Hi Angie

I take paracetamol too and it does help. I seem to recall reading somewhere- I think it was on the forum, that you need to take a small dose everyday rather than just as and when it's needed- obviously I don't want to recommend this in case I'm wrong ( hopefully someone will read this and confirm/ correct me) although I do take one tablet every morning then top up if necessary. I was told not to take ibuprofen as it's not suitable with methotrexate. Hope this helps

Maria

Hi Angie,
Just wondering what other meds you take?
Do you take any other painkillers? I know some can be used in combination but others not, so perhaps your gp said that because it is safe.

I take cocodomol on prescription, it comes in different strengths according to your needs. It is a combination of paracetamol and codeine and seems to work well for me, but I do have to be careful to eat a roughage rich diet with it. I was also given tramadol at one time which I was told I could use with it but did not suit me.

I was told by my rheumy nurse to take a lower dose of painkillers continuously rather than at odd times as it works better, but I also know that continuous use of some can actually cause headaches.
I think when you have such a chronic illness painkillers should be given on prescription as a matter of course.

I think a call to your rheumatology nurse would be helpful. She may suggest something better or perhaps as Maria said you need to be reassessed in your treatment. Paracetamol alone does nothing for me either.
Hope you find something to help, pain needs to be controlled.
Zena xx

Angie

It is always difficult in getting pain medication right and the answer is to take the right dose continuously. I use paracetemol and it works wonders after following my GP's advice. Take the full dose every day i.e. 2 x 500 mgs spaced out over 24 hours to a maximum of 8 tablets a day. Take them each day even if you are not in pain. You need to build up the medication in your body for a couple of weeks to see the benefits. Whatever you do don't dip in and out of it otherwise it won't work.

If this does not work then you need to go back to your GP. Don't take any other over the counter medications without checking with your GP. You do not mention if you are on an anti-inflammatory such as Naproxen. Most over the counter medications such as Nurofen or Anadin Extra contain an anti-inflammatory and you may be doubling up.

There are some super duper pain killers available through your GP such as Tramadol etc if you are suffering.

Good luck

Jackie
xx

Rang Rheumatologists secretary as still having problems.

She was most indignant saying that I'd had an appointment in December & Dr doesn't want to see me for another year.

Had to explain that things had changed and I needed some advice. She's put me on the list for the Rheumy Nurse to ring me.

Trying paracetamol & codeine at the moment, think it has eased a little but still fizzing.

Angie

Hi Angie - yes, I echo what the others say - talk to the rheumy nurse again and ask for help. I take naproxen daily - also omeprazole to protect my tummy- and I really do start to notice if I miss a dose, but otherwise am very well and consider myself in remission. I wouldn't bother with OTC meds because they won't be as effective as the prescribed painkillers - but that's just me! Ocassionally I do take 2 naproxen in a day, but usually it's just one. I'd rather take an extra pill and get on with my life rather than endure lots of pain again - but maybe I'm being a wimp - hahahah!

Best wishes - Sylvia xx

Of course, one of the issues with taking paracetamol is that it's a max of 8 tabs a day = 6 hour interval whilst it's potency is limited to 4 hours. So another good technique when things are bad is to use paracetamol alternated with an NSAID such as ibuprofen on a 3 hour cycle, if your stomach can tolerate an NSAID. The intervals and max tabs per day are similar to paracetamol so if you alternate them you will keep potency up.

You can buy combo products of paracetamol and ibuprofen. I avoid those because while they are useful for intense pain, you lose the benefit that alternating doses provides for 'potency coverage.'

Celecoxib (Celebrex) is a good gut friendlier NSAID if you can't stomach (literally) ibuprofen.