Aleve use for pain other than pmr

[Linny3]

I have found the occasional use of an Aleve helps so much with pain when I am decreasing the prednisone. Most of my pain comes from my back fractures. As I reduce the pred. My back aches get worse.

Does anyone know why an Aleve would be worse for me than some of the meds they suggest that have much more severe side effects?. I just don’t get it.🥴

[MrsMarigold]

Hi Linny. I have lupus and my pred dose is 31/2 mgs. My spine is in awful shape. I am in the US, I can only think that aleve may harm stomach without a stomach protector like famitodine or omeprazole. I take 2 aleve every other day. It makes me tired but relieves pain. I’m curious where you got this information? Best, MM

[Linny3 in reply to MrsMarigold]

I have been told for 9 years not to take Aleve due to the stomach issues while on prednisone, and yet, they are always offering me medication with the same warnings about the stomach and much worse. Makes no sense to me and I can’t find a pharmacist who can explain it.

[agingfeminist]

Aleve (naproxen) carries the same gut risks as ibuprofen....suggested the risks are higher because it acts for longer....It is not a good idea to combine with pred (which carries similar risks)...it increases the risks of effects on gut (bleeding etc). You really need to talk this through with our doctor.

[PMRpro Ambassador]

Aleve/Naproxen is an NSAID and all NSAIDs have long term adverse effects on heart and kidneys. However, the main problem is that when you are on pred, both pred and NSAIDs are associated with stomach irritation and in combination the risk is increased so you are at a higher likelihood of developing gastric inflammation and, ultimately, ulceration and bleeding. A stomach protector such as a PPI reduces the irritation but doesn't entirely ban it. Naproxen is claimed to be less stomach irritant but less doesn't mean not.

My daughter isn't around just now but you should hear her wax lyrical about the damage she has seen due to pred and NSAIDs used carelessly - she is a nurse endoscopist.

I have the same problem as you - just 200mg ibuprofen deals brilliantly with my constant low back pain but the Pain Clinic doctor has hissy fits! The only stuff she lets me use does very little. They do admit that there is no good solution for longterm pain. However - the worst of mine was finally solved with a steroid injection. No thanks to the Pain Clinic but my rheumy was willing to do it under U/S guidance.

[Linny3 in reply to PMRpro]

Thanks for the reply.

So I guess the long term meds, that have the same warnings as nsaids, must somehow work differently on the stomach? I find it very confusing.

[PMRpro Ambassador in reply to Linny3]

What do you mean by longterm meds?

[SusanEleven in reply to PMRpro]

I was warned off ibuprofen since starting prednisone years ago for the reasons you describe; the risk of gastric bleeding was stressed. I've been on lower dose (2mg) steroids for awhile now. I spoke to my pharmacist who said I'd be okay to have a single ibuprofen occasionally, but only on a full stomach and hours apart from my steroid. (A single 200 mg ibuprofen is tremendously helpful. My body loves it.)

After 7 years I'm finally being weaned off prednisone. My rheumatologist says my pains now are my (x-ray confirmed) osteoarthritis (hips, hands, spine being the worst). We're talking about pain treatment options next, including ultrasound guided injections.