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Diclofenac cardiovascular risk? Options
Sheila-R
#1 Posted : Wednesday, February 20, 2013 5:23:13 PM Quote
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Have just driven back from shopping listening to Radio 4 "Health Today " program at 3.30 this afternoon. There have been calls to withdraw Diclofenac as it can increase the risk of heart attack for some people by 40%, the example given was a diabetic, smoking , 40 odd year old footballer with high blood pressure (not too sure there'd be many of them about ). It also said that there were much safer alternatives such as low dose ibuprofen and naproxin? naproxen? .

Nothing was mentioned that many of us take Diclofenac along with handfulls of other drugs so I'm not sure of the relevence
However it also acknowledged that for some people Diclofenac was the only drug that gave them consistant pain relief.

I find this a huge worry as I'm sure I'm not the only one who takes 3 doses or Diclofenac a day, apparently the reasearch has been around for some while and this new research confirms what the previous research showed, so what do we do? ring the rheumy helpline? go to the GP? wait till the next appointment? Think I'll try the GP first.

By the way for those of you that have tried both Naproxin and Diclofenac which did you find was best for pain?

Sorry can't work out how to put a link on to the program, has only taken me three years to work out how to add an avatar (should have read the introductory notes years ago)

Best wishes
Sheila
anne_t
#2 Posted : Wednesday, February 20, 2013 8:49:28 PM Quote
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Hi,
Diclophenac has had this reputation for some years but has only now
got to the headlines. Mine was stopped 2 years ago. I had tried Naproxen
30 (!!0 years )ago but didn't tolerate it. was stopped after only 3 days.
Everyone is different but I rely on paracetamol and Tramadol 200mgs.
By the way Diclophenac is the main igredient of Voltarol. Perhaps the
makers wouldn't allow BBC to use that info!
Kathleen_C
#3 Posted : Wednesday, February 20, 2013 9:18:05 PM Quote
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Hi Sheila,

The question of diclofenac is indeed a thorny one - when I was first diagnosed I was taking it three times a day. This continued while I took DMARD after DMARD and the RA raged on its merry way around my joints.Once I was put on humira, and my RA became more controlled, the rheumy advice was to stop taking the diclofenac, which I have to say was a marvellous help, and gave me no side effects. However, I did as I was told, and in fact found I no longer needed it.

When flares happened, I had the option of taking it until the flare subsided, but my GP - while never refusing me diclofenac - was not very happy with it - because of the cardio-vascular risk. I asked him was there a NSAID that was less damaging, and he suggested naproxen, which I have on standby now in case I need it. I don`t feel it works quite as well as diclofenac for me, but it does a satisfactory enough job, so I`ll stick with it should a flare spring up.

I have to say here that my GP is very "clued up" about risks and benefits, and reacted with horror when a locum rheumy prescribed me arcoxia. My GP said he never, ever prescribed that and I stopped it immediately.I do trust my GP`s judgement, as he knows me best, and has the full picture, rather than just he RA bit.

It`s almost 6 years now since I last took diclofenac, but I am well aware that for some people it is the drug they need, and for them it comes down to whether the benefits outweigh the risks.

Take care,

Kathleen x

PS My older son was in a minor car accident a couple of weeks ago, and the GP prescribed anti-inflammatories - he was given naproxen, and he`s young and fit and active, and has the same GP as me.

zena_mary
#4 Posted : Thursday, February 21, 2013 11:48:11 AM Quote
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Location: Powys
Hi Anne, I also heard this prog. on radio 4 yesterday and had never heard of this link before.
I was initially given ibruprofen before being diagnosed properly but was put on diclofenac when symptems worsened.
I actually found the first a much better painkiller.
I was later given naproxen instead by my rheumy doc during a hospital stay. This helped inflamation, but not pain for me.
It has however has caused me gastric problems after a year or 2 of taking it, so I do not take any anti inflamatries now at all, my tummy is still not right, I now get a lot of indegestion and heartburn which I never had at all before.
As Kathleen I now manage quite well without them. I am not quite so well controlled at the mo. because I have had to come off abatercept whilst a skin prob. is looked at,
but hopefully I can get back on it afterwards.
I'm glad I'm not the only one who struggles with this technology!!! luckily I have a daughter who has heaps of patience getting me out of sticky situations!BigGrin people tell me I can not do anything wrong on it, but I seem to manage to do just that quite easily!!Confused
BigGrin Zena BigGrin xx
Anne-P
#5 Posted : Thursday, February 21, 2013 1:52:05 PM Quote
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I remember having this conversation with my rheum consultant a while ago. She said although there is a raised risk with volterol - declofenic - most of her patients needed to be on it and she wasn't concerned! She said the benefits outweigh the risk. It helps with both the pain and the inflammation. The inflammation being the problem with joints getting damaged long term. She said GPs get very anxious prescribing it; but she makes sure it is clearly in my letters to him - so that he is ok with prescribing it! For me it is a better option than a higher dose of steroids! So I guess it is swings and roundabouts... the steroids seem to be upsetting my liver!

I actually take 150mg a day of Volterol - I have the slow release version - 75 mg morning and 75 mg evening. I tried Naproxen but it didn't work for me; although it does work for my daughter who also has RA. If you take any of these though - you need a stomach protector like omeprazole or ranitidine - or you get stomach problems. These are available on prescription too.

Every time I try and stop it, my wrists start swelling - so I was told to keep taking it rather than increase the steroids.

I am sure we all have different reactions to the drugs... and I am sure being aware of the risks is useful - but we need to put it into context in the overall management of our RA - which is somewhat different to members of the general public. When my husband asked our GP for it to help his knee - he was told no... use ibuprofen - but then it was just one joint injury - not a whole disease!!

I am off for a few days in a friends caravan now... for a nice break!! Leaving kids in charge of the house Smile

xxx

Naomi1
#6 Posted : Friday, February 22, 2013 2:54:02 PM Quote
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I wonder if the Voltarol gel carries the same risk. I tried this on my painful neck yesterday and it worked a treat. I'm particularly concerned about cardiovascular risk as I have a lot of heart didease in my family and have had inflamed blood vessels, ectopic heart beat and breathlessness during flare ups as well as having a constant battle with secondary Raynaud's.
zena_mary
#7 Posted : Friday, February 22, 2013 5:03:44 PM Quote
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Sorry, Sheila, should have addressed that to you not Anne!!!!
Must be an age thing.BigGrin
Zena xx
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