Prednisone and Aspirin

[arvine]

well we have been told by our dr,s etc, cant take these 2 med,s together, but in my case, since now my rheumy had an MRI done, and result showed "subacute stroke", he has prescribed 81 mgs of aspirin as protection and precaution for further stroke episode, going for catscan Monday on neck arteries , check for blockages , then on to a stroke clinic, My question is, has anyone out there had anything like this happen during their journey with PMR, Im now over 6 years on pred, was down to 4 mgs, before this happened, then in Dec, with some what appeared to be GCA symptons, put up to 40 mgs, now down to 15mgs, but getting to my point, again anyone had this scenario, and then also been prescribed a "pump inhibitor" , in my case initially rabeprazole, now changed to pantoprazole, (tecta) , which could come in other names of course, I know there are possible,side affects with all med,s, and wondering if any one side affect in particular is prevalent in using these inhibitors, suppose to prevent acidity and inflammation of stomach lining, prevent potential stomach, duodenal ulcers, like to hear of any similar cases out there , thank you

[DorsetLady PMRGCAuk volunteer]

Who says we can't you take Pred and aspirin together? -back in the day a small dose of aspirin just to be prescribed for GCA patients- albeit it has now been stopped.

For info I was already on small dose as part of a mix for hypertension [75mg in UK] way before I started Pred - and I took it all the way through my GCA - start dose 80mg - I didn't keel over. No longer on it, as BP medication has been amended.

And yes many are on a PPI, as was I during GCA/Pred years..but no longer.

[Twopies]

we’re all so different—I recently talked to my pharmacist about this at my docs suggestion. Pharmacist said I could take aspirin for 5-7 days but if I had any stomach issues at all, I was to stop immediately. I didn’t have any problems for the short term. My situation was very different from yours, others will have some actual advice, I’m just telling you what the pharmacist told me. If you need to take it long term, I’m betting there are some solutions available, best wishes to you.

[DorsetLady PMRGCAuk volunteer in reply to Twopies]

If you are taking OTC aspirin -the dose per tablet is usually 300mg…and you can take 2 tablets up to 4 times within a24 hour period.

The dose Arvine and I mentioned -in her case a stroke and mine hypertension is much smaller 75mg/81mg per day.

Significant different in total taken.

[arvine in reply to DorsetLady]

so to understand, are you still taking 81 mgs daily for high BP? then, along with what dose of prednisone? and dr didn,t prescribed any meds to protect stomach then?

[DorsetLady PMRGCAuk volunteer in reply to arvine]

No I’m not, as I said I was on small dose aspirin and PPI when I was on Pred for my GCA for 4.5 years.

I am not on any of those meds since since late 2016.

What I was saying it that you can take small dose of aspirin with Pred….and if you do then a PPI is sensible.

[PMRpro Ambassador]

Low dose aspirin was commonly prescribed alongside pred for patients with GCA. In the meantime it has been stopped because they decided it wasn't worth it for GCA. Always take it with food or get an enteric coated version if you aren't already taking a PPI (omeprazole or the like) if you are worried. But taking low dose aspirin with food should be plenty.

[arvine in reply to PMRpro]

ok thank you

[altywhite in reply to PMRpro]

I'm still taking my low dose aspirin, didn't know they weren't prescribing it for GCA any more. I take it at night and am reluctant to stop it. I have also been on Omeprazole since my diagnosis....8 years now. I have tried to stop that....gradually...but the reflux returns!! Also on Amlodipine now, pred is still at 5mg. I'm rattling!!!!! 😊

[PMRpro Ambassador in reply to altywhite]

It isn't that they aren't prescribing it, I'm sure doctors still do, but that it is no longer a recommendation in the latest guidance for GCA. But they'd have to read the paper to know ...

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

read the paper to know…

Hmmm 🤔

[PMRpro Ambassador in reply to DorsetLady]

Well quite ...

[altywhite in reply to PMRpro]

😂😂

[Theziggy in reply to PMRpro]

I believe that GPs no longer prescribe aspirin, it is sold in all supermarkets here for less than the price of a prescription

[PMRpro Ambassador in reply to Theziggy]

I wish here! Higher doses of aspirin, ibuprofen or paracetamol here require a script but you still pay for them and only pharmacies can stock them so no nipping to Lidl for their exceptionally cheap offers! The only pain medications you don't pay for are the opioids! Must save the healthcare budget a fortune but it does mean people don't turn up at the GP or ED for pain relief!

[MrsNails]

l take a 75mg Aspirin everyday but do have the enteric type even though l take a PPI (lansoprazole)

[arvine in reply to MrsNails]

thank you , and how long have you been taking a PPI?

[MrsNails in reply to arvine]

As long as l’ve been on Pred - February 2012 - 11years

[altywhite in reply to MrsNails]

It's 8 years for me 😊 Pred, Aspirin, Omeprazole!!! Plus my thyroxine, Adcal, Vit K2 and blood pressure meds!!! I think I'm finally resigned to having my own 'pharmacy'!!!! 😊

[MrsNails in reply to altywhite]

I know the feeling 🤦🏻

[Thelmarina in reply to altywhite]

😂

[TizzyS in reply to altywhite]

me too hunny….

[HeronNS]

There are problems with PPIs. Notably because they reduce production of stomach acid you may after a time suffer from some nutritional deficiencies. One of the more concerning is they are implicated in bone thinning, which pred also can contribute to. Originally PPIs were not meant to be taken longterm so if this is going to be temporary it should be okay. If you have to be on them indefinitely you really need to be careful of your bones, and also pay attention to the possibility of other deficiencies.

Do you need the PPI? At least now that your pred dose is down from the recent high amount? Your stomach can be protected, especially if not taken with a meal, by always having aspirin of any dosage with a glass of water and a small amount of food, perhaps a slice of bread or a large spoonful of plain yoghurt. I would avoid taking aspirin at the same time of day as pred.

[arvine in reply to HeronNS]

thanks so much, yes always take with food, and am reluctant to take the ppi

[Purplecrow]

I use aspirin daily, with a double dose of omeprazole. I have allergies to ibuprofen and most other pain meds, which I need to help manage my non-PMR related chronic pain. My docs disapprove, but agree that it seems to be the best choice, given alternatives. Alternative choices were fentanyl or morophine, neither is acceptable to me. My current dose of prednisone Is 5.5, my PMR was diagnosed in 2013.

[Exflex]

I’m on a reducing dose of Pred at almost 1.5mg, but was on 7.5 or 8mg when first prescribed aspirin due to stenosis of heart artery 2021. Stent inserted and I’m on aspirin for life.