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NSAIDs - Ibuprofen, Naproxen, Diclofenac

LittleGreyCat

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4,421
Location
Suffolk, UK
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Diet drinks - the artificial sweeteners taste vile.
Having to forswear foods I have loved all my life.
Trying to find low carb meals when eating out.
I've got an inflammation around the knee at the moment (I am assuming Bursitis because that is what I get from time to time).

The standard treatment is to use a NSAID (non steroidal anti inflammatory drug).
In the past I have gone to the doctor and been prescribed Diclofenac and more recently Naproxen.
The standard over-the-counter NSAID is Ibuprofen.

The Ibuprofen box had a warning about taking it if you were diabetic, and also mentioned diabetic medication.
A look at Naproxen also carries similar warnings for diabetics.
This seems to be centred on increased risk of a cardiovascular incident (because diabetics are also statistically at higher risk).
I think that in the case of both these drugs (Proprionic Acid derivatives) there is also the risk of adversely affecting the kidneys.

Diclofenac also carries a higher cardiovascular risk (and seems to be less popular these days) but doesn't seem to have the same kidney risk (I think).
Diclofenac is in another drug group, being an Acetic Acid derivative.

So I am awaiting a call back from the doctor to try and sort out which is the safest anti-inflammatory.
My feeling is that because my GFR is a bit low but my cardiovascular system seems fine I would be better off with the Diclofenac.
We shall see.

One thing this illustrates is that the drug companies seem to be covering themselves by listing an enormous range of possible side effects - the list with the Ibuprofen is two sides of paper. The strip of paper is 16 inches long and has two columns of small print on both sides. Looking up Naproxen online gets 7 pages of text.

Ploughing my way through all this guff, I did notice something a bit weird.

With Ibuprofen a couple of the possible side effects were headache and not feeling well.
When do you take Ibuprofen? When you have a headache and you're not feeling well.
Go figure!
 
Just had a quick chat with the doctor and she says my GFR is fine (last one was 88, much higher than previous ones) so Paracetamol and Ibuprofen are the way to go. Diclofenac is dodgy with the kidneys as well and generally worse all round for side effects. Very rarely prescribed now.
 
The list of side-effects can be very off-putting, I've taken Diclofenac in the past when I had inflammation in my sternum, it was only after taking them that I read about the cardio risks.
 
Diabetics are advised to take Paracetamol. The trouble with that is if you are also on Propranolol.
 
I was told recently that my GP surgery no longer prescribes Diclofenac at all. Naproxen is the alternative.
 
I used to have diclofenec prescribed but since I was diagnosed with prinz metal angina I am no longer allowed and have to have naproxen.
 
For me, I take ibuprofen, Arcoxia, or aspirin without blood sugar problems, for pain and inflammation. I also take Paracetamol + Codeine sometimes, if I don't suspect any inflammation (Paracetamol doesn't work for inflammation).
 
Voltarol-Pain-eze-Emulgel is a topical anti-inflammatory the active ingredient being Diclofenac Diethylammonium.
 
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