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NSAIDS and Prednisone interaction

Posted , 6 users are following.

LisaCACO
LisaCACO

okay, now that i have my right foot in a lace up boot because of Posterior Tibial Tendonitis-it really, really, really, hurts- I need to decide what pain killers to take. My docs seem to think tylenol is nifty, but it doesn't do squat for swollen, painful tendons. I might as well go to the local faith healer. so here's my question: I noticed that NSAIDS and prednisone have "moderate" interaction warnings, which is probably why they suggested tylenol (and prescription vicodin). I'm probably especially prone to it given i'm still on a liquid diet due to the prednisone and already suffer gastrointestinal issues, etc. no sense adding to the volcano.

I'm wondering if any of you folks take NSAIDS with your prednisone and whether your docs warned you of the possible interactions. I have to admit to having cheated and taken a small swig of my kid's children's ibuprofen bottle...couldn't stand the pain any longer. so sad. I just wanted pain reduction without going to sleep (vicodin knocks me out). 

1 like, 9 replies

9 Replies

  • judytal
    judytal LisaCACO

    Posted

    Lisa.... ice, ice, ice, ice and ice some more....
  • EileenH
    EileenH LisaCACO

    Posted

    Both NSAIDs and pred can cause stomach irritation and gastric bleeding - in combination, twice as bad. Some doctors believe it isn't the presence of the pred in the stomach per se that does the damage but the presence of the pred in the system, particularly when it is high dose. One lady on another forum was told by her GP to use ibuprofen alone for her PMR (it is mentioned in the rubrics for mild cases) and after 3 doses ended up in the ER with a coffee-grounds gastric bleed.

    I have used the odd dose of ibuprofen and never had a problem - I was on the enteric coated version of pred at the time and it was not regular. I know exactly where you are with tylenol (paracetamol, acetaminophen) - useless and actually also really not good for livers. Co-codamol (no idea what you call it, maybe that's vicodin) is OK with pred - but possibly a bit sleep inducing.

    Ice? Compression? Faith healer? wink

    • EileenH
      EileenH

      Posted

      To echo Judy - ice and ELEVATION!! And don't forget the REST!!!!!!
    • LisaCACO
      LisaCACO EileenH

      Posted

      they offered a codeine/acetaminophen combo, but since I was already taking vicodin (hydrocodone/acetaminophen combo) for migraines I said I'd stay on that. 

      I guess they figure I'm such a mess they don't want to risk w the nsaids. probably a smart move on their part...

  • rita38591
    rita38591 LisaCACO

    Posted

    Hello:  After my visit to ER for my ankle. They recommend ice,elevate, rest & Advil. I take my pred. In the morning,  Advil  in the afternoon.  

    I

     

  • snapperblue
    snapperblue LisaCACO

    Posted

    Like you, I have found tylenol useless for that kind of pain. For years, I have taken aspirin or ibuprofen (for osteoarthritis and headaches) without any digestive system problems. However, after starting the prednisone I experienced stomach pain from these NSAIDs and stopped taking them. 

    However, the arthritis pain vanished after I’d been on prednisone for a while.  This makes me curious about why prednisone is not knocking out the inflammation in your tendons.  Are you on a really low dose?  Any ideas on this from the others on the forum?

    Sorry to be no help at all!

    • snapperblue
      snapperblue

      Posted

      I should have mentioned that, like Rita, I was taking the pred and ibuprofen at different times of day, not realizing that the problem was not just having them in the stomach at the same time (which Eileen explained above).
    • LisaCACO
      LisaCACO snapperblue

      Posted

      I'm on 40 mg. The docs think the massive doses of prednisone have done a job on my muscles and made them more prone to tendonitis-either that or the vasculitis is doing a job on the muscles. Prednisone doesn't like me. we have a hate/hate relationship.

      Anyway, I've iced this thing and it's no fun because I have cold feet to begin with wink. Resting is very boring but I'm doing it. Even sent my husband out shopping with my 10 year old and to get her haircut today. Pretty scary.

      Just sitting here waiting for the next thing to fall apart... 

    • EileenH
      EileenH LisaCACO

      Posted

      It's only physical resting we're on about! Do what you like with your mind and hands! As long as its legal and decent that is!

      Weakening tendons is one of the side-effects of pred, especially in localised large doses - hence the reason you can't have too many local cortisone shots for a joint injury. Using the intramuscular sort instead of oral pred is different. If it weren't for the oral pred the inflammation mihgt be worse - but here it is more an injury than JUST inflammation.

      Try icing just the injured area (it is ankle isn't it?) with your toes on a (warm) hot water bottle...

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