Ibuprofen overuse?

Think it comes down to how sensitive your tummy is. When I broke my back, I was on 2000mg Paracetamol, 1000mg Ibuprofen and 1000mg Tramadol daily for 6 months and I didn't die or have any stomach problems. Bugger of a problem getting off the trammies in the end mind you!

I took Ibuprofen, then Naproxen, then Ibuprofen again, for about 3 months. No ill effects noticed at the time but 3 months later I was declined for giving blood because of low iron. Investigations into possible reason were delayed by covid, and found nothing, but the assumption is that I had stomach bleeding which stopped when I finished taking the NSAIDs. So now I have a prescription for Omeprazole, which helps protect the stomach. There are other similar mitigator drugs, talk to your GP.

Could you use ibuprofen gel directly onto the affected area, rather than in tablet form to avoid your stomach completely?

Oh, and I'm 6 months into a rotator cuff injury after trying to shoulder charge the planet Earth while riding at Comrie Croft. Still can't sleep on my right hand side. 

Omeprazole +1, get a prescription for it.  I usually get prescription NSAID as well whilst I'm there (can't remember which one but it does seem to work).

My stomach can get wrecked in a mater of days on ibuprophen, and i can't even take low doses for more than a week.  Shows up as either nausea or a 'bad back' which it's not, it's just my internal organs getting a bit of an acid bath.  The only way through it is to cut the NSAID's for 2-4 weeks. 

I'm waiting for my first self-referered NHS physio appointment and diagnosis, but I think my unique for me left shoulder injury that began around early December, is another one joining the rotator cuff injury list for the first time.

A couple of weeks ago, the pain in bed got worse, even if I avoided trying to sleep on my left side.

I hate taking pills, but I took Ibuprofen just before bed and once in daytime for a few days, once I'd had something to eat.

I then started doing a few stretches and exercises suggested by Dr internet for rotator cuff injuries, taking note of any pain during exercises.

Current favourite one I call the "double Fonzie" and can even be done sitting down in front of PC, the aim is to get your straight arm thumbs up to around shoulder height with arms out to the side, with your clenched palms facing forwards. Keep elbows behind chest, slowly move straight arms from sides to shoulder height 8-15 times, up to 3 reps. If no pain, you can try adding a small weight of ~0.5Kg to each hand and drop the thumbs up.

Dr internet's exercises are helping, I'm sleeping better and not waking up feeling like I have huge bruising around my left shoulder, shoulder less upset riding my road bike on the turbo rather than 720mm bars on my Marasa hybrid.

But the reduced range of motion in my left arm is shocking, latest discovery was placing straightish arm by my glutes and trying to bend elbow upwards, OMG no chance! Raising left arm to side or front is approx 10 o'clock at best, easily 12 'oclock on right arm.

Be very careful and please consult your doctor.  I had a messed up knee and was on Naproxen for 1 year without any protection for stomach and now 8years later I have chronic gastritis and duodenitis  - the anti-inflammatories slowly attacked my stomach.

Yeah I was on ibuprofen on and off for a shoulder problem and ended up with stomach problems, cameras down the gullet and Omeprazole. The reflux was ghastly and my gp basically said don't go near the ibuprofen again. 

I was given Omeprazole with the Naproxen.

I will call in to see the GP, thanks one and all.

That's why you get a spec sheet with possible side effects that nobody ever reads although it was drummed into my by doc to take omeprazole if staying on ibuprofen. Tramadol is a toughie to come off, I was on it for two years max dose but trying to stop taking the last two a day was a miserable 2 weeks cold turkey

I was given Omeprazole when I was on prescribed diclofenac for a few months (about 15 years ago).  If you've got chronic pain and going to need to take NSAIDs for an extended period have a word with your GP I think

Posted by: stumpy01

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Could you use ibuprofen gel directly onto the affected area, rather than in tablet form to avoid your stomach completely?

I think it is debatable how much anti-inflammatory gel actually helps although it does significantly reduce the risk, although not completely remove, the risk of upset stomach.

I reckon Naproxen/Voltaren suppositories would be a better option, minimises the risk to your stomach and goes straight into the bloodstream.

Although the risk is then to your kidney, which personally I would take seriously. I would want regular kidney function tests.

Maybe try acupuncture instead!

By the way lanzaprozole and omeprazole can have interesting side effects on your bowel function, either all stop or full steam ahead. Very unpleasant.

This side effect is not as common with Esomeprazole but I understand that it costs more hence your GP might start you on the other ones. 

Years of ibuprofen mean i can no longer tolerate it. Nothing dramatic just uncomfortable. 

Talk to a pharmacist 

I'm another one who ended up with low iron levels, which led to a camera down the gullet.  This detected internal bleeding, a damaged esophagus and stomach caused by ibuprofen use. Omeprazole and iron supplements resolved it, but I'm very wary of taking ibuprofen now. I've always used it for minor pain, as aspirin and paracetamol do absolutely nothing for me. Ibuprofen was effective and, or so I thought, harmless. The worst thing apparently, is taking it on an empty stomach. I will only use it in extremis now and then stop asap.

Many people tend to think that the stomach issues are due to the local effects of tablets on the stomach lining. Sadly that’s not the case. It’s a systemic effect of Cox1 blockade that shuts down bicarbonate secretion that makes the acid-neutralizing gel that coats your stomach. Same for aspirin and other cox1 inhibitors. Omeprazole is prescribed to turn off acid production so there can be less irritation, but that brings its own issues of absorption as your acid breaks down and processes food  

for once daily, you’ll probably have few issues, but that’s under-dosing as ibuprofen has a short half life. But if it brings immediate relief to help, say, getting to sleep, no bad thing as there will be limited acid secretion over night. You could apply a 15% gel, but ibuprofen gel is readily absorbed through the skin so not a perfect answer either (but the dose is a lot lower).

The now infamous Cox inhibitors were selective for Cox2, which were able to block pain and inflammation without the stomach effects of Cox1. Sadly analyses suggested an increase in cardiovascular toxicity and they were withdrawn from the market. Subsequent analyses of ibuprofen, which was of course generic and widely used, suggested that it carried a similar risk!

Always enjoy reading TiRed’s posts on anything of a medical nature, even I can grasp the details of the subject!

FWIW, I take two Naproxen a day, one in the morning, one last thing at night, along with an Omeprazol, plus a supplement for my retinal degradation, because of the arthritis in my knees, and now my thumb joints, plus I’m now wearing elastic wrist supports to help prevent the pain that the naproxen only barely reduces. So far, fingers crossed, I’ve not had any significant issues with side effects from the NSAI’s.

Not sure how I’d manage if I did, although I do have a prescription for Co-Codamol, which I sometimes use during the day if things start playing up. 🤷🏼‍♂️

Have you tried just taking paracetamol?

Ibuprofen needs regular use to make the most of its anti inflammatory effects. As mentioned above, single doses will simply act as pain relief. Paracetamol will do the same without any GI issues. 

I am taking paracetomol before bed,  I will drop the ibuprofen and see how that goes.

Definitely don't take long term. I took naproxen followed by ibuprofen for about 3-4 weeks after I broke my pelvis (as I thought it was a muscle injury). Long term it's not fine, and when I broke my spine, the consultant stopped the other medical staff prescribing ibuprofen whilst I was still in hospital as it can interfere with bone healing (bloody great - NHS missed my pelvic fracture - only discovered 6 weeks later and my break was non-union).

I tend to maybe take it once a day presently during the recovery, and co-codamol at night to help sleep. Paracetemol is OK at taking the edge off, and my GP once said, to get better relief, take one every 2 hours, max 8 tablets. Means you keep up that relief at a low steady level.

I'm trying not to take any during the day and letting pain keep me from doing too much. I'm now 9 weeks post breaking my pelvis and hip socket.

Jeez Fossy, I'll stop complaining about my shoulder... Healing vibes pal.

My experience is that 12 months, means life, not for the ibuprofen, I have no idea about that, but for those injuries to truely sort themselves out.

For me, the issues are exasperated by posture problems and the best long term cure I have found is physio led pilates. 

There is some evidence that regular intake of NSAI’s, like Ibuprofen, can be beneficial in slowing development of Alzheimer’s, and similar neurodegenerative disorders.

Here:

https://www.mensjournal.com/health-fitness/common-painkiller-appears-to-lower-alzheimers-risk-when-used-long-term

Please also bear in mind that this entire family of drugs have significant kidney insult implications, should be completely avoided when participating in any long distance exercise, especially where rhabdomyolysis can be a risk. 

TiRed's comments also ring true with regard to negative cardio effects; seems to be gathering evidence to suggest that over a lifetime, heavy use of all of these increases risk of heart disease. 

Should be avoided completely in the first 48hrs following a fracture injury as the same mechanism that damages your kidneys also inhibits the start of bone healing. 

They are the Devil's drugs....