact your surgery and politely , but firmly , request the full blood count. kidney and liver function tests required , as well as a Ferritin / iron panel , Folates , Vitamin B 12 and Vitamin D and Inflammatory markers.
Hopefully, they are normal but in which case your GP should not just dismiss breathing issues but arrange more testing.
If they aren't in normal range , there could be very simple reasons for it that could be treated and solve your added symptoms quite quickly.
Not being offered the blood tests doesn't mean there is no risk or no need for them , it just means that the risk isn't being assessed . They have no idea if their assessment is right without confirming it with the right tests.
I know it begins to feel like it's a full time job dealing with doctors and appointments, and you begin from a point when you are working under the belief that anything a GP decides or dismisses at appointments must be followed , or right. But , unfortunately, that isn't the case and doctors often need a gentle prod to do things that should be done as standard.
I hope you feel ok at present but I would suggest you arrange a face to face appointment with your GP to arrange these checks as soon as it's possible at this time of the year. Take care.
methinks it’s time to find a doc that is interested in your health! Can’t imagine one not concerned enough to order blood tests. I have a standing order requisition that tells me what my inflammation markers are, that I use every few months to help me decide my tapering regime, then have another battery of tests for kidney function, cholesterol, sugars etc every six months. I can access those results through the lab.
But having that level of monitoring isn't hard - a UK doctor should be ordering something similar for any PMR/GCA patient on pred. And they don't have to do it - the nurse can and refer to a doctor if necessary,
I wouldn't be keen - but that would have been at the start mixing it with a solid dose of pred. If you have got this far, it works well and you are down to such a low dose of pred and are being well monitored it is probably fine. I think that other pain sources can "feed" PMR and it makes reducing the pred hard.
I don't think it makes much difference - everything has potential adverse effects and then it is a case of balancing the pros and cons and that is what your GP has done. She sounds a fairly good one. After all - it keeps you mobile and even if it doesn't stop the effects, being mobile and able to exercise without pain is a big plus to balance it out
If you find it - do tell!!! Had physio this morning, she inflicted mobilisation exercises on me. It occurred to me, I'd never have been a professional athlete, couldn't take the training pain! I'm sure it will have helped but it doesn't feel much like it at the moment ...
As an Athlete in my youth, whom just missed the stage of big competition because of shoulder injuries, I can say the increased training, forcing things further and further beyond the limits is part of the cause of most athletes and dancers suffering from various illnesses , and much early than the guidelines state, in their middle years.Even many digestive and gynaecological issues can be put down to aggressive training and movement undertaken in our youth , or as a sportsperson , made worse if there is also a genetic link to certain health conditions.
See how you feel in the next 48 hours. If it's still aching within the first 24 hours they need to dial those exercises back a bit. Pain isn't meant to be a part of physio and it doesn't help either.
Since finding my physio I have never had a moments pain after a session , and if I got a twinge during physio he wouldn't let me continue that movement or that intensity either. I wish I could clone him and send everyone a copy for Christmas!
My physio started with Manipulation Therapy during this break from being able to use Hydro , then some exercise followed by Manipulation Therapy. It definitely helped get rid of the worst tightness and knots, and improved my Autonomic Nervous System effect on circulation.I actually got back the inch I'd shrank over the last few years.
Then we worked on breathing and posture adjustment. I've one leg nearly 2 CMS shorter than the other which I'd not realised after a life of growing up accomodating it. New shoe inserts have helped.
All that before he allowed me to build up on stretches.
I can share my personal experience ..... I was on Celebrex until I started on Prednisone. With my history of ulcers, sometimes bleeding, my second Dr. after starting Prednisone took me off it. I'd had a hip replacement and revision in that hip and I'm sure have some arthritis. I got a cortisone shot in that hip and only have a twinge now and then. My best💞
If you can move without pain it seems that would be as good time to start exercising. This, in turn, would improve your strength and conditioning. The arthritic joints need strong muscles to support them. That reduces or even eliminates pain. Maybe them Celebrex can be discontinued.
I became so deconditioned staying in because of covid. I have less room for breathing because of scoliosis. I am on Oxygen 24/7. I want off ! The only way will be exercise- lifelong.
I am very motivated- believe me.
I do online videos, use my stationary bike and treadmill. Watch favorite shows while going that.
,Sorry the first part of my reply just disappeared!
I took 12 doses and then developed Diverticulitis and felt quite Ill, but I agree the pain relief was incredible and I was able to cope with a weeks holiday and a 4 hr flight, but I wouldn’t repeat taking Celebrex because it would be too dangerous for me.
Hi Evercurious...I tried Celebrex years ago.but it didn't.do anything...however I am on 800 mg. Motrin 2 x day. I have several different pain causing conditions...though PMR has wooped my butt big time. I can't get relief for more than a few days so we are trying to figure out what's going on -- can't get past 23. I take prilosec everyday and have since being prescribed the motrin.several years ago. My old rheumy said he would not give me the motrin w/o my being on it. I also take the Motrin with a meal. So far so good. I think we should be mindful of the scary side effects before taking any med. If it causes a particular thing...what symptoms do we look for? I think how you are feeling from the celebrex might be worth the risk if you handle the risk with smarts.....getting blood work done, seeing your doc, educating yourself on what to look for. Which you seem to be doing. Being able to be active is so good for your health....I would imagine it's a positive when it comes to inflammation. Anyway...good luck with it all.
The combination of an NSAID and Steroid is not generally recommended, especially at higher doses because of the increase that can occur in various side effects , and the higher possibility of bleeding or ulcers even with a PPI.That being said , a good clinician , may prescribe it under supervision if the benefits to the patient outweigh the potential risks that can come from it on an individual basis.
In reality , the possible risks to the combination were higher when you were taking a higher dose ( 9.5mg) than they are now at ( 2.5mg) . If you are taking the PPI and have not had any stomach issues , before , or currently, to do with this combo it appears that you haven't suffered any damage to the stomach from its long term use.
If your case of PMR was mild in comparison to the average , but other inflammatory pain in your hip or joints which could be treated with an NSAID / Celebrex was more severe the combination , on this occasion , could have actually assisted you in tapering your steroid dose more easily and quicker . Although , you wouldn't ever trial that without a GP recommendation or information that suggested that this balance of health issues was present.
Nobody should really combine a steroid and NSAIDs , even over the counter ones before discussing it with a GP , even if it only for a short time or the pain killing effect appears to be quite instantaneous , especially without having some type of stomach protection specific to the patients individual needs.
It would appear it is working for you , and now you are on lower doses of Pred the continued use of the Celebrex could be the thing needed to control your long term inflammatory pain issues , even after PMR has recovered and you are off steroids. Basically , if things are stable it appears from your post that this is more of a concern to you now because you have learned more about the risks, rather than you suffering from them at present. Positively, though , your new knowledge will help you to recognise the symptoms if they do occur , or to request monitoring tests if you need them. Or it can help you to consider a trial reducing the dose of Celebrex very slowly too , just to see if that is possible , or whether that is actually helping your symptoms the most at present.
The one thing it may be worth doing , even if you have no obvious symptoms is to get monitoring blood tests done as you are in this Adrenal Phase of recovery , just to be sure that your body is in its best range to improve the speed of your recovery.
Combining Steroids and / or NSAIDs and a PPI , or also taking other antacid medications , Antihistamine, muscle relaxants or antidepressants can all reduce your absorption of Vitamins B 12 and Folates , which in turn reduces your absorption of Vitamin D , K2, C and E and your metabolism of Iron and Calcium. Low levels of B12 or Folates, or deficiency in them , can cause Anaemia , and actually produce their own symptoms of Fatigue , Pain , Muscle numbness and weakness , breathing changes , neurological changes , thyroid and adrenal dysfunction and Palpitations.
Therefore , if you haven't had these tested in the last six months , it is a good idea to request blood tests now , as you are in the final stages of recovery , and are hoping to begin building up your activity , exercise and muscle strength.
Having a full blood count , liver and kidney panel , Ferritin and iron panel , Vitamin B 12 , Folates and Vitamin D test are all advisable. You GP appears proactive so they should be happy to help you get a baseline of results to work from.
If you are low you can take the appropriate supplements or make diet changes which in themselves will reduce the impact of side effects , or symptoms that might occur because of long term use of combined medication.
thank you so much, Blearyeyed for this comprehensive answer! Vit. B12, Folates and Vit D have never been tested but I am taking a B complex, Vit D, K2, Magnesium and getting lots of calcium from diet. I was on alendronate for 3.5 years but have just stopped.
Even on the normal oral supplements it is a good idea to have those blood tests done to check the diet and supplements are enough . Sometimes , on medication or with certain health conditions, even with the best recommended Self Care you can still end up with a deficiency, as I know from my own experience, so double checking that everything is in range is a great way to prevent something popping up in the future , and to help ensure your success in recovery.Take care you seem to be progressing well and I hope that improvement continues for you.
I was prescribed celebrex for trochanteric bursitis whilst on pred. Rheumy said it was a newer nsaid than some others, and a little bit gentler on the stomach than the likes of ibuprofen. I was prescribed 200mg twice a day and she doubled my lansoprosole dose. She told me to stop the celebrex if I had even the mildest problem with my stomach and to contact the rheumy nurses. I never had any stomach problems, but they didn't help with the pain at all, so I stopped taking them after about 4 months (kept hanging on, just in case they worked 🙄)
I have been on celebrex for years and started prednisone two years ago. I have had no problems. Both my rheumy and IM drs know I am taking both. Good luck to you!
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