Ibuprofen gel/cream

[random901]

Morning, all. I don't take ibuprofen tablets for pain because of my GCAPMR plus IBS. I know it's not a good idea on preds. Could I use the gel on my neck, though? Or would that find its way into blood or stomach? Paracetamol does very little. Dihydrocodeine is highly effective, but I limit that as it bungs me up, plus it's addictive.

[DorsetLady PMRGCAuk volunteer]

I used the ibuprofen gel for arthritic knee when on lower doses of Pred, quite sparingly, never caused me an issue.

But to be honest, nothing much affects my stomach, probably depends how sensitive yours is..

[PMRpro Ambassador]

I use ibuprofen tablets without problems so it definitely depends on the person - my rheumy approves by the way. It is better if you take a PPI/H2 antagonist if you use it a lot. The topical forms are absorbed to some extent and can cause problems if you use a lot over a large area of skin.

[random901 in reply to PMRpro]

Thanks!

[scrambledegg in reply to PMRpro]

I take from this the implication that ibuprofen shouldn’t be taken with pred. because of the effects it could have on the stomach? I presumed it was because of its anti inflammatory effects on top of the anti inflammatory effects of the pred. potentially exaggerating or in some way clashing?

[DorsetLady PMRGCAuk volunteer in reply to scrambledegg]

The Patient Information Leaflet in all makes/types of Pred should have a similar warning to this regarding other medications-

* aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) for example ibuprofen and indometacin, used to treat pain and inflammation due to increased risk of bleeding in the gut or ulcers

And this from NIH -

Prednisone (sold as Rayos, Prednisone Intensol) and Advil (ibuprofen) are among the most common medications for pain and inflammation. Although they are largely safe on their own, taking them together significantly increases the risk of potential side effects, including bleeding in the gastrointestinal (GI) tract

[PMRpro Ambassador in reply to scrambledegg]

No, my rheumy suggests using ibuprofen for other sorts of pain since pain isn't a painkiller in that sense for pain due to muscle problem. There is inflammation but other aspects too. But you have to be very careful.

[winfong]

What kind of IBS do you have? I've got C, and it never bothers me.

[random901 in reply to winfong]

I'm not sure, winfong. The type that alternates between severe constipation for weeks, then acute diarrhea for weeks. But I'm going to try the ibuprofen gel in a small quantity on my neck.

[Stills]

I’m not on pred but do use the 2% stronger gel prescribes to me by a GP, at the same time as Paramol when the pain is bad in my neck. I rarely use it on other joints as that pain seem different compared to the neck pain which sparks migraines and nausea too. The gel works well without side effects for me.

[random901 in reply to Stills]

Thanks, Stills. Reading your bio, you are putting up with many conditions. I think my neck pain, which, as in your case, is different from my other aches and pains - sharper and spasmodic - is connected with my ocular migraines. Sending you best wishes 🏵️

[Stills in reply to random901]

I am beginning to think mine is thyroid related but don’t want to open that Pandora’s box of misery. I’m resolved to coping until I can’t tbh. Wishing you better days.

[Dinahmite]

I use Voltarol Gel every night for OA with the GP's blessing. Both hips and back/sciatica which date both date the PMR... Am on 8.5 pred now and low dose 10mg Omeprazole.

[Sharitone]

I have a very sensitive stomach, but I have occasionally used ibuprofen gel on various muscles. There were no problems with the stomach, but the gel didn't help either. I find its best use is as a kind of massage gel, as the massage seems more effective.

[random901 in reply to Sharitone]

Yes, agreed, Sharitone. Massage with virtually any cream or gel gives relief 🙂

[MiniSpec]

I can't take ibuprofen tablets, they cause me immediate and very painful stomach cramp. So I've tried using the gel as well, but for me it doesn't seem to have done very much.

As to using codeine tablets, I agree that they do bung you up, but as far as addiction goes, I remember reading a large survey about the effects of codeine. The survey divided the participants into those who took it for headaches and those who took it for other pains, such as chronic back pain. Overall they found that if taken for headaches then it's indeed addictive, but if taken for back, or other pain it rarely becomes addictive.

So if you're not taking codeine tablets to cure a headache then I wouldn't worry too much about the threat of addiction, just limit them to how much constipation you can cope with.

[random901 in reply to MiniSpec]

Thank you, MiniSpec, that's interesting and reassuring. They are by far the most effective pain killer for me. The constipation I can deal with!

[PMRpro Ambassador in reply to random901]

They shouldn't ever be handed out without advice on taking something from the outset to avoid the constipation ...