Increase Pred or take Paracetamol or Ibuprofen?
Posted , 13 users are following.
Hi All, I've had great encouragement from this forum over the last year so thanks to everyone for the support and shared experiences.
I've dropped to 6mg (originally at 15mg almost 18 months ago when diagnosed aged 55). Using DSNS from 15 to 10mg was straight forward and I felt I was doing great and feeling lucky. It's since become more challenging, particularly from 7mg to 6mg - in retrospect I should have dropped by half than a full 1mg! Back to feeling really stiff for longer periods; through the night, waking up when I need to move in bed, and when getting up in the morning, I find getting out and walking helps but am frustrated with the stiffness. My question is; is it ok to take a couple of ibuprofen and/or paracetamol for some relief or should I increase pred to 7mg? I guess I'm reluctant to increase, having just lost the hamster face!! I've stuck it out for c4 weeks but things aren't improving and have just tried paracetamol over the last few days, intermittently (one day on two days off etc) and it seems to help the days I take it, although it would be good to feel better and quicker/earlier in the day
Anyone been at a similar stage - what worked?
0 likes, 21 replies
amkoffee Jan20533
Posted
Taking ibuprofen or any other NSAID can cause stomach upset. Combine that with prednisone which can also cause stomach upset and you're asking for some real GI problems. Also it does not work for PMR pain. For whatever reason PMR pain really only response to an anti-inflammatory like prednisone. When I was diagnosed with PMR ( I was 55 also) I was already taking narcotics for lower back pain and yet I still felt all the pain from PMR. If you really don't want to increase your prednisone dosage you might consider trying turmeric and other known anti-inflammatory supplements. If you're not already taking any it would be worth trying it. I tried turmeric myself but it upset my stomach too much.
Jan20533 amkoffee
Posted
Hi Amkoffee, Thanks for your advise. I do take Omeprazole for stomach and I've heard about Turmeric so will certainly give it a try. Good luck with your journey, keep well. J
patricia38799 Jan20533
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Jan20533 patricia38799
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Hi Patricia - I have read somewhere about bicarb and baking powder, doesn't it matter which one you take? Definitely worth trying - I'll give it a go tonight. Thank you.
ptolemy Jan20533
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Michdonn Jan20533
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Jan20533 Michdonn
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HI Michdonn, thanks for your advice - Sorry you had to go up so high, I certainly don't want to have to go way up so might just have to go back to 7mg and hopefully get better relief. Thanks for sharing your experience. Good luck
Michdonn Jan20533
Posted
dmart7 Jan20533
Posted
There is a discussion to be had about whether NSAIDs could be used occasionally as a supplement to Pred during tapering. As the NHS says on its official PMR website: “Your doctor may prescribe other painkillers, such as paracetomol or NSAIDs, to help relieve your pain and stiffness while your dose of prednisolone is reduced”. I have occasionally used NSAIDs in this way, and it did eliminate residual PMR pains and relapsing symptoms for the days it was taken. I have never taken NSAIDs as a long term measure for PMR, even as supplement.
Prednisolone is also aggravating to the stomach and adding NSAIDs to the mix will make this effect much worse. Doing so – even occasionally – should only be considered if you are on a protective PPI as well (Omezaprole, Lanzaprole etc), which many of us are anyway.
As so much with PMR, research into these matters is weak. It would be nice to know more from clinical research and trials.
EileenH dmart7
Posted
I have to say I don't know where you have seen on this forum that people say NSAIDs are not anti -inflammatory - it's all in the name Non-Steroidal Anti-Inflammatory Drugs. What we DO say, repeatedly and as the result of long experience, is that NSAIDs mostly do not deal with PMR pain while they may help steroid withdrawal pain which is so similar to PMR pain you can't tell the difference.
"research into these matters is weak" - what matters?
Jan20533 dmart7
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ptolemy dmart7
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BettyE Jan20533
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At one stage when I was getting down to lower doses ( around 7 ) my GP asked me to try Paracetamol to see if it helped my pain and stiffness, his reasoning being that maybe the pain was down to my long term OA. and if the Paracetamol controlled it then we could probably assume that it was no longer PMR.
Like you, I found a marginal improvement stiffness wise. but the pain remained. I tried for a week but had to stop because, unlike the rest of the world, it turns out I must not take Paracetamol which is another story. So back to just the Pred. and eventually ( five years ) I got to zero.
It doesn't sound as though it's giving you much help and four weeks is giving it a good chance to see. Four weeks is also a long time to be in such discomfort.. If it were me I'd go back to the Pred. dose where I was last comfortable. 7 is quite a low dose and maybe not enough to give you hamster face.
Jan20533 BettyE
Posted
Thanks Betty, it's great to hear some good news of people getting to zero. Five years is nothing when you're feeling well.
EileenH Jan20533
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It doesn;t matter how slowly you reduce - you will not get below that dose which is just enough to manage the daily dose of inflammation,
EileenH
Posted
And PS - an extra mg of pred has far fewer side effects than NSAIDs, especially taken in combo with pred, something that really isn't advised long term.
Jan20533 EileenH
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Hi Eileen, It's great to get your positive wisdom on the matter. You certainly make me feel better about 'no big deal in going back to 7mg'; keep of the NSAID's and avoid the major flair. I certainly don't want to wait until that dripping tap fills my bucket to overflow mode!
I'm going to try the bicarb/baking powder and get some great recipes with turmeric, if I still feel the same in a couple of days I'll move back to 7mg.
Thank you so much everyone for your great support and advice - this forum is so much more helpful than our GP experiences.
Poupe EileenH
Posted
Wanted to get your opinion on the baking soda and water approach to reducing inflammation. Been reading a few articles, some cautioning liver/kidney problems....
EileenH Poupe
Posted
The research is very early basic stuff, done in rats and just a few healthy humans. The paper repeatedly says "may", "possibly" and that it needs to be confirmed. One of the reports of the work interviewed the lead author and quoted him as saying "don't do this at home".
https://drugsafetynews.com/2018/05/02/could-an-effective-treatment-for-autoimmune-disease-be-as-simple-as-drinking-baking-soda/
OTOH, it has been a home remedy for indigestion for years. One risk of trying it may be that you lose potassium through the kidneys - and in this very hot weather that may add to dehydration problems.
Poupe EileenH
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EileenH Poupe
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No, not really. I read the nearest to the paper I could! And decided I wouldn't try it at home yet...