I am currently taking Ibuprofen - usually around 600-800 mg per day.
I honestly don’t really get the impression that they do much for pain or inflammation.
I’m curious as to what NSAIDs others are taking and at what dose
Is there any major difference between Ibuprofen and Naproxen?
None of them are good for your liver. It’s a script, but toradal can help. Wife takes Alleive for her RA.
If you don’t think they are working and they give you no relief, give your liver a break.
Hi Kyle, I find NSAIDs to be reasonably effective for axial symptoms, but the further it gets away from my spine, the less it seems to work.
The Ibuprofen I didn’t find terribly effective, and the over-the-counter ones used to have a rollercoaster effect for me as they wear off way too fast. My GP precribed me celecoxib (Celebrex) 100mg, which I find is far more effective. Mine are 12 hour tablets, sometimes I take none, but when I do take them, I can often get away with just one when I get up in the morning, giving my body a rest overnight.
I’ll get more information on this when I see a rheum
I was just curious.
I was reading about the treatment protocol for PsA based on type and joint location.
Below is the excerpt regarding axial PsA treatment.
It suggests that for moderate cases NSAIDs in “antiinflammatory dose regimens” would be tried first and if this is unsuccessful or for more severe cases then the next step would be anti TNFs.
This is why I was wondering what doses others are taking.
From what I understand the normal recommended dose of the NSAIDS isn’t sufficient to address inflammatory arthritis
Mild axial symptoms — In patients with mild symptoms of axial disease, which includes patients with inflammatory back pain that does not interfere with function, we suggest the use of NSAIDs in antiinflammatory dose regimens (eg, naproxen 375 to 500 mg twice daily, indomethacin 100 to 150 mg daily in divided doses, celecoxib 200 mg twice daily). NSAIDs can lessen pain and stiffness in spondylitis, although support for their use for axial manifestations of PsA is based upon their demonstrated benefit in patients with ankylosing spondylitis, expert opinion, and clinical experience [1,2,24,25,87]. (See “Assessment and treatment of ankylosing spondylitis in adults”.)
Moderate to severe axial disease — In patients with axial symptoms that do not respond adequately to treatment with NSAIDs, such as those with prolonged morning stiffness and severe pain, interfering with function, we recommend a TNF inhibitor rather than a traditional nonbiologic DMARD, as the latter have been shown to be ineffective for spondylitis. The choice of agent and dosing are the same as those used for peripheral arthritis. (See ‘Choice of TNF inhibitor’ above and ‘TNF inhibitor use and efficacy’ above and “Assessment and treatment of ankylosing spondylitis in adults”, section on ‘Tumor necrosis factor alpha antagonists’.)
Thanks, I’ll check out Celebrex.
I’ve been through a bunch of NSAIDs. started on ibuprofen 600mg x 3. It wore off too fast. Naproxen didn’t do much for me. The last year or so I’ve been using daypro for chunks of time, weeks at a time. I’ve been pretty happy with it. That’s at 600mg 2x/day. Doses are based on the med so you can’t always do direct comparisons.
My general goal is to not be taking a daily NSAID. But Enbrel isn’t quite doing the job anymore.
In respect to dosage
This is a bit of a silly question but I just want to be sure
When you say that you were taking ibuprofen 600mg x3 do you mean that you were taking a total of 1800mg per day as opposed to splitting that 600mg in three parts?
You say that you’re on Enbrel as well.
How long have you been taking that and what was your route did your rheum try NSAIDs first then move to DMARDs then eventually to Anti TNFs?
600 mg 3x a day for a total of 1800mg/day. When I first started out I was just on an anti-inflammatory, for the first 9 months or so. Then I added in my first DMARD. . . . plaquenil in part because I was still nursing a baby. A few years later added in MTX then switched it over to leflunomide. Added in Enbrel a few years ago. I’ve been on NSAIDs much of the time but not all of the time, and when I take them I’m typically taking them to deal with increased pain/swelling. It’s been 10 years since I was diagnosed.
I’ve taken many different NSAIDs over the years because of so many knee problems, which we now know is/was caused by PsA. I’ve found it all comes down to what my stomach can handle. Ibuprofen and Voltaren wreck my stomach (constant nausea), DayPro was awesome, but my Dr isn’t a fan of it any longer, so I’ve been on Celebrex for the last 18 months. It helps, but not as much as I’d like. I’ve tried a few others in there but can’t remember their name. I also take Plaquenil (a DMARD) for the PsA, but will be asking for something stronger tomorrow at my next Rheumatology appt., as I don’t think it’s working. I didn’t even bother with Naproxen,as my Orthopedist said it wouldn’t make a dent in the knee swelling/problems I’ve struggled with the last 2 yrs.
Hi there Ktel, I have been taking one tilcoltil 20mg daily, since April last year, which I can increase to 2 a day for up to 5 days (only as needed)… Initially I found it helped reduce pain pretty quickly, and by about 2 weeks in I would say pain was about 50% improved… My body certainly let me know pretty quickly if I missed a dose 
… I also take omeprazole with it to reduce risk of stomach ulcers.
Have also been on Mtx since Oct last year, with some/minimal improvement and not too many side effects… am thinking about trialing a break from the tilcotil to give my body a bit of a rest, and it’s a while now since I’ve even missed one lol But a bit nervous about how bad the PsA will get without it lol
I didn’t notice any improvement at all on ibuprofen/naproxen
The protocols you posted above, for axial involvement are interesting… I did mention my spine problems to the rheumy at last visit, but he wants to see how I go on the Mtx for another couple of months (which doesn’t do anything for the spine)… I guess I’m back on the wait cycle for now lol
All the best with your rheumy visit!! I do hope you get something that will give you some relief!!