By way of brief summary I have had PMR since 2020. Over that time I have flared four/five times on tapering to about 5mg. I am currently on 7/6.5mg on a slow taper.
Last Saturday I received a letter from my cardiologist saying that parts of my heart are not receiving an adequate blood supply. That could explain my extreme tiredness which I thought was (and still could be) adrenal insufficiency. It could be both I suppose. I will have an angiogram but no date set yet. The doctor also prescribed statins, glyceryl nitrate spray and aspirin.
Although it's not listed specifically Corticosteroids are mentioned as a medicine that the aspirin may affect. Does anyone have any experience of this or have any knowledge what the effect could be. I definitely do not want the effectiveness of my pred being reduced.
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SudsSuds
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Depends what the dose of aspirin is - I took a daily dose of 75mg [part of a cocktail for high BP] all through my GCA/Pred days - so on considerably higher doses of Pred that you are on now with no issues whatsoever…
.. in the past a small dose of aspirin was recommended for GCA patients alongside the Pred.
There is a moderate interaction which may affect the effectiveness of Pred, but it’s the increased risk of gastrointestinal issues when taking both which is probably more likely … but if you are on a PPI then it shouldn't be an issue.
Presumably your cardiologist is aware you are on Pred, but if you are concerned then talk to your doctor.
It's 75mg daily like you. My cardiologist does know but not sure if it would in the front of his mind, however he prescribed it through my GP who most certainly knows and he referred to "my other illnesses" during the appt. As you say I have a PPI which protects my gastrointestinal tract. Your reply as ever is timely and gives me a good degree of comfort. I'll start the aspirin tomorrow (only got it yesterday). Thanks again.
I’m no longer on aspirin - after I’d finish Pred, my BP took a dive so stopped all meds… but it crept back up over the years - and now just on Candesartan.
It isn't so much there is an interaction as that both pred and aspirin can cause gastric irritation which increases the risk of gastric bleeds and the low dose aspirin is also used to make platelets "slippier" and reduce the risk of forming clots and that also can increase bruising and bleeding.
As DL says, aspirin used to given as standard alongside pred in GCA although more recent guidelines say it isn't necessary as the risks outweigh the benefits there, However its use in cardiology is a different thing - more benefits.
The leaflet accompanying the tablets definitely states that aspirin may influence the effectiveness of aspirin but does not say how - your thoughts are interesting. As I have a PPI, I feel protected. As many people have reported they have taken aspirin without undue effects so I have started (without a problem).
"steroid medications like predniSONE have been reported to decrease the blood levels of aspirin and similar drugs in some cases, which may make them less effective in treating your condition"
but the reason for using low dose aspirin will still be effective I imagine.
I would have said almost the same as DL and pmrpro. If you consider 75mg daily compared to the total 4g a day that you can take for pain relief, that is actually a comparatively low dose. (Though, as an aside for safety, aspirin is not intended to be taken long term at the maximum dose without a doctor's supervision and if you need it for longer than the number of days specified on the pack, you should speak to your doctor).
The 2012 study below (of cancer patients) recommends taking a PPI (proton pump inhibitor) to protect the gastrointestinal tract from the combined side effects of corticosteroids and aspirin. No other interaction is mentioned.
Make sure you follow your doctor's instructions. Many medications, these days, are preventative: they must be taken before the damage appears, not after symptoms appear.
I have taken Lansoprazole (a PPI) for many years so feel protected in that regard. I presume that's what the leaflet is getting at as alluded to by PMR Pro. Thank you.
I was prescribed 75mg aspirin after a TIA, but the stroke clinic changed it to 75mg Clopidogrel because it would be 'kinder to my stomach'. I have taken that alongside enteric coated Pred for 3 years with no problems. I don't take a PPI but always have a good glug of kefir and dollop of greek yoghurt before my neds.
Good that there is a kinder substitute for aspirin. I have taken a PPI since 2013, when I was hospitalised with a duodenal ulcer, so feel protected from the twin effects of aspirin and pred. Thank you.
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