Want to get off Diclofenac - alternative NSAID's ?

Dancing Girl
Dancing Girl Member Posts: 25
edited 21. May 2015, 17:07 in Living with Arthritis archive
Hi,

As the title says, I have been on Diclofenac for years now (75mg slow release once a day) and I want to try something else not so harsh on my stomach. I do take a stomach protector (Lansaprazole).

I didn't take the diclofenac last night and today feel rubbish, not aching anywhere badly just more fluey and so drained.

Any help appreciated - thanks ! (ps - it's RA I have). :(

Comments

  • frogmella
    frogmella Member Posts: 1,115
    edited 30. Nov -1, 00:00
    I found naproxen to be a good NSAID for my facet joint arthritis pain - well better than diclofenac anyway!
  • dreamdaisy
    dreamdaisy Member Posts: 31,558
    edited 30. Nov -1, 00:00
    I suspect they are all harsh on the stomach - maybe you could ask your GP about increasing the protector? I found naproxen rubbish and diclo far better but I am fortunate in that my inflammation levels are very well controlled, thanks to the other meds I take, so I rarely need to 'imbibe'. I think this is something to chat over with your rheumatologist (or maybe your GP) because they know your situation far better. DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • Dancing Girl
    Dancing Girl Member Posts: 25
    edited 30. Nov -1, 00:00
    frogmella wrote:
    I found naproxen to be a good NSAID for my facet joint arthritis pain - well better than diclofenac anyway!

    Thank you Frogmella, I have tried this years ago and like Dreamdaisy found the Diclofenac better for pain management.
    dreamdaisy wrote:
    I found naproxen rubbish and diclo far better. I am fortunate, however, in that my inflammation levels are very well controlled thanks to the other meds I take so I rarely need to take it. I think this is something to chat over with your rheumatologist (or maybe your GP) because they know your situation far better. DD

    Thank you for replying, I guess I could do with getting the inflammation levels under better control in order to try and cut the Diclo down. It's such a vicious circle isn't it. Currently on triple therapy (Leflunamide, Plaquenil and Sulpha). Will have a chat to gp or next Rheumatologist at next app.

    Thanks guys :)
  • As5567
    As5567 Member Posts: 665
    edited 30. Nov -1, 00:00
    I suggest talking to your doctor about your concerns, there are many NSAID's available which are either COX-1 or COX-2. The more traditional NSAID's are prescribed first such as Naproxen, Diclofenac etc due to costs. My favourite NSAID is Arcoxia because there is no need to take a stomach protector with it. It's designed with a special coating on the outside which helps the drug bypass the stomach and absorb further down the line. The only problem with Arcoxia is the cost, it costs something like £36 for 28 when naproxen costs something like £3 and that is the main reason my GP often tries to take it off me.

    If you feel that the diclofenac is having an impact on your stomach then I would try to change the medication ASAP. I personally would ask about a NSAD like Arcoxia that has a coating on the tablet to help it bypass the stomach. I know there are alternatives to Arcoxia but I cannot remember the names of the drugs. They are all equally priced like Arcoxia so don't be surprised if your doctor says no at first. I was put on Arcoxia because I was a child and my doctor said it was likely I'd need to take NSAD all of my life, that didn't stop my GP trying to change the medication every year, but as far as I understand if the medication comes from a consultant your GP cannot over rule his/her decision to keep you on that specific medication.
  • dreamdaisy
    dreamdaisy Member Posts: 31,558
    edited 30. Nov -1, 00:00
    We are all so different in how we react to the meds, the only way is to make changes, after consulting with the relevant people and seeing what happens. I take injected meth weekly, injected humira fortnightly and six sulph tablets daily: back in my early days sulph alone had little effect on my inflammatory levels, and I tried it in combination with a variety of other DMARDs to little gain. It wasn't until I began the anti TNFs that any impact was made on the CRP and ESR (but not on the joints, alas, because OA has moved in and of course they do nothing for that). I need the occasional diclo when the OA has a bite, that's all.

    Many moons ago my rheumatologist prescribed Celebrex (which was lovely and effective) but my GP altered that due to its expense. DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • stickywicket
    stickywicket Member Posts: 26,278
    edited 30. Nov -1, 00:00
    I remember years ago, when there were far more NSAIDS about and I was back at my docs with more stomach trouble. He said it'd be caused by my current NSAID. I said this one was supposed not to damage the stomach. He opened his desk drawer to reveal a load of leaflets. "They're all NDAIDS" he said. "The selling point of all of them is that they won't damage the stomach. And that's because they all do."

    I believe the Cox2 inhibitors are supposed to be better for the stomach - but worse for the vascular system :roll:

    I took diclofenac for years. It was one of the better ones for me. But that was before DMARDS. I think this is a problem for your rheumatologist to solve not the GP. Why not contact your helpline and ask for an earlier appointment?
    "The deeper sorrow carves into your being the more joy you can contain." Kahlil Gibran
  • Dancing Girl
    Dancing Girl Member Posts: 25
    edited 30. Nov -1, 00:00
    Thank you so much for all of the above advice, it's certainly given me food for thought - I guess it's all down to cost at the end of the day :shock: I'd no idea there were different types of Nsaids, I thought they were all pretty much the same albeit a few safer than others.

    I will book a GP appointment and take it from there, if no joy I'll ring the SOS clinic and see what they say.

    Thank you so much, very much appreciated.
  • elnafinn
    elnafinn Member Posts: 8,043
    edited 30. Nov -1, 00:00
    My story is that I cannot take diclo. I took it for years and then suddenly it gave me stomach and bowel problems. I was put on arcoxia and no side effects and worked really well re inflammation. GP in recent years has been twitchy about me being on it. We carried on. In about January it was discussed again and I decided to take something else as it had pushed my BP up pver the years of taking it - one of the side effects. I tried lansaprazole and omeprazole, the stomach protectors along with naproxen and ibuprofen (not all together! ;)) and all these gave me stomach and bowel problems with a vengeance and were not as effective as arcoxia. I decided to start to take Zapain, a painkiller instead.

    The positive in all this was my BP came down so I was able to stop taking the Lisoprinol 2.5 daily and only take the bendroflumethiaze (water tablet) but the down side is that the Zapain is not as effective as the arcoxia.

    As I have osteoporosis I was very reluctant to take the stomach protectors anyway, as they can contribute to OP when used over a long period of time. When in hospital for an operation I was given Celebrex and I had no side effects.

    Elna
    The happiest people don't have the best of everything. They just make the best of everything.

    If you can lay down at night knowing in your heart that you made someone's day just a little bit better, you know you had a good day.
  • Jaclyncollin
    Jaclyncollin Bots Posts: 36
    edited 30. Nov -1, 00:00
    The fact is there are many NSAIDs but all will have their share of side effects. Cox 2 are believed to softer on GI, but harder on vascular system so need to be carefully monitored in blood pressure patients.
    In spite of choice you make, be sure you take it with food – empty stomach is not a good idea for NSAIDs. Always take diclofenac with at least 8 ounces of water. I also found, taking an NSAID later in the day may be less likely to lead to stomach upset and other side effects than taking the same drug in the morning. Personally, I would stick to diclofenac if I am getting the desired results and work on combination of stomach protector like Misoprostol. Misoprostol reduces the risk of stomach ulcers and promotes healing of existing ulcers by replacing stomach-protective substances called prostaglandins, which NSAIDs block. However, this kind of advice should come from your GP or rheumy before trying one. There are loads of pain dullers available, so perhaps worth asking and explaining your need to continue painkillers as well as keeping your quality of life at same time.
  • lynnemarie1123
    lynnemarie1123 Member Posts: 295
    edited 30. Nov -1, 00:00
    Ive been on loads. Diflo, Naproxen, Arcoxia etc - now on Celebrax - nothing seems to help :0( xxx

    Good luck with finding an alternative x