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Medical Forum / Diseases and Disorders / Lupus / June 2006

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NSAID's and Heart Problems......

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Maggie - 24 Jun 2006 06:37 GMT
I take Daypro as my daily NSAID.  I know some may not know of it well
as it's an older drug, but one that works for me.  Does anyone have any
experience with it though?

Vioxx and Celebrex were pulled because of heart problems as I recall.
I tried Vioxx for a few days, and it worked at first, but then I got
worse.  I tend to have problems with Ibuprohen-like drugs.  Well, today
I just happened to glance at my drug info on the Daypro and noticed
that there's a warning about heart conditions on it.  There was never
this warning before, so I wonder if it's now in the same category as
Vioxx and Celebrex.  Furthermore, I wonder what everyone here takes for
their NSAID as I may be looking to switch after reading that.

Maggie
janers - 24 Jun 2006 14:37 GMT
Hi Maggie, I was told by my cardiologist that ALL NSAIDS will have a warning
about Problems with heart conditions.
I talked to her about use of NSAIDs since I have irregular heart rhythm and
highpertension and she told me it is BEST NOT to take them with my health
condition and lupus.

I was trying different brands due to my pain level and inflammation and well
she told me right out, if she had to choose the use of ONE drug for me to
take it would be to continue use of MEDROL instead of any NSAID. WHAT??? I
said?   Medrol is terrible side effects let alone give a moon butt and moon
gut!!!  she laughed and said "well you wanted a choice and that is all the
choices I had.

But it  is true.   I had read the alleve was the least likely to cause heart
problems but then IT is still listed as a NSAID and will still cause the
problems.
HOW in "H" are we to decide but to trust our doctors in helping us do this.

I am not on NSAID and gather I never will be again.  Celebrex and Vioxx were
wonder drugs for me and Off went the vioxx and celebrex, neither rheumy or
cardiologist will let me take it again...
So pop the medrol on low and high doses and hope there is a bathing suit
that will fit  this  year and next and next...
Water classes in the future won't need a life jacket, I will have one built
right IN>

have a smiley day.

janers
Shelagh - 24 Jun 2006 18:15 GMT
Ditto on all that said by janers and her docs.
my cardio also said NO nsaids at all! especially after my incident of chf .... and no, i wasn't on any then thank god!
they are trouble for heart problems of many types and also add to fluid retention just on the side... one more thing to worry about with cardio or renal issues!
I too was told that pred and like steroids <medrol>  are better and to stay with it and to increase it when needed without worrying about it's side effects; they are 'safer' than the nsaids for my health care according to my docs
<my disclosure here is that this is what was recommended for me as a lupus patient, but also is generalized for lupus patients as a group and yes, generalizing nsaids in one group as well>  
is what the cardio said!
Also I was told that provided I get the go ahead again on chloroquin which is like the plaquenil, both are antimalarials and used for joints and skin issues and the fatigue also with lupus patient care,  that they are safer than the NSAIDs as a group as well speaking on a cardio/renal level
.... so there you go...coming from two countries and in different areas geographically speaking and saying the same things....
It is not often you get doctors that much in accordance?!
Wishing you good luck, and try to avoid the nsaids if you can at all!
hugs,
Shelagh
http://clik.to/lupus

> Hi Maggie, I was told by my cardiologist that ALL NSAIDS will have a warning
> about Problems with heart conditions.
[quoted text clipped - 25 lines]
>
> janers
Maggie - 24 Jun 2006 19:16 GMT
Wow, Janers & Shelagh...that's just scary!

To be honest, I'm scared to stop AND scared to continue, but I'm going
to stop taking it and just see how I do.  The Imuran should be
sufficient as long as I've been on it.  Do either of you take Tylenol
Arthritis?  I know it's not an NSAID, per se, and too much is bad on
the liver, but a couple a day, 3 or 4 times a week shouldn't be
dangerous, should it?

Thanks and Hugs,
Maggie
janers - 24 Jun 2006 20:48 GMT
hi Maggie again.

I also take Arthritis strength tylenol.  I also take darvocet for pain too
NOT at the same time and that has tylenol in it.

I was told that you can take up to 4000mg of tylenol in one day but check on
that with a doctor ok?

I take my tylenol maybe during the day but if I get really bad pain and or
headaches then in goes the darvocet.

You can take according to the bottle or tylenol arthritis NO more than 3
doses a day or 6 pills a day.  It is kinda hard to even get that in, since
those are extended release pills and need to only be taken every 8 hours.

I just take maybe 2 doses a day and if needed my darvocet.  So far no liver
problems and I am ALSO on other meds to raise liver enzymes.  NOW that is
not saying YOU should do it, it is saying ASK you doctor and make sure he or
she knows before you start this.

good luck
janers
Shelagh - 25 Jun 2006 00:51 GMT
I only take aspirin at 81 mg. daily to prevent clots etc.
... with antiphospholipid syndrome a part of my 'family genetics', it was recommended,
but that is it for any nsaid at all....
Tylenol messes with my renal 'labs' and can't have that with past renal issues in a big way!
But if you've never had renal probs don't even consider the issue... your doc will advise you the best!

But, don't be scared Maggie.. just move on and do what you can with what the doc says!
I do also take pred daily 5mg and more when necessary, also decadron <steroid too> when necessary for the bigger problems and I have a pain med. specialist who set me up with a program that works for me using the ms contin and break throughs and it too keeps me living a quality lifestyle..... but I can't wait to be able to restart the antimalarial med.... it really helped my joints which are a big problem for me now that I was forced off it temporarily... funny how you find out how much good the stuff does you when you have to stop taking it!
I wasn't sure it was doing a lot till I had to stop and now I want back on so bad!!!... praying for a good field vision test:  no more ongoing damage and if possible <though unlikely> a reverse in the damage done would be really great!!
good luck to you!
hugs,
Shelagh

> Wow, Janers & Shelagh...that's just scary!
>
[quoted text clipped - 7 lines]
> Thanks and Hugs,
> Maggie
Andy - 25 Jun 2006 09:42 GMT
>I only take aspirin at 81 mg. daily to prevent clots etc.

Odd... the standard UK dose for that is 75 (and aspirin only comes in 75
and 300 strengths). I wonder why the difference?
Signature

Andy Taylor [Chair, N E Lupus Group]
See http://www.northeastlupus.org.uk for more!

janers - 25 Jun 2006 14:53 GMT
USA is Spelled different than UK Andy.  Didn't you know that?  That just
means our letters and numbers are MUCH different hahahahahaha

It ain't odd, it is fact LOL.   AWE comeon now, MORNING JESTing

heheheh

janers
Andy - 25 Jun 2006 17:28 GMT
>USA is Spelled different than UK Andy.  Didn't you know that?  That just
>means our letters and numbers are MUCH different hahahahahaha
>
>It ain't odd, it is fact LOL.   AWE comeon now, MORNING JESTing

Well, I wondered if it was something to do with milligrams per average
body weight, but then I decided that was a Wicked Thought.
Signature

Andy Taylor [Chair, N E Lupus Group]
See http://www.northeastlupus.org.uk for more!

janers - 26 Jun 2006 17:08 GMT
Wicked ain't the word for it.  My goodness I hate to see MY weight in
micrograms.  Shock me for sure and make me wonder if I should get a bigger
urn ready for the road up.

haha.
Honestly I have no clue about UK or USA numbers.  I was joshing you but ya
never know now do we?

janers
Maggie - 26 Jun 2006 19:21 GMT
> Odd... the standard UK dose for that is 75 (and aspirin only comes in 75
> and 300 strengths). I wonder why the difference?

That's easy...our blood is thicker. :P
janers - 24 Jun 2006 20:43 GMT
while you are there Shelagh, did you try the plaquenil?   I did and had a
severe rash and hives.
DO you think that I could maybe give it a try to ue the choloquin.  Maybe
they are made up differet, ya think?
RHeumy has mentioned to try it, so I am still wondering about that and
believe me that rash and blisters was NO darn fun ..

hugs janers
Shelagh - 25 Jun 2006 00:44 GMT
didn't see it here Janers.... i sent you back on personal email... saying:
Hi janers.... Just got in from my 'hair day out'...
I got nausea bad from plaquenil and because the chloroquin screwed my eyes so badly, with the loss of central vision; i was recommended to try the plaquenil subQ instead.... avoiding nausea they think; i may try that this time if given the all clear after next field vision test.... re you and the plaq. it is a different 'make up' of a drug definitely...
one: chloroquin is  chloroquin phosphate and
two: plaquenil is hydroxychloroquin sulphate
.... so I'm thinking that  maybe the sulphates in the plaq. got to both of us in different ways? you with the rash etc. and me the nausea?
IMO? yes, worth trying the other for sure for you! and i too may try the sub  cutaneous prior to going back onto the chloroquin, which I know is a good drug for my joints and skin and all! How I miss it now! you don't really know just how much good you are getting from it till you are forced off it cold turkey!  wow, my joints are so bad and I had forgotten just how bad bad is with them lol!!
whine whine... any cheese left for me?
hugs to you
> while you are there Shelagh, did you try the plaquenil?   I did and had a
> severe rash and hives.
[quoted text clipped - 4 lines]
>
> hugs janers
Lyndal - 26 Jun 2006 07:12 GMT
Hi gang
Some thoughts on NSAIDs and hearts

1. All NSAIds potentially affect the pumping action of the heart and can
worsen cardiac failure = generally bad for loopies, although some seem to
tolerate them fine (obvioously those without much heart damage!)

2. Vioxx/Celebrex/Mobic are a diffrent class (Cox-2 antagonists) and Vioxx
had the added kicker that it increased risk of ischaemic heart disease and
heart attack ++ as well as the standard heart failure risk.  So it was
withdrawn.  Now Celebrex in doses of 200mg per day or less is OK, providing
the person does not have existing coronary heart disease (I understand in
USA they often use doses up to 400mg a day- which makes it just as bad as
Vioxx).  There is no clear evidence that Mobic is a problem..but I would say
...tread carefully.

3. Summary?
Don't take NSAIDs/COX-2's if you have known cardiac failure or coronary
heart disease.
Use with care if you have hypertension or arryhtmia
Don't take Vioxx under any circumstances
If you're unsure check with your doc..

Does that help at all?

Lyndal
didn't see it here Janers.... i sent you back on personal email... saying:
Hi janers.... Just got in from my 'hair day out'...
I got nausea bad from plaquenil and because the chloroquin screwed my eyes
so badly, with the loss of central vision; i was recommended to try the
plaquenil subQ instead.... avoiding nausea they think; i may try that this
time if given the all clear after next field vision test.... re you and the
plaq. it is a different 'make up' of a drug definitely...
one: chloroquin is  chloroquin phosphate and
two: plaquenil is hydroxychloroquin sulphate
.... so I'm thinking that  maybe the sulphates in the plaq. got to both of
us in different ways? you with the rash etc. and me the nausea?
IMO? yes, worth trying the other for sure for you! and i too may try the sub
cutaneous prior to going back onto the chloroquin, which I know is a good
drug for my joints and skin and all! How I miss it now! you don't really
know just how much good you are getting from it till you are forced off it
cold turkey!  wow, my joints are so bad and I had forgotten just how bad bad
is with them lol!!
whine whine... any cheese left for me?
hugs to you
and good luck too janers!

> while you are there Shelagh, did you try the plaquenil?   I did and had a
> severe rash and hives.
[quoted text clipped - 4 lines]
>
> hugs janers
Shelagh - 26 Jun 2006 18:48 GMT
Thanks LPN.... that was very much to the point.
Having just had a 'cardiac event' as they like to call it; another fun word they use is 'episode'.... kind of makes you wonder why they just don't call a spade 'a spade'?!
Anyhow yes, you made it very clear as to what and why with the NSAIDs and the vioxx issue as well... helps too to hear it from a doc, not just another 'know it all loopie'.... well almost 'all' <g> lol!
Signature

hugs,
Shelagh
http://clik.to/lupus

> Hi gang
> Some thoughts on NSAIDs and hearts
[quoted text clipped - 51 lines]
>>
>> hugs janers
Maggie - 26 Jun 2006 19:17 GMT
Thanks Lyndall, Shelagh and Janers!  I have divided up my dose to 300mg
twice a day, instead of 600mg once a day, until I can see the doc and
get his okay to stop it altogether.  If he can't get me in soon, I will
go to 300 once a day in a couple of weeks though.  Something just told
me not to go cold turkey, but get off of it ASAP nonetheless.  I am so
glad you all are here with your expertise and concern.  Love to you
all.....Maggie
 
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