After taking diclofenac I got tachycardia. My rheumy added verapamil. Yesterday he said I would be on these meds the rest of my life. Do you take NSAIDS everyday? My cardiologist said "maybe I didn't need the arthritis meds" He said if I needed them I wouldn't have the side effects. I beg to differ though but I didn't argue. I just wondered if the NSAID controls the disease or do I only really need to take it when I have alot of pain. thanks.
I've been on NSAIDs for the better part of the last 6 years. I have taken breaks whenever possible, so I usually wind up not taking them for 1-3 months out of the year.
The NSAIDs can be a part of managing inflammation, but still won't control the progression of the disease. You take NSAIDs for inflammation, and these must be taken on a schedule, for extended periods to control inflammation (weeks, not days). If you are taking for pain control, it would be as needed, but that won't work on inflammation.
Now I'm wondering though, what the heck was your cardiologist talking about? If you need them, then you won't get side effects? That's just utter hooey, and I would seriously think about calling him on it. So cancer patients don't really need chemotherapy because it gives them side effects? Really?
Mom5, I’m with you on what the cardiologist said. No point in arguing … it’s been a long time since he did the rheumatology unit at med school. I’m sure his cardiac advice is just fine. 
I take Diclofenac (voltaren) 75 mg once a day, and twice if I really need it. My GP would prefer that I stick to once a day as much as I can. I know it’s not easy on my body (kidneys, etc.). If I don’t take the diclofenac, I basically seize up and can’t move, which is a very bad thing. So for me, it’s a case of choosing between two evils – the drug or immobility. One pill a day seems to be the compromise I can live with.
I don’t know if the NSAID controls the disease or the symptoms. I’m guessing it controls the inflammation, and with reduced inflammation, less damage happens. Really, this is a question for Lamb.
Oh, forgot to add in. . . My rule is that if I'm taking daily NSAIDs, then I am also taking prilosec daily. If you are not alreadyi taking a proton pump inhibitor, talk to your rheumy about this.
If there are only a few joints, an option would be to use Voltaren gel, which is a topical form of diclofenac. If you do this, you can't take oral NSAIDs at the same time.
Taking an oral NSAID doesn't necessarily eliminate topicals talk to your doc. And yes you should take an "acid pill"
Here is how I look at things... You ask is it safe to take every day and the answer is another question Is it safe not to????? The purpose of the NSAIDs daily is to control inflammation. So long as you have your blood work done no problem Almost everything reverses itself if for any reason you have to stop. They thinb the blodd so your body thinks there is a problem and starts pumping faster. The verapamil will fool it into thinking the blood is thicker and everything is okay. The body adapts pretty well and you may be able to DC the verapamil after a while.
The rheumatologist has never told me to take an acid medication. I have prescription omeprazole. My stomach is burning like crazy. Occasionally I have acid shoot up into my mouth like vomit. I will go back on the omeprazole. He hasn't told me to supplement with anything really. Some people have said to take folate with sulfazine. The rheumatologist is checking my vitamin D levels. I already know I am very low on that. My family doctor told me to take 5000 iu daily. The rheumatologist mentioned I could have the vitamin D infused weekly, from what I understood him to say. I think I would rather take the pill daily than drive there weekly to get it infused.
It is very hard to talk at the rheumatologists office. I told him I was out of diclofenac but he told me to have the pharmacy fax him a request. For two days I have not had the diclofenac. It is probably why I am so stiff today. After what the cardiologist said about "maybe I didn't need my my meds', lol. and I have read where some only take NSAIDS as needed, I wondered if it is needed on a daily basis or just when I'm in pain. There is a lot of information out there. I know very little about PsA. Thank you all for the help. I will not go off any of my meds. With my past experience with doctors and surgeons it is hard for me to trust them now. The proof is how much better I am doing since beginning the psoriatic arthritis treatments so I really shouldn't doubt the treatment. At times I just question the safety. I really need to stop doing that and just make the best of what life has thrown at me. For awhile I am fine and then it seems like I start worrying over what these meds are going to do to me.
The cardiologist said he has always been of the belief that if you need your medications you don't have side effects. I just looked at him. I know better than that, lol.
Stoney said:
I've been on NSAIDs for the better part of the last 6 years. I have taken breaks whenever possible, so I usually wind up not taking them for 1-3 months out of the year.
The NSAIDs can be a part of managing inflammation, but still won't control the progression of the disease. You take NSAIDs for inflammation, and these must be taken on a schedule, for extended periods to control inflammation (weeks, not days). If you are taking for pain control, it would be as needed, but that won't work on inflammation.
Now I'm wondering though, what the heck was your cardiologist talking about? If you need them, then you won't get side effects? That's just utter hooey, and I would seriously think about calling him on it. So cancer patients don't really need chemotherapy because it gives them side effects? Really?
My GI doctor had me on prescription omeprazole. I will be sure to start back on that while I'm taking diclofenac.
Stoney said:
Oh, forgot to add in. . . My rule is that if I'm taking daily NSAIDs, then I am also taking prilosec daily. If you are not alreadyi taking a proton pump inhibitor, talk to your rheumy about this.
If there are only a few joints, an option would be to use Voltaren gel, which is a topical form of diclofenac. If you do this, you can't take oral NSAIDs at the same time.
I take 75 mg of diclofenac twice daily. I would say I do need it because today my low back, sacrum is aching, ankles and heels aching, my sternum also aches. I have costochondritis (sp)
Seenie said:
Mom5, I'm with you on what the cardiologist said. No point in arguing ... it's been a long time since he did the rheumatology unit at med school. I'm sure his cardiac advice is just fine. ;-)
I take Diclofenac (voltaren) 75 mg once a day, and twice if I really need it. My GP would prefer that I stick to once a day as much as I can. I know it's not easy on my body (kidneys, etc.). If I don't take the diclofenac, I basically seize up and can't move, which is a very bad thing. So for me, it's a case of choosing between two evils -- the drug or immobility. One pill a day seems to be the compromise I can live with.
I don't know if the NSAID controls the disease or the symptoms. I'm guessing it controls the inflammation, and with reduced inflammation, less damage happens. Really, this is a question for Lamb.
yesterday I had a piriformis injection. He said he just injected the muscle not the nerve. I may be so anxious today because of the steroid. Couldn't sleep last night. The anxiety may have me worrying about my meds. Lol.
Piriformis! Oweeeeee! I had that after one of my joint replacements. The PT did a very cool release procedure on it, and it worked first time! (I was just lying there as she manipulated and moved my leg this way and that way in slow mo … quite strange.) Ask your PT about that sometime.
I forgot to say that I take omeprazole (prilosec) every day to protect my stomach. From what I understand, pretty well a must.
I take 2 Celebrex, omeprazole and voltaren gel daily. I used to take naproxen, which was effective, but eventually caused stomach issues. I also take methotrexate injections .8 ml (=20 mg) once a week, 1 mg folate daily, Enbrel injection once a week, vitamin d, calcium, b1, biotin and iron daily, and a b12 injection once a month.
I am doing the best I have been since starting to see my rheumy 4 years ago!
I have also done physical therapy including water walking, and changed my diet to Low carb (following Akins). This has helped Ibs symptoms as well as arthritis stiffness and pain.
The piriformis is my worst pain. I hate it. I need to get a new referral to the PT. I will ask her first to make sure she does the release technique. That would be great if she can help me.
Ircjvl, I need to take my supplements faithfully. Im just not sure which ones I need. im always anemic. I know I need vitamin d and folate. I usually have fatigue. B12 would prob help me too. I take a multi most days. Can’t sleep without trazadone. Maybe after I stop sodas and exercise i will sleep on my own. Im gonna go low carb. gi thinks I am sensitive to wheat. I appreciate your all’s advice. am on my cell with husband’s crazy driving. hard to type.
I want to second the comment about topical NSAIDs and oral NSAIDs. Just because you use one, it does not rule out the other, but I’m pretty sure it depends on what your doc is comfortable with. Topicals are a lot safer than those taken orally. Much, much less of the drug is metabolized through the kidneys and, of course, the stomach is bypassed altogether. I gather that some docs won’t prescribe them together, but I think that this is an older school of thought? Maybe it depends of how much of each med is used?
Really hoping that I can get to where I'm almost normal again. I feel like I am of no use to anyone. Am bad about not taking care of myself ie. not drinking my water, last person to eat, not taking my supplements or resting. I try to take care of everyone else and make sure everyone else is happy. That is my new year's resolution to take better care of myself. It makes me feel guilty to even say that. It is something I have to do though.
GrumpyCat, I will ask him about a topical the next time I see him. I think it would be helpful. He never mentioned a topical to me but I haven't told him about my stomach burning and the acid. My piriformis is killing me today. It is sore from the injection. Hopefully the injection will last longer this time.
How often do you see your rheumatologist? Anyone can answer this. I'm just curious. I go once per month. Many labs are drawn each time. Have only been in treatment since October so maybe I have to go so often because I'm still in the early stages of treatment.
I took high doses or oral NSAID's for PsA from age 10 to age 33. At that point I had a bleeding incident, and can only take them on rare occasions. NSAID's used to be a major part of treatment.
How much better off will everyone be if you have a major flare and can't move at all? Better to make changes now to how your household runs rather than make those changes in a crisis.
mom5 said:
Really hoping that I can get to where I'm almost normal again. I feel like I am of no use to anyone. Am bad about not taking care of myself ie. not drinking my water, last person to eat, not taking my supplements or resting. I try to take care of everyone else and make sure everyone else is happy. That is my new year's resolution to take better care of myself. It makes me feel guilty to even say that. It is something I have to do though.
Mom5 your primary care physician and/or your rheumy should be diagnosing and treating any vit/mineral deficiencies you have. You should be having labs done. Please discuss with your team, don’t just take things randomly.
Also please discuss low carb with your GI.