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Treatments > Drug Guide > Drug News & Info > Analgesics and NSAIDs > Avoiding Stomach Problems with NSAIDs
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Avoiding Stomach Problems with NSAIDs

How to Reduce Your Risk

At some point in the course of arthritis treatment, virtually everyone takes a nonsteroidal anti-inflammatory drug (NSAID). These plentiful and often inexpensive drugs can work wonders at relieving pain and inflammation. Unfortunately, there can be a downside to such medication: stomach upset and bleeding ulcers.

Celecoxib (Celebrex) is a part of a class of NSAIDs called COX-2 inhibitors that has been promoted for the ability to ease pain and inflammation while causing less gastrointestinal damage than traditional NSAIDs do. But a COX-2 drug isn't your only drug option if NSAIDs bother your stomach. In some cases, taking an acid-blocking drug along with your regular NSAID may help. These drugs include histamine blockers such as cimetidine (Tagamet) and ranitidine hydrochloride (Zantac), or proton pump inhibitors such as lansoprazole (Prevacid) and omeprazole (Prilosec). In other cases, doctors may prescribe a drug called misoprostol (Cytotec) along with your NSAID.

Misoprostol reduces the risk of stomach ulcers and promotes healing of existing ulcers by replacing stomach-protective substances called prostaglandins, which NSAIDs block. Misoprostol may also be taken as part of a combination product called Arthrotec, which contains both misoprostol and the NSAID diclofenac sodium. Another combination is Prevacid NapraPac, which packages Prevacid and naproxen together. In still other cases, no special medication is necessary. If your doctor recommends it and you can just reduce the dosage of your current NSAID, stomach problems may become manageable.

Regardless of the medication option you and your doctor choose, there are some things you can do on your own to minimize the risk of NSAID-related stomach upset and other problems. The following tips may help:

  • Skip alcohol. You increase your risk of gastric bleeding if you consume alcohol while you're taking an NSAID.  
  • Take with food and water. Unless the product label or your doctor advises otherwise, always take medications with a full glass of water and some food ­even if it's just a few crackers. Taking your NSAID along with an antacid/calcium supplement may also help, but first speak with your doctor.  
  • List your medications. Keep a list of all the medications you take, updating your list as necessary and sharing it with your doctor and pharmacist whenever you start a new medication. Taking some medications together can increase your risk of side effects. For example, taking corticosteroids and blood thinners such as warfarin (Coumadin) along with NSAIDs can increase your risk of gastrointestinal bleeding.  
  • Check the clock. If you take an NSAID once a day, ask your doctor if it's OK to take your daily dose in the afternoon or evening. Taking an NSAID later in the day may be less likely to lead to stomach upset and other side effects than taking the same drug in the morning.  
  • Don't overdo it. Avoid the temptation to take more NSAIDs than prescribed or more often than prescribed. If your current dose of NSAID doesn't sufficiently relieve pain and inflammation, speak to your doctor about increasing your dose or perhaps changing medications. You also risk overdose and increase your risk of stomach ulcers and other side effects if you take your prescription NSAID and then unwittingly take another medication, such as a cold remedy from the drugstore shelf that contains an NSAID.

 

Robert
08 Oct 2011, 17:27
I have degenerative disk disease which is the standard diag for back pain, however I also have ruptured vertabrae in the low back and cervical spine with one disk pushing on the spinal cord. I also have nerves being pushed back into the foramen in my neck. This cause extreme pain in my arms, which are weakening. This condition has lasted about 9 years now, otherwise I had not seen a doctor in 30 years prior. I just went when I could not stand it anymore. Finding the right doctor is the worst nightmare about the whole process. They all want to sell surgery and if you mention any statistics they always say thier patients have no problems "completly cured". Thats when I dont go back. In the meantime I have a good pain specialist who prescribes the right meds and eventually had to take me off Celebrex after 3 years. It was ok but eventually my stomach started burning. Celebrex is not long term. The best meds are narcotics for the long term, however it is hard to find a pharmacist that cant mind thier own business and treat you like a addict. You need to understand two things about narcotics. 1. Your body, not you become dependent as endorphins are depleted. 2. Always take as prescribed, if you are looking for a buzz, forget it, after using them for a while all you get is pain relief period. Try to control you pain with whatever movement you can stand and your meds. Only when pain is beyond meds would I start getting wedges stuck in my neck. Use epidural nerve blocks, they will last 6 to 8 months if done correctly. Expect at leat 3 rounds. Depression and Anxiety will eventually kick in due to constant pain. Every morning I wake up I feel like I was in a rodeo the night before. DO NOT DRINK !! I am 59 years old and have suffered around 18 years or more. Under treatment of pain is an epidemic in America and most state have "Intractable Pain" statutes. A doctor can be sued if they fail to treat your pain due to predjudice. And should not fear the DEA as the DEA expressly states that they have no problem with the proper use of narcotics. Go to the DEA diversion control site and check it out. Most pharmacists are to suspicious for thier own good and are behind on regulations. Bottom line is Opiates are an effectivve treatment and with proper guidance the body dependence can be gone in 21 days. Be prepard for 3 days of hell before you are on your own.
Signed

No need to suffer needlessly
Ed
28 Apr 2011, 07:49
The recreational users who drink and party with pain killers is ruining it for all of us who respect the importance and use of pain killers to help us with our everyday activities. No we do not drink or take more than we need. We respect the wonders of medicine. Unfortunatly we have to pay with lousy quality of life because of a few idiots and we are painted with a broad brush with these morons. If the government really wanted to help they would set up distribution Docters within a specified distance for a daily dispense of these meds so the legitimate ones in pain can get them.
Pat
16 Mar 2011, 06:40
I was told at age 23 after years of pain including with gymnastics I have RA. Now age 54 my life is planned around saving what I can do to earn a living. NSAIDS Methotraxate
prednisone cause such a severe gastritis while bring a pain of 8 only down to a 7. I have been taking zantac which works as well as prilosec for decades. Two years ago I was in a car accident, placed on oxycodone it allowed me to move enough to get past the pain and make huge improvements in my ability to earn a living. Not only was I able to work but actually participated in some volunteer work and family activities. It seems to me the goverment pressuring physicians to avoid pain medication results in more people having to resort to disability to get relief. I'm not talking about pain medication 24 hours a day but just enough to start moving. Yes exercize reduces inflamation by causing lymphatics and venous return of edema. However it takes a few hours of exercize and then have to keep moving. I wonder how many more taxpaying citizens we would have if the goverment would allow pain releive for chronic conditions.
DEAN
15 Jan 2011, 15:02


DEAN

HI.. I think my case is a GOUTY ARTHRITIS base on the symptoms i read on the books. i'm an RN that's why i easily scan on medical books when ever i do feel somethings not right about my body. and just recently my big toe were inflamed and felt pain on it. and then again i went to my books and read something about gouty arthritis.and i guess i do have one. so on my own, i went to the drug store and prescribed my self with celecoxib and allopurinol. Do you think im doing the right thing? I NEED AN EXPERT ADVICE...
Scott Ashburn
11 Dec 2010, 03:21
I paint apartments for a living and have severe pain all over...over the counter pills do not help, unless I drink with it. I wake up hurting and go to bed hurting. being on my feet all day and holding paint shields pull at my arm socket and elbow. What can I try that is new?
Miriam
16 Aug 2010, 16:22
One other thing that helps lessen pain in my knees is to strengthen the muscles that surround and support the knees. My physical therapist is teaching me some moves that will make those muscles stable and very supportive of the knee. The therapist says to start with gentle exercises and eventually do some squats each day, after a couple of weeks of doing easier exercises. Don't start your program by doing squats unless your legs are already very strong. If you do start out with squats, it's more likely you'll hurt yourself because the other muscles have not yet been improved. I know this because I made the mistake of doing ten squats on the first day: I had moderate pain just walking around my home, with severe pain when I was climbing down stairs. Squats are wonderful--don't get me wrong--but we need to work up to them. When you're ready to do the squats, be sure to tuck in your belly for extra support to the back, and then sit back just like you were sitting on a chair--so put your derriere out there while keeping your back nice and straight. Your knees must not extend past the toes. Once your thighs are almost parallel to the floor, hold the pose for 20 seconds. Keep breathing so you don't pass out! Then stand up slowly, taking at least 8 seconds to stand erect. Get strong, last long!
Miriam
16 Aug 2010, 15:57
In my town there is a public pool that offers very gentle movement classes especially for people with arthritis. The water is perfect--just a mite cooler than the water in your bathtub! The classes last fifty minutes, but you can leave any time--there are always some of us that follow the class movements in the water for ten or fifteen minutes (it is so much easier to move in the soothing warm water); then we tuck one of those pool "noodles" under our necks and wrap our arms around them for support and then just float around, doing our own little stretches and exercises according to our abilities. I'm so thankful these classes are offered! I always feel better after a class--they feel like play! And it's fun to see people with arthritis actually enjoying themselves while moving gently. I've noticed my mood has improved since participating in the water exercises--the brain gets a break from all those pain signals, I guess. I've never felt pain while in the warm pool. It's dreamy! Maybe your Parks and Recreation of your county could offer information about water classes for those with arthritis in your town. Or call the pools directly to ask! Good luck! Have some fun!
hilda
29 Jul 2010, 02:58
I have OA in my hip and started using Arnica oil. I do not know whether it is only my imagination but the pain is much less when I use the oil.
Cornelia Turgeon
19 May 2010, 09:01
Ronda asked if anyone had surgery for thumb arthritis, I did a little over a year ago. It is called Suspensionplasty, and it has ended the pain and I have full use of my thumb. It was done by an orthopeadic surgeon and I am thrilled with the results.
Ronda
17 May 2010, 11:48
I am a pharmacy tech and yes you can take prilosec for longer than the box says. Remember to always take it on an empty stomach 1/2 hour before meals or 2 hours after. It will work much better if taken that way..also has anyone had surgery for thumb arthritis.
Brenda
14 May 2010, 13:34
It is a challenge to work and have RA.Especially if you are a nurse,sometimes I wonder if I will be able to get out of bed.
It would be nice to stay at home when I am hurting so bad, but I will continue to take care of the ones that depend on me. Guess someone has to step up to the plate. I wish for all with RA--a pain free day.
Alan
17 Mar 2010, 08:11
After reading all the comments, I was surprised that no one mentioned exercise to reduce NSAID consumption. I have RA, AS and a spinal stenosis. I started exercising as an experiment several years ago. I started gently with yoga and kept adding on other forms of exercise. I now go to the gym 5x/wk (5 days of elipitical/spinning aerobics, and 3 days of weights). It has relieved my pain significantely and my NSAID consumption has been reduced by at least 50%. Some days I forget to take anything. Flairs have also been reduced. Something to consider. Good luck to all of you. Remember "motion is lotion"
Mardee
07 Mar 2010, 22:11
I am allergic to NSAIDs, I went off all nightshade vegetables and it helped mypain tremendously. Try going off of ALL tomatoes, white potatoes, all peppers (fresh and dried), eggplant, tobacco..check the internet to make sure I gave you the complete list... this diet has helps many but not all people.
Dawn E. Beale
04 Mar 2010, 19:12
I have arthritis in my rt knee and foot and a bad back. I also had alot of muscle and bone pain. I stop drinking all soft drinks including diet sodas, now the pain is almost gone. I take very little pain med's now. I also limit my dairy and no white pasta or bread.
SANDEE STACK
04 Mar 2010, 09:14
HI, I AM A 59 YR. OLD WOMAN WITH SEVERE RA, OSTEOPOROSIS AND OSTEOARTHRITIS WITH FIBORMYALGIA... I HAVE STOMACH ULCERS CONTINUALLY, I TAKE ENBREL SHOTS AND METHOTREXATE SHOTS EVERY WEEK...FOR PAIN I TAKE HYDROCODONE AND SOMA AS I HAVE HAD THIS DISEASE FOR 25 YEARS...MY WRIST HAVE FUSED ON THERE OWN, & I HAD A TOTAL KNEE REPLACEMENT & WAITING FOR THE OTHER TO BE REPLACED...MY SUGGESTION IS, AS THERE IS NO CURE FOR US..IT ONLY GETS WORSE ..SO LEARN TO LIVE WITH THE PAIN AND KEEP A GOOD ATTITUDE, OTHERWISE YOU MAY GET INTO A MAJOR DEPRESSION.. I KNOW !! I DO PRAY EVERY NIGHT FOR ALL THOSE IN PAIN...I WISH EVERYONE, BRIGHTER DAYS AND JOY FOR THE THINGS GOD PROVIDES..ESPECIALLY CHILDREN & GRAND CHILDREN.. AGAPE, SANDEE
Michele
03 Mar 2010, 05:50
Maureen,
I can understand your pain. I too have severe arthritis in every joint in my body.
I have had OA for the past 9 years and have deteriorated very rapidly from just a hip to the rest of me.
I take NSAIDs 3x daily and Vicoden at night. I also take Percocet for severe pain and even sometimes that doesn't help. I use a TENS machine often and ice packs on my neck (had ACDF w/autograft and instrumentation 3 years ago.)
Trying my best to hold off taking the really heavy stuff because I have a long way to go with OA and pain (I'm 50 years old.) Not many understand how hard it is to live with the pain of OA. It's very energy draining.
I wish you all the best Maureen!
LETTY
02 Mar 2010, 11:24
I recently attended a lecture on Arthritis.
Do you recommend acupuncture for RA?
How about massage and Chinese herbs?
Mickey
02 Mar 2010, 10:53
I have chronic pain in my back and right side for waist to and including the foot and both feet, ankles are swollen, cannot even get my wide shoes on at times. My doctor only gave me peroceot and it helps a little but not as much as I would like so is there anything anyone might suggest for me to try? I sincerely would appreciate it and thank you.
Maureen
02 Mar 2010, 10:28
I cannot take any NASIDS because they botherd my stomach and they didnt help with my severe arthritis pain. These are for mild or medium pain only. I cant take steriods either becuse my wrist bones are splintering. Im now on time released Morphine and Hydrocodone for breakthru pain. I will be on this for the rest of my life for my pain management. I wish U all the best of luck with U all experincing pain. Steroids also made me extremly agitated. They dont tell U about all the side effects of taking this medication and are very bad for people who have soft bones. A good sit to check out all the side effects of meds is www.webMD
Anne
02 Mar 2010, 10:24
I would like to hear the answer and/or comment to Carol and Rhonda's question. i have been told to take prilosec but I have a difficult time understanding whethter I need to wait 4 months to start the next 14 days.
Thank you
Sheila Justice
02 Mar 2010, 10:24
I got an rx from my dr. for prilosec. prescribed me 3 pills a day. for long period of time now. so it is ok to take longer than 2 weeks. it just takes that long to get into your system is all.
hoe that helps someone.
ask your dr for rx.
Carol Hill
02 Mar 2010, 10:14
Can you take prilosec more than the two weeks
shown on the box. When I took it I had no
stomach pain so would like to keep taking it.
Would appreciate your answer. Thank you.
Carol Hill
Rhonda
02 Mar 2010, 09:44
I have been taking Prilosec 2x daily. This is helped me a lot with the stomach pain and I am not as hoarse as I use to be.
Annette Jackson
12 Sep 2009, 17:18
Is there an NSAIDS that I could take? I am allergic to aspro and a lot of medication upsets my stomach.
J M TAYLOR
18 Jun 2009, 14:56
HELLO .
I HAVE BEEN TAKING DICHLOFENAC FOLLOWINNG LAP-BAND SURGERY.I HAVE HAD NO PROBLEMS WHATSOEVER..
WHAT DO YOU THINK?? I HAVE HEARD THAT THIS IS NOT A GOOD IDEA
Judy Popp
17 Apr 2009, 23:59
I seem to have a sensitivity to NSAIDS. I used to take Aleve twice a day on a regular basis for my arthritis pain but I developed skin rashes and itching so I quit taking them. My work requires that I be on my feet for sometimes 8 hours and it becomes very painful to walk. Is there anything else I can take to relieve my pain?

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