Type 2 War between painkillers and Gliclazide.

[cineman]

Hi, sorry for confusing title. I have recently been put on 40mg Gliclazide daily. I see in the notes, that I cannot take aspirin or Ibuprofen while on them. This is awkward, as I have bad arthritic pain in my hips (as well as other places), that is threatening to stop me performing many daily tasks, including walking! Ibuprofen is one of the best things for this, only now I seemingly cannot take it anymore. I am also on 15/500 x2 Co-Codamol, which doesn't seem to do anything, even when taken regularly. Also, I occasionally (mostly at night) get chest pain which is general tightness, making it difficult and uncomfortable to sleep, so I have been taking one single aspirin, which may only be for reassurance, but does seem to take the pain away, whereas now, the pain continues for quite some time and again I cannot take that! Or can I? As it is only the lowest dose of Gliclazide that I am on, would one small aspirin really do that much harm? (BTW I have been checked out for heart trouble and don't seem to have any problems with that). My blood sugars have been a bit funny lately. They go up and down and the first day I took a Glic, I had a reading of 6.3 the next morning! Having been getting scores between 8.5 and 13.6! Though only rarely for that high one. So I started cutting the tablet in half, stupid I know, as the result has never been as low as 6.3 since and I am back on a whole tablet every day. My bloods are now between 7.0 and 9.0 most mornings, though due I think, mostly to Christmas! Having had a free 12 week membership to Slimming World (referred by my surgery), I have discovered that their diet is not good for diabetics. They even told me that I mustn't exercise! So I am now back on a low-carb one and that seems to be helping slowly to get it all back to normal. Sorry for waffling on so much. My question is just about the NSAID's really, as though it sounds bad, I don't need any help with the blood sugars, as they are falling back into place. Just for info, my meds are currently 2000mg slow-release Metformin, 25mg Alogliptin and 40mg Gliclazide daily. I am also on perindopril (to help kidney function rather than high blood-pressure) and also a statin to control triglycerides as cholesterol is fine.

 

[Rachox]

Hi cineman, I’m glad you’ve seen that SW meals aren’t suitable for Type 2s and you have reacquainted yourself with low carbing. I hope you see a continued improvement in your blood sugars.
As for your question about NSAIDs you need to ask your HCPs as we onthe forum cannot advise about drug doses or combinations etc.. I do sympathise as I have arthritis but can’t take NSAIDs as they mess up my asthma

 

[Boo1979]

Hi, sorry for confusing title. I have recently been put on 40mg Gliclazide daily. I see in the notes, that I cannot take aspirin or Ibuprofen while on them. This is awkward, as I have bad arthritic pain in my hips (as well as other places), that is threatening to stop me performing many daily tasks, including walking! Ibuprofen is one of the best things for this, only now I seemingly cannot take it anymore. I am also on 15/500 x2 Co-Codamol, which doesn't seem to do anything, even when taken regularly. Also, I occasionally (mostly at night) get chest pain which is general tightness, making it difficult and uncomfortable to sleep, so I have been taking one single aspirin, which may only be for reassurance, but does seem to take the pain away, whereas now, the pain continues for quite some time and again I cannot take that! Or can I? As it is only the lowest dose of Gliclazide that I am on, would one small aspirin really do that much harm? (BTW I have been checked out for heart trouble and don't seem to have any problems with that). My blood sugars have been a bit funny lately. They go up and down and the first day I took a Glic, I had a reading of 6.3 the next morning! Having been getting scores between 8.5 and 13.6! Though only rarely for that high one. So I started cutting the tablet in half, stupid I know, as the result has never been as low as 6.3 since and I am back on a whole tablet every day. My bloods are now between 7.0 and 9.0 most mornings, though due I think, mostly to Christmas! Having had a free 12 week membership to Slimming World (referred by my surgery), I have discovered that their diet is not good for diabetics. They even told me that I mustn't exercise! So I am now back on a low-carb one and that seems to be helping slowly to get it all back to normal. Sorry for waffling on so much. My question is just about the NSAID's really, as though it sounds bad, I don't need any help with the blood sugars, as they are falling back into place. Just for info, my meds are currently 2000mg slow-release Metformin, 25mg Alogliptin and 40mg Gliclazide daily. I am also on perindopril (to help kidney function rather than high blood-pressure) and also a statin to control triglycerides as cholesterol is fine.

Speak to a pharmacist or your doctor about what pain relief might work best for you
. NSAIDs are discouraged for long term use for anyone as they have been found to increase heart risk and also to have potential gastric problems increasing risk of stomach ulcers

Edited to add
https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm107856.htm

 

[bulkbiker]

also a statin to control triglycerides as cholesterol is fine.

Your trigs should improve greatly with your dietary change to low carb which may make the statins unnecessary (which I would say they probably are anyway)...

 

[cineman]

Thank you all for such quick replies! I shall be in touch with my doc's soon then! (If I can get them to talk to me), they're usually too busy to do anything with patients!

 

[SimonCrox]

The catch is "protein binding". All these drugs are bound to protein in the blood, so that if on gliclazide, adding another protein bound drug like aspirin should theoretically displace the gliclazide from the protein so more free gliclazide around so more effect eg hypos.
I have never seen this happen despite seeing a lot of people on gliclazide and aspirin. Also, if one is on a regular dose of aspirin / NSAID, then gently adding in gliclazide on top is not going to lead to a sudden surge in free active gliclazide in blood stream.
So, no worries there.
As above, I would be more bothered by the use of ibuprofen - if it cannot be avoided, then that is the case; ibuprofen and NSAIDs are very effective painkillers for many people in an easy to take dose, but there are side effects, so good to see if a topical NSAID would work or smaller dose; ibuprofen or naproxen seem to be the safest
best wishes

 

[desidiabulum]

It means nothing, but I have been on low dose of aspirin (post-angioplasty) and gliclazide -- among other things -- for 5 years and not one HCP (including some top people) has batted an eyelid