Supplemental analgesics

Posted by elizabethjoan @elizabethjoan, Oct 10, 2022

Is it ok to take ibuprofen and acetaminophen to help with pain relief while on steroids? If so is one recommended over the other?

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John, Volunteer Mentor | @johnbishop | Oct 10, 2022

Hi @elizabethjoan, I never needed anything other than prednisone for my PMR pain but I did use Tylenol when I had a headache but not very often. From what I've read you may want to ask your doctor or pharmacist before using ibuprofen when you are taking steroids.

"Can you take Tylenol and ibuprofen with steroids? (Drugs.com)
It should only used together on the instruction of a Doctor, and needs to be used with caution together especially if you are prone to stomach upset including stomach ulcers and bleeding. Both medications taken together can cause serious gastric complications in some patients."
-- I just took 800 mg ibuprofen and 30 mg of prednisone. Is that going to be ok?:
https://www.drugs.com/medical-answers/800-mg-ibuprofen-30-mg-prednisone-gonna-3156908/.
"Acetaminophen is recommended for headaches when taking prednisone. There is a risk of a moderate interaction between prednisone and ibuprofen. Talk to your doctor or pharmacist before taking ibuprofen for a headache if you are taking prednisone."
-- Is It Safe to Mix Tylenol and Prednisone?:
https://www.verywellhealth.com/tylenol-and-prednisone-5116894

suetex | @suetex | Oct 11, 2022

My personal opinion about using NSAIDS and tylonal is this: Ibuprofen seems to be too hard on the stomach, so I avoid it. Naproxen, used occasionally seems safer. Aspirin (which I took as a kid for migraines a lot) has never bothered me. But I never take anything on an empty stomach, including my pred. I go for the tylonal first but you have to be mindful of your liver with that one. Anything used everyday will lose its effectiveness in time anyway. (There is a complicated reason for this.) It is a mindfield so find out what works for you but use it sparingly and with stomach protection.

suetex | @suetex | Oct 12, 2022

PubMed has an excellant article on the efficacy of MSM if you are interested. It is titled:
Methylsulfonylmethane: Applications and Safety of a Novel Dietary Supplement
It is pretty deep going but looks very promising for us to try. I know I am. I am still pondering when is the best time of day to take it. Right now, I'm trying to determine when we should be trying to counteract cytokine release. which has a diurnal pattern it seems. Looks like very early in the morning. (4:30 am?)