RE: Re: Non-steroidal anti-inflammatory drug (NSAIDS):Joanne

[Guest guest]

Thanks, Joanne.

So Ibuprofen is also metabolized by the liver. And as

i remember there has been an FDA new warning on its

effect on the kidneys, too few months ago. You

probably heard about it.

I am like , i try to take 2 of 325mg Tylenol when

my pain is not too intense. For few months now my pain

has been intensified so i was given Vicodin, but i did

go back and asked my doctor to replace it by Codein

alone after i read once on this site that the previous

has some strong side effects. But i guess in small

doses it is o.k. since has been taking it. I

always try to go less on any med, if that is possible.

As you have mentioned a lot of them do affect the

liver enzymes. I think narcotics are pretty popular

among the pain sufferrers of PSCER's. Also as i

recall, you are a nurse and you mostly do have a very

good knowledge about these pain relievers.

Back on the Ibuprofen, subject. I always get mad when

these doctors, specially primaries give high doses of

it like it is nothing. I would ask my doctor if a

prescription is o.k. w/the liver and he would say yes.

But then afterwards i do find out that it is not.

Thanks, again for your input Joanne, with my best

wishes.

PSC/UC

--- Copper copper@...> wrote:

> -

> I would encourage you to talk with your doctor about

> Tylenol versus NSAIDS -

> Ibuprofen, Advil, Aleve, etc. Tylenol and NSAIDS

> are metabolized by the

> liver. In prior discussions, some PSC'ers have been

> told by their

> physicians to avoid or minimize Tylenol and others

> told the same for

> Ibuprofen, etc. I am a believer that minimizing or

> avoiding ibuprofen is

> really important. 's GI had limited him in past

> to two Tylenol per day

> (he weighs about 124 pounds). Recently he had

> dental work done and the

> dental surgeon gave him 800 mg ibuprofen tablets! I

> asked the GI doc and he

> wanted him to stop them completely. He was

> concerned BOTH for the liver, as

> well as for exacerbating ulcerative colitis by

> irritating the colon! The

> doctor preferred that for severe pain, he take small

> doses of vicodin

> (Hydrocodone - a narcotic and Tylenol).

>

> Ask what medicine, what dose and how often is safest

> and best to relieve the

> type of pain you are having. If that doesn't work,

> then ask again what

> other alternatives there are - pain relief is

> important and there are many

> ways to relieve pain.

>

> Joanne H

> (, Ca., mom of , 17, UC/PSC 2-06; JRA 1998

> - in 1999, 's liver

> tests were up - the first question was the ibuprofen

> he took for arthritic

> pain. We stopped Ibuprofen and did one additional

> test - liver enzymes were

> down. Next test they were up again - we later found

> out about PSC, but at

> first glance, medications were thought to be the

> culprit)

>

>

> ..... I always thought that i should be more

> worried about

> the liver. Also Ibuprofen helps toward healing

> other

> aches and pains, like the joints for example.

> Although

> on the other hand one should be careful regarding

> internal bleeding. Probably in small doses it will

> be

> fine i guess, correct?

>

>

>

>

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[Guest guest]

Thank you, Joanne.

That is very good to be overly conservative, specially

with the way pain medications are being handled as you

said and with the big varieties of everyday new

composite, formulas that makes it so easy for the

patient to be mixed up and not to absorb the whole

information. And that if enough info and warnings were

given!

--- Copper copper@...> wrote:

> I looked at some other references on NSAID

> metabolism, but am not computer

> literate enough tonight to site them! Overall,

> for me, the general

> message is to be careful what medications (NSAID or

> otherwise) that you

> take, being sure your doctor is aware of what and

> how much you are taking.

> I have always been very vigilant about protecting

> livers and kidneys - both

> of which can be affected by drugs.

>

> And I agree with Arne, the medical messages aren't

> always clear on pain

> medications, including use of NSAIDs. And I am

> probably overly

> conservative, while carrying my never-ending mantra

> that pain can and should

> be managed - appropriately and safely for the

> individual.

>

> Joanne H

> (, Ca., mom of 17, UC/PSC 2-06; JRA 1998)

>

>

>

>

>

>

> Ibuprofen is metabolized by the kidneys.

>

> From

>

http://www.fda.gov/medwatch/SAFETY/2006/Jan_PI/MotrinSusp_PI.pdf

>

> Renal Effects

> Long-term administration of NSAIDs has resulted in

> renal papillary

> necrosis and other renal injury. Renal toxicity has

> also been seen in

> patients in whom renal prostaglandins have a

> compensatory role in the

> maintenance of renal perfusion. In these patients,

> administration of a

> nonsteroidal anti-inflammatory drug may cause a

> dose-dependent reduction in

> prostaglandin formation and, secondarily, in renal

> blood flow, which may

> precipitate overt renal decompensation. Patients at

> greatest risk of this

> reaction are those with impaired renal function,

> heart failure, liver

> dysfunction, those taking diuretics and ACE

> inhibitors, and the elderly.

> Discontinuation of NSAID therapy is usually followed

> by recovery to the

> pretreatment state.

>

> Hepatic Effects

> Borderline elevations of one or more liver tests

> may occur in up to 15% of

> patients taking NSAIDs including MOTRIN Suspension.

> These laboratory

>

> A patient with symptoms and/or signs suggesting

> liver dysfunction, or in

> whom an abnormal liver test has occurred, should be

> evaluated for evidence

> of the development of a more severe hepatic reaction

> while on therapy with

> MOTRIN Suspension. If clinical signs and symptoms

> consistent with liver

> disease develop, or if systemic manifestations occur

> (e.g., eosinophilia,

> rash, etc.), MOTRIN Suspension should be

> discontinued.

>

> The only recent FDA alert I could find on

> ibuprofen was its use in

> addition to aspirin.

>

http://www.fda.gov/cder/drug/InfoSheets/HCP/ibuprofen_aspirinHCP.htm

>

> I stand by my original statement - Everything's a

> tradeoff, nothing is

> risk-free. The problem with this one is the medical

> community does not have

> a consistent recommendation either.

>

>

>

> Arne

> 56 - UC 1977, PSC 2000

> Alive and well in Minnesota

>

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