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The big map o the Caminos de Santiago

Ibuprofen side effects

Camino(s) past & future
Frances (1989 and 2016), Portugues - from Porto (2018)
#1
Hi all,

Just a word of warning from my own experience on the Camino.

I was on the Camino in the summer of 2016 and I had the usual range of challenges: some plantar fasciitis, minor tendon issues and heat rash on my legs and feet at the beginning, minor blister problems part way through, and knee problems throughout. But the one issue I wasn't expecting was a bad case of hives. It really hit in the latter part of my Camino and persisted after the Camino was over. It got quite bad and spread widely. I didn't know what it was? Some sort of bug bites (was I infested)? An allergic reaction? When I got back, I ended up going to several specialists and eventually it was diagnosed as chronic urticarea (hives).

Apparently, a common cause of chronic urticaria is non-steroidal anti-inflammatory drugs (NSAIDs - like Ibuprofen). Of course, like many pilgrims, I was downing ibuprofen regularly to get me through my daily walks with my bum knee. Little did I realize what I was setting myself up for. Once chronic urticarea sets in, it doesn't want to let go. Months after I stopped taking ibuprofen the hives wouldn't go away. Eventually, after months of taking very expensive medication (thank heavens for drug plans), it has finally gone into remission.

All of this to say - we pilgrims take a lot of Ibuprofen. And we tend to think of it as a very safe medication (which I'm sure it is). But it may have side effects. If you start seeing hives, your ibuprofen may be the cause. I would advise switching right away to acetaminophen for your pain relief needs, as it is not a NSAID. When I look up ibuprofen on the Internet, I see similar advice on the medical websites. For example, drugs.com says "Stop using ibuprofen and call your doctor at once if you have: ... the first sign of any skin rash, no matter how mild."

I share this here because I wish I had known to look out for this when I walked my Camino.
 

natefaith

Moderator
Staff member
Camino(s) past & future
Sarria-Santiago (2009)
León-Ponferrada (2014)
Camino Inglés (2017)
#2
Thanks for sharing from your experience, David! I'd never heard of this side effect before. Hopefully others will also keep an eye out for it while taking ibuprofen during their Camino.

Glad you're getting better... Hope it continues until you're completely hive-free!

Take care,
Faith
 

martyseville

Active Member
Camino(s) past & future
a/a
#4
David, thanks for posting this!

It is nasty stuff. While may relieve the pain and make you feel better -- the side effects can be bad news.

Be careful when taking that stuff and drinking excessive wine, beer, or other alcoholic drinks.

Hives can be bad... but liver damage can be worse. Consider what it does to the liver!

Again, thanks.
 
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davebugg

"When I Have Your Wounded" - Dustoff Motto
Camino(s) past & future
Camino Frances...
Sept. 2017: SJPdP to Burgos
Sept./Oct. 2018: SJPdP to Santiago de Compostela
#6
Hi all,

Just a word of warning from my own experience on the Camino.

I was on the Camino in the summer of 2016 and I had the usual range of challenges: some plantar fasciitis, minor tendon issues and heat rash on my legs and feet at the beginning, minor blister problems part way through, and knee problems throughout. But the one issue I wasn't expecting was a bad case of hives. It really hit in the latter part of my Camino and persisted after the Camino was over. It got quite bad and spread widely. I didn't know what it was? Some sort of bug bites (was I infested)? An allergic reaction? When I got back, I ended up going to several specialists and eventually it was diagnosed as chronic urticarea (hives).

Apparently, a common cause of chronic urticaria is non-steroidal anti-inflammatory drugs (NSAIDs - like Ibuprofen). Of course, like many pilgrims, I was downing ibuprofen regularly to get me through my daily walks with my bum knee. Little did I realize what I was setting myself up for. Once chronic urticarea sets in, it doesn't want to let go. Months after I stopped taking ibuprofen the hives wouldn't go away. Eventually, after months of taking very expensive medication (thank heavens for drug plans), it has finally gone into remission.

All of this to say - we pilgrims take a lot of Ibuprofen. And we tend to think of it as a very safe medication (which I'm sure it is). But it may have side effects. If you start seeing hives, your ibuprofen may be the cause. I would advise switching right away to acetaminophen for your pain relief needs, as it is not a NSAID. When I look up ibuprofen on the Internet, I see similar advice on the medical websites. For example, drugs.com says "Stop using ibuprofen and call your doctor at once if you have: ... the first sign of any skin rash, no matter how mild."

I share this here because I wish I had known to look out for this when I walked my Camino.
Good information to share. I would caution, however, that acetaminophen (Tylenol) is far more dangerous than ibuprofen when taken to excess. Due to the severe risk of liver failure, Tylenol/acetaminophen use needs to be carefully monitored and not taken beyond the recommended dosage. Coupled with alcohol consumption, even the recommended dosage can be too much. Suicide attempts using overdoses of acetaminophen are sadly common; and sadder still is that many of these attempts do not die right away as failure of the liver can be a delayed reaction.

Taking the recommended dosages of both ibuprofen and Tylenol together can provide better relief. Of course, those with liver damage or disease must not take any level of acetaminophen.
 
Camino(s) past & future
Walker from St Jean to Santiago in September "2017" YAY
#7
Another very serious side effect is gastrointestinal ulcers and bleeding. People have died from it. If you have a history of tummy troubles please be careful.

Another thing I discovered while walking was the dosage of the tablets. In Australia the standard tablet is 200mg. On going to the pharmacy in Logrono they calmly asked if I wanted 400 or 600mg tablets. WOW 3 times our strength. They also come in huge boxes. Make sure you take the correct dosage.

PS: it is still a wonder drug where shin splints are concerned
 
Camino(s) past & future
Francés ('14/'15)
St Olav/Francés ('16)
Baztanés/Francés ('17)
Ingles ('18)
#8
Forwarded is forearmed.
And not to forget diclofenac - it can work magically, but also has big-time side effects.
Good information to share. I would caution, however, that acetaminophen (Tylenol) is far more dangerous than ibuprofen when taken to excess.
And for those of us who don't take these, but do take aspirin, what would you say to us, Dave? Is it correct to say that long-term aspirin use has a lower risk of liver damage, but more bleeding risk?
 

davebugg

"When I Have Your Wounded" - Dustoff Motto
Camino(s) past & future
Camino Frances...
Sept. 2017: SJPdP to Burgos
Sept./Oct. 2018: SJPdP to Santiago de Compostela
#9
Forwarded is forearmed.
And not to forget diclofenac - it can work magically, but also has big-time side effects.

And for those of us who don't take these, but do take aspirin, what would you say to us, Dave? Is it correct to say that long-term aspirin use has a lower risk of liver damage, but more bleeding risk?
Aspirin, like other NSAIDs, have relatively little negative impact on the liver, even when the dosage is above recommended levels.... although GI bleeds and pain are a risk.

Aspirin CAN have a blood thinner effect, but how serious the issue is depends on whether or not there are any clotting abnormalities as well as the dosage taken. Most know that in the event of a heart attack, the timely dosage of an aspirin can help mitigate the damage to the myocardium, making the possibility of a full recovery a high potential (depending, of course, on a number of factors including the severity of the clot, the length of time to a hospital that can competently provide treatment regimen, medical history, etc....)

Most studies would indicate that most NSAIDs, including aspirin, have similar risks of GI issues. However, aspirin has many advantages the other NSAIDs do not, including reducing the likelihood of blood clots that can cause heart attacks and strokes, and there is indications that it may have anti-cancer benefits. On the other hand, many of the other NSAIDs, including ibuprofen, can raise blood pressure and increase the risk of heart attacks.

What is interesting, is that there seems little clinical proof that other NSAIDs offer better pain relief or anti-inflammatory reduction than plain old aspirin.
 
Camino(s) past & future
CF SJPdP to SdC
(May 2015)
CF Sarria to SdC
(May 2016)
CF SJPDP-SdC
(Apr/May 2018)
VdlP (2020)
#10
What is interesting, is that there seems little clinical proof that other NSAIDs offer better pain relief or anti-inflammatory reduction than plain old aspirin.
I shall conduct a trial next Camino!
I pop Ibuprofen all the way (under medical advice) for Achilles Tendonitis.
Basically wouldn't last more than 8-10 kms without them.
I might try a few days on Aspirin.
Will ask my doctor's advice first......
 
Camino(s) past & future
Francés ('14/'15)
St Olav/Francés ('16)
Baztanés/Francés ('17)
Ingles ('18)
#11
Thank you Dave, for this comprehensive and quick answer!
Aspirin, like other NSAIDs, have relatively little negative impact on the liver, even when the dosage is above recommended levels.... although GI bleeds and pain are a risk.

Aspirin CAN have a blood thinner effect, but how serious the issue is depends on whether or not there are any clotting abnormalities as well as the dosage taken. Most know that in the event of a heart attack, the timely dosage of an aspirin can help mitigate the damage to the myocardium, making the possibility of a full recovery a high potential (depending, of course, on a number of factors including the severity of the clot, the length of time to a hospital that can competently provide treatment regimen, medical history, etc....)

Most studies would indicate that most NSAIDs, including aspirin, have similar risks of GI issues. However, aspirin has many advantages the other NSAIDs do not, including reducing the likelihood of blood clots that can cause heart attacks and strokes, and there is indications that it may have anti-cancer benefits. On the other hand, many of the other NSAIDs, including ibuprofen, can raise blood pressure and increase the risk of heart attacks.

What is interesting, is that there seems little clinical proof that other NSAIDs offer better pain relief or anti-inflammatory reduction than plain old aspirin.
And aspirin is a whole lot less expensive.
(My dear Dad was a pathologist - and Battalion Surgeon in Okinawa at the end of WWII - and always swore by aspirin, saying it was a wonder drug; he never took any other NSAIDs. He worked at a University hospital, (teaching, doing research, and still on call for doing autopsies) literally until the day he died at 90. Seeing what you say about its benefits, the low dose aspirin he took may have had something to do with that....)
 

martyseville

Active Member
Camino(s) past & future
a/a
#12
Aspirin, like other NSAIDs, have relatively little negative impact on the liver, even when the dosage is above recommended levels.... although GI bleeds and pain are a risk.

Aspirin CAN have a blood thinner effect, but how serious the issue is depends on whether or not there are any clotting abnormalities as well as the dosage taken. Most know that in the event of a heart attack, the timely dosage of an aspirin can help mitigate the damage to the myocardium, making the possibility of a full recovery a high potential (depending, of course, on a number of factors including the severity of the clot, the length of time to a hospital that can competently provide treatment regimen, medical history, etc....)

Most studies would indicate that most NSAIDs, including aspirin, have similar risks of GI issues. However, aspirin has many advantages the other NSAIDs do not, including reducing the likelihood of blood clots that can cause heart attacks and strokes, and there is indications that it may have anti-cancer benefits. On the other hand, many of the other NSAIDs, including ibuprofen, can raise blood pressure and increase the risk of heart attacks.

What is interesting, is that there seems little clinical proof that other NSAIDs offer better pain relief or anti-inflammatory reduction than plain old aspirin.

Good post David.

By the way, did you see/read my private message to you?
 

Harington

una abuelita inglés
Camino(s) past & future
Vézelay/Francés 2011, Primitivo 2012, VdlP 2013, Via Domitia 2014, Inglés 2015, Francigena 2016
#15
David, thanks for posting this!

It is nasty stuff. While may relieve the pain and make you feel better -- the side effects can be bad news.

Be careful when taking that stuff and drinking excessive wine, beer, or other alcoholic drinks.

Hives can be bad... but liver damage can be worse. Consider what it does to the liver!

Again, thanks.
In my experience (unfortunately) NSAIDs damage the kidneys rather than the liver. They should also be taken only with food, and possibly (if the use is prolonged) with a proton pump inhibitor (PPI), such as omeprazole or lansoprazole. Take care!
 
Camino(s) past & future
Camino Frances 2012
Camino del Norte 2012
Geneva/Le Puy/SJPP/Bilbao 2015
Prague/Geneva ?
#16
Here is an unusual example of complications due to excessive amounts of ibuprofen.
My step-sister was hospitalized in October and diagnosed with something we had never heard of...Stevens-Johnson syndrome (SJS).
SJS is a rare, serious disorder of the skin and mucous membranes. It's usually a reaction to a medication or an infection. Often, it begins with flu-like symptoms, followed by a painful red or purplish rash that spreads and blisters.
Drugs that can cause Stevens-Johnson syndrome include:
  • Anti-gout medications, such as allopurinol
  • Medications to treat seizures and mental illness (anticonvulsants and antipsychotics), with added risk if you also undergo radiation therapy;
  • Pain relievers, such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve)
  • Medications to fight infection, such as penicillin
In my step-sisters case, she had hurt her back during the summer and was taking a lot of ibuprofen on a regular basis. After a few months of this Vitamin-I regimen, she was feeling exhausted and she thought she had the flu. Then she developed a horrible skin rash and was hospitalized for five days. Thankfully, she is fine now but it was very scary for her and the family.

I know this is an extreme case but it is a reminder to be thoughtful about the medications you take and to pay attention to your body.
 
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Camino(s) past & future
CF11, CF12, CP13, CF14, CA15, S.Anton15, CF15, CI15
Ditch Pig16, CF17, CP17, CdN, CM, CF18, LePuy19
#17
This is a very illuminating thread. As one who has a compromised immune system due to a genetic blood disorder (hemochromatosis) which directly affects my kidney and liver function, I am acutely aware on the consequences of taking NSAIDs because I am tested regularly. That being said I still take Advil on a daily basis to deal with neuropathic nerve pain.
My only additional warning for this thread is: taking NSAIDs like Advil and applying creams like Voltaren for pain and inflammation is in effect double dosing.
 
Camino(s) past & future
Camino France's (2018)
#18
Good thread warning to all about taking NSAIDS ASA or any drug more than needed. Even recommended doses not to exceed x does not take into account daily use! Best advice stretching, rubber ball on you feet, self masssage and using heat and cold. The more you can do the less hopefully pills you will have to take! As one with chronic pain I learned the hard way! Voltaren and other topical also help but are also medicine- be careful! Moderation in all things!
 
Camino(s) past & future
Frances (1989 and 2016), Portugues - from Porto (2018)
#19
Thanks for all of the responses. I've been hive-free for a while now. Initially, when I got back, prednisone was prescribed to get rid of the hives. It worked like a charm! But they don't want to keep you on it (it has its own risks) and every time I was weaned off the hives would come back. But the second, more expensive, prescription medicine seems to have done the trick.

I am aware that acetaminophen certainly has its dangers, which is one of the reasons I was taking ibuprofen. Believe me that when I take acetaminophen I pay close attention to the recommended dosage and never go over! I will also be wary of other side effects.
 

PlutseligPilegrim

Frances-Norte-Levante-Sanabres-Portugues-Gudbrands
Camino(s) past & future
St Olav’s way - Åbo - Stiklestad - Nidaros
(2018)
#20
Another thread perhaps.....?.....but here it goes....

“We all use a lot....”

My take on this after...

4 caminos...Exeeding 4000 km in total in approx 20 months, and there is the pattern I am able to see....

After 13-17 days on foot.....everything changes......on top of my walk so to say and much more in tune of what was going on at any given point physically ..... and even before this «turning point» I tried....and got away with....reduced ibuprofen dosage....

My point is that the restitution and fitness level fluctuated wildly first two weeks...then got more «foreseeable» ....but it pays off to experiment some.....wait in the morning for the first hour or two before taking a pill or just a half maybe....just to get a grip of what’s going on ....today ...just now..

I do better now and avoid not taking ibuprofen regularly like clockwork ....while on my Camino...as as “a habit”...instead of using “a lot”....all the time

This is my personal experience.....it’s only that....but I have been pushing the envelope at times...and used the hours of the day instead of walking to fast ...to hard....and with that a better flow so to say.

Adjusting the pace , use the hours, is my best take on avoiding to much painkillers...

It all adds up I guess....

 
Camino(s) past & future
None
#21
My doctor recently changed my maximum ibuprofen dose from 800mg to 600mg three times a day. I guess he might know something. I rarely get that high.
 

falcon269

no commercial interests
Camino(s) past & future
yes
#22
While it is good to know that ibuprofen can trigger hives, it appears to be rare:

About 20% of people get hives -- itchy red or skin-colored welts also known as urticaria. They’re often caused by an allergic reaction to a food or drug. Usually, they go away quickly.

For a small number of people, though, hives come back again and again, with no known cause. When new outbreaks happen almost every day for 6 weeks or more, it’s called chronic idiopathic urticaria (CIU).

One percent or less of people have it. It’s most common in people between the ages of 20 and 40. With CIU, a single outbreak usually lasts no more than 24 hours. After that, new hives form.

What Causes It?
Experts don’t know. The immune system seems to play a role. Some people get chronic hives at the same time that they get other problems like thyroid disease, hormonal problems, or cancer.

What Are Some Common Triggers?
Even though doctors can’t say for sure what causes CIU, they do know things that can lead to flare-ups. They include:

  • Alcoholic drinks
  • Tight clothing
  • Nonsteroidal anti-inflammatory drugs (NSAIDS) like aspirin and ibuprofen
  • Exercise
  • Cold
  • Heat
 
#23
Hi all,

Just a word of warning from my own experience on the Camino.

I was on the Camino in the summer of 2016 and I had the usual range of challenges: some plantar fasciitis, minor tendon issues and heat rash on my legs and feet at the beginning, minor blister problems part way through, and knee problems throughout. But the one issue I wasn't expecting was a bad case of hives. It really hit in the latter part of my Camino and persisted after the Camino was over. It got quite bad and spread widely. I didn't know what it was? Some sort of bug bites (was I infested)? An allergic reaction? When I got back, I ended up going to several specialists and eventually it was diagnosed as chronic urticarea (hives).

Apparently, a common cause of chronic urticaria is non-steroidal anti-inflammatory drugs (NSAIDs - like Ibuprofen). Of course, like many pilgrims, I was downing ibuprofen regularly to get me through my daily walks with my bum knee. Little did I realize what I was setting myself up for. Once chronic urticarea sets in, it doesn't want to let go. Months after I stopped taking ibuprofen the hives wouldn't go away. Eventually, after months of taking very expensive medication (thank heavens for drug plans), it has finally gone into remission.

All of this to say - we pilgrims take a lot of Ibuprofen. And we tend to think of it as a very safe medication (which I'm sure it is). But it may have side effects. If you start seeing hives, your ibuprofen may be the cause. I would advise switching right away to acetaminophen for your pain relief needs, as it is not a NSAID. When I look up ibuprofen on the Internet, I see similar advice on the medical websites. For example, drugs.com says "Stop using ibuprofen and call your doctor at once if you have: ... the first sign of any skin rash, no matter how mild."

I share this here because I wish I had known to look out for this when I walked my Camino.
I saw MANY people taking it...mostly Americans.
 
Camino(s) past & future
2018 CF Spring
#24
I am a bit surprised by the possible regular and frequent use of pain relief / anti inflammatory medication. In my simple and unprofessional view these are just short term intervention to bridge the healing process.
With my health having taken a "knock" during the past two years i try to inform myself and carefully look after my body (and mind...). Learned to differentiate between treatment / medication that actively helps the healing process (or at least the management of the problem) vs just the simple suppression of the symptoms.
I hope my personal opinion and rather generalised comment does not offend anyone. If inappropriate - am happy to delete this comment.
 
Camino(s) past & future
April 20, 2016 to May 20, '16 SJPdP to Santiago d C.
#25
Hi all,

Just a word of warning from my own experience on the Camino.

I was on the Camino in the summer of 2016 and I had the usual range of challenges: some plantar fasciitis, minor tendon issues and heat rash on my legs and feet at the beginning, minor blister problems part way through, and knee problems throughout. But the one issue I wasn't expecting was a bad case of hives. It really hit in the latter part of my Camino and persisted after the Camino was over. It got quite bad and spread widely. I didn't know what it was? Some sort of bug bites (was I infested)? An allergic reaction? When I got back, I ended up going to several specialists and eventually it was diagnosed as chronic urticarea (hives).

Apparently, a common cause of chronic urticaria is non-steroidal anti-inflammatory drugs (NSAIDs - like Ibuprofen). Of course, like many pilgrims, I was downing ibuprofen regularly to get me through my daily walks with my bum knee. Little did I realize what I was setting myself up for. Once chronic urticarea sets in, it doesn't want to let go. Months after I stopped taking ibuprofen the hives wouldn't go away. Eventually, after months of taking very expensive medication (thank heavens for drug plans), it has finally gone into remission.

All of this to say - we pilgrims take a lot of Ibuprofen. And we tend to think of it as a very safe medication (which I'm sure it is). But it may have side effects. If you start seeing hives, your ibuprofen may be the cause. I would advise switching right away to acetaminophen for your pain relief needs, as it is not a NSAID. When I look up ibuprofen on the Internet, I see similar advice on the medical websites. For example, drugs.com says "Stop using ibuprofen and call your doctor at once if you have: ... the first sign of any skin rash, no matter how mild."

I share this here because I wish I had known to look out for this when I walked my Camino.
nksDThab

Thanks David. I haven't heard of the hives side-effect, but I too was taking ibuprofen almost every night, though I would not take it during the day, as I wanted to be able to feel if I was getting a hot spot on my feet. After about 3 weeks I got a bad case of acid reflux, feeling like I needed to burp but couldn't, followed by really bad heart burn. It was from the ibu, and it lasted the rest of the way to Santiago. I was searching for Rolaids or the Spanish equivalent, but there were none to be found in any of the farmacias until I happened past a little health foods type store in Melide. I considered it another Camino small miracle!
 
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falcon269

no commercial interests
Camino(s) past & future
yes
#26
Drugs have side effects. Some are very common (10% or more), some are uncommon (1% or less). I doubt that anyone gets them all!! For ibuprofen:

General
The most frequently reported adverse effects were gastrointestinal (GI) in nature and included nausea, vomiting, flatulence, and diarrhea.

Patent Ductus Arteriosus: The most frequently reported adverse effects were sepsis, anemia, intraventricular bleeding, apnea, GI disorders, impaired renal function, respiratory infection, skin lesions, hypoglycemia, hypocalcemia, and respiratory failure.[Ref]

Gastrointestinal
Very common (10% or more): Nausea (up to 57%), vomiting (up to 22%), flatulence (up to 16%), diarrhea (up to 10%)
Common (1% to 10%): Dyspepsia, abdominal discomfort, epigastric pain, heartburn, abdominal distress, indigestion, constipation, abdominal cramps/pain, fullness of GI tract, bloating, GI hemorrhage, melena
Uncommon (0.1% to 1%): Abdominal distention, dyspepsia, gastritis
Very rare (less than 0.01%): Peptic ulcer, perforation, hematemesis, mouth ulceration, exacerbation of colitis, exacerbation of Crohn's disease
Frequency not reported: Dry mouth, duodenitis, esophagitis, gastric ulcer, duodenal ulcer, GI bleeding, glossitis, rectal bleeding, stomatitis, eructation, gingival ulcer, pancreatitis

Patent Ductus Arteriosus:
Very common (10% or more): GI disorders non-necrotizing enterocolitis (22%)
Common (1% to 10%): Necrotizing enterocolitis, intestinal perforation
Frequency not reported: Abdominal distension, gastroesophageal reflux, gastritis, ileus, inguinal hernia
Postmarketing reports: GI perforation[Ref]

Cardiovascular
Very common (10% or more): Hemorrhage (up to 10%), hypertension (10%), hypotension (10%)
Very rare (less than 0.01%): Cardiac failure
Frequency not reported: Congestive heart failure, tachycardia, arrhythmia, myocardial infarction, palpitations, vasculitis, sinus bradycardia, angina pectoris, thrombotic events

Patent Ductus Arteriosus:
Frequency not reported: Tachycardia, cardiac failure, hypotension[Ref]

Nervous system
Very common (10% or more): Headache (up to 12%)
Common (1% to 10%): Dizziness, nervousness
Very rare (less than 0.01%): Cerebrovascular accident
Frequency not reported: Syncope, drowsiness, paresthesia, somnolence, tremors, convulsions, coma

Patent Ductus Arteriosus:
Common (1% to 10%): Intraventricular hemorrhage, periventricular hemorrhage
Frequency not reported: Convulsions[Ref]

Renal
The number of total renal events in preterm infants within 30 days of therapy following IV use was 21% and included increased blood urea (7%), renal insufficiency/impairment (6%), reduced urine output (3%), increased blood creatinine (3%), renal failure (1%), and increased blood urea with hematuria (1%).[Ref]

Very rare (less than 0.01%): Acute renal failure, renal papillary necrosis, interstitial nephritis, nephrotic syndrome, renal failure, renal insufficiency
Frequency not reported: Cystitis, azotemia, creatinine clearance decreased, glomerulitis, tubular necrosis, nephrotoxicity

Patent Ductus Arteriosus:
Very common (10% or more): Renal events (21%)
Uncommon (0.1% to 1%): Acute renal failure[Ref]

Hematologic
The incidence of total bleeding events within 30 days of therapy with IV use in preterm infants was 32%. This percentage included grade 1 and 2 intraventricular hemorrhage (15%), grade 3 and 4 intraventricular hemorrhage (15%), and other bleeding (6%).[Ref]

Very common (10% or more): Anemia (up to 36%), eosinophilia (up to 26%), neutropenia (up to 13%), thrombocythemia (up to 10%)
Common (1% to 10%): Hemoglobin decreased
Very rare (less than 0.01%): Leukopenia, thrombocytopenia, agranulocytosis, hemolytic anemia, aplastic anemia, pancytopenia, hematocrit decreased
Frequency not reported: lymphadenopathy, bleeding episodes

Patent Ductus Arteriosus:
Very common (10% or more): Anemia (32%), total bleeding (32%), intraventricular hemorrhage (29%), Neutropenia, thrombocytopenia[Ref]

Dermatologic
Common (1% to 10%): Rash, maculopapular rash, pruritus
Very rare (less than 0.01%): Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis
Frequency not reported: Ecchymosis, purpura, alopecia, sweating, photosensitivity, angioedema, exfoliative dermatitis, urticaria, vesiculobullous eruptions, Henoch Schonlein vasculitis

Patent Ductus Arteriosus:
Very common (10% or more): Skin lesion/irritation (16%)[Ref]

Metabolic
Very common (10% or more): Hypokalemia (up to 19%), hypoproteinemia (up to 13%), blood urea increased (10%), hypernatremia (10%), hypoalbuminemia (10%)
Common (1% to 10%): Appetite decreased, fluid retention
Frequency not reported: Appetite changes, hyperglycemia, hypoglycemic reaction, acidosis

Patent Ductus Arteriosus:
Very common (10% or more): Hypoglycemia (12%), hypocalcemia (12%), blood creatinine increased, blood sodium decreased
Common (1% to 10%): Hypernatremia
Frequency not reported: Feeding problems, hyperglycemia[Ref]

Other
Very common (10% or more): Bacteremia (13%), blood LDH increased (up to 10%)
Common (1% to 10%): Peripheral edema, wound hemorrhage, tinnitus, hearing impairment, edema, fatigue
Very rare (less than 0.01%): Aseptic meningitis, vertigo, exacerbation of infection-related inflammations
Frequency not reported: Fever, infection, sepsis, weight changes, asthenia, malaise, pseudo-tumor, hearing loss, drowsiness

Patent Ductus Arteriosus:
Very common (10% or more): Sepsis (43%)
Common (1% to 10%): Edema, fluid retention
Frequency not reported: Various infections[Ref]

Respiratory
Very common (10% or more): Bacterial pneumonia (up to 10%)
Common (1% to 10%): Cough
Very rare (less than 0.01%): Asthma, bronchospasm, dyspnea, wheezing
Frequency not reported: Apnea, respiratory depression, pneumonia, rhinitis, epistaxis

Patent Ductus Arteriosus:
Very common (10% or more): Apnea (28%), respiratory infection (19%), respiratory failure (10%), bronchopulmonary dysplasia
Common (1% to 10%): Atelectasis, pulmonary hemorrhage
Uncommon (0.1% to 1%): Hypoxemia
Postmarketing reports: Pulmonary hypertension[Ref]

Hepatic
Very rare (less than 0.01%): Hepatitis, jaundice
Frequency not reported: Hepatorenal syndrome, liver necrosis, liver failure, abnormal liver function tests

Patent Ductus Arteriosus:
Frequency not reported: Cholestasis, jaundice[Ref]

Hypersensitivity
Hypersensitivity reactions have been reported and may consist of any of the following: a syndrome of abdominal pain, fever, chills, nausea, vomiting, and anaphylaxis; respiratory tract reactivity comprising bronchospasm, asthma/aggravated asthma, or dyspnea; skin reactions, which rarely included exfoliative and bullous dermatoses, Stevens-Johnson syndrome, toxic epidermal necrolysis, angioedema, pruritus, and urticaria.[Ref]

Frequency not reported: Anaphylactoid reactions, hypersensitivity reaction[Ref]

Ocular
Very rare (less than 0.01%): Visual disturbances
Frequency not reported: Blurred vision, amblyopia, diminished vision, scotomata, changes in color vision, conjunctivitis, dry eyes, diplopia, optic neuritis, cataracts, optic neuritis, toxic optic neuropathy[Ref]

Musculoskeletal
Frequency not reported: Lupus erythematosus syndrome[Ref]

Psychiatric
Frequency not reported: Anxiety, confusion, depression, dream abnormalities, insomnia, emotional lability, hallucinations[Ref]

Genitourinary
Common (1% to 10%): Urinary retention
Very rare (less than 0.01%): Proteinuria, hematuria
Frequency not reported: Dysuria, oliguria, polyuria, menorrhagia

Patent Ductus Arteriosus:
Very common (10% or more): Oliguria, hematuria
Common (1% to 10%): Urinary tract infection[Ref]

Immunologic
Frequency not reported: Serum sickness[Ref]

Local
Common (1% to 10%): Infusion site pain
Postmarketing reports: Transient sensation of burning in mouth/throat

Patent Ductus Arteriosus:
Frequency not reported: Injection site reactions[Ref]

Endocrine
Frequency not reported: Gynecomastia

Patent Ductus Arteriosus:
Common (1% to 10%): Adrenal insufficiency[Ref]


As for hives, it looks like .1 to .3% prevalence:

NSAID-induced urticaria and angioedema: a reappraisal of its clinical management.
Sánchez-Borges M1, Capriles-Hulett A, Caballero-Fonseca F.
Author information
Abstract

Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs), resulting in urticaria and angioedema, is being observed with increasing frequency. Prevalence rates range from 0.1-0.3%, which is partly due to the large size of the exposed (at risk) population. Some predisposing factors for these cutaneous reactions have been identified, among them atopic diathesis, female sex, young adulthood, a history of chronic urticaria and the use of the NSAID for the relief of acute pain. The description of two different arachidonic acid cyclo-oxygenases (COX) about a decade ago, designated COX-1 and COX-2, and the incorporation into the therapeutic armamentarium of more selective enzyme inhibitors for the control of inflammation and pain, has led to an improved understanding of the pathogenesis of adverse reactions to NSAIDs. This has allowed investigators to study 'sensitive' individuals to see if they can safely receive these new pharmaceutical compounds. The reasons why some people react to NSAIDs are not completely clarified. The prevalent theory about the pathogenesis of urticaria and angioedema due to NSAIDs in cross-reactive patients assumes that the inhibition of COX-1 leads to a shunting of arachidonic acid metabolism towards the 5-lipoxygenase pathway, which results in an increased synthesis and release of cysteinyl leukotrienes. Although COX-2 inhibitors are well tolerated by the majority of classic NSAID-sensitive patients, cutaneous reactions to highly selective inhibitors of COX-2 have been described in some of these individuals, casting some doubts about the relevance of such hypotheses. On the other hand, in patients who react to a single NSAID and chemically similar products (single-reactors), specific immunoglobulin E antibodies to haptenated NSAID metabolites have been suspected, although these metabolites are not easily demonstrated by means of routine in vivo or in vitro techniques. Facial (periorbital) angioedema constitutes the most common form of clinical presentation, and one-third of the patients show a mixed clinical pattern of cutaneous (urticaria and/or angioedema) and respiratory symptoms which include upper respiratory tract edema, rhinorrhea, cough, breathlessness and tearing. When necessary, diagnosis is confirmed by means of controlled peroral drug challenges done by experienced physicians in the hospital setting and test results are helpful for clinical management, which will be based on strict avoidance, and the use of alternative tolerated medications. This approach is specially indicated in hypersensitive patients with chronic medical conditions who require continuous NSAID therapy, such as those with arthritis and coronary heart disease.
 

Tazz

New Member
Camino(s) past & future
Frances/Finisterre (2016/5)
San Salvador/Primitivo (2017/5)
Frances/Finisterre (2018/5)
#27
NSAIDs are probably the most dangerous class of any medication mainly because of Gastrointestinal and kidney related side-effects. NSAID related hives are fairly uncommon. The fact that NSAIDs are available on the shelf also makes them seem safer than they are.
I tend to avoid NSAIDs whenever possible. Given all the alcohol consumed on the Camino I think taking a PPI (proton pump inhibitor) while on an oral NSAID is a good idea, however chronic (well beyond Camino duration) PPI use can lead to bone density loss. A major risk of NSAIDs which can be very serious are the kidney related effects of taking them while in a dehydrated state. By that I don't mean mild dehydration due to sweating a lot while walking the camino but rather if one takes them during an illness during which they cannot maintain adequate hydration, such as a bad bout of gastroenteritis (stomach flu). In such a circumstance taking an NSAID, water pill, ACE inhibitor, ARB (Angiotensin receptor blocker), metformin (Diabetes medication) and a few other diabetic medications can possibly lead to kidney failure.
Unless one has a localized or more serious allergy, topical Voltaren should safe and some what effective. Tylenol taken at prescribed doses is likely the safest option and can be used with topical voltaren.

That being said what I found works best is stopping every 5 Kms (plus or minus), taking off my hiking shoes and putting on my comfortable but heavy Birkenstocks and having a café con leche, Cola, etc.. and then starting again after 20 - 30 minutes.

small print: talk to your doctor or medical professional prior to taking any advice posted on a blog.

Happy New Year from Canada
 
Camino(s) past & future
Ponferrada - Santiago (2013)
Porto to Santiago (2015)
Lugo to Finisterre (2017)
#28
Hi all,

Just a word of warning from my own experience on the Camino.

I was on the Camino in the summer of 2016 and I had the usual range of challenges: some plantar fasciitis, minor tendon issues and heat rash on my legs and feet at the beginning, minor blister problems part way through, and knee problems throughout. But the one issue I wasn't expecting was a bad case of hives. It really hit in the latter part of my Camino and persisted after the Camino was over. It got quite bad and spread widely. I didn't know what it was? Some sort of bug bites (was I infested)? An allergic reaction? When I got back, I ended up going to several specialists and eventually it was diagnosed as chronic urticarea (hives).

Apparently, a common cause of chronic urticaria is non-steroidal anti-inflammatory drugs (NSAIDs - like Ibuprofen). Of course, like many pilgrims, I was downing ibuprofen regularly to get me through my daily walks with my bum knee. Little did I realize what I was setting myself up for. Once chronic urticarea sets in, it doesn't want to let go. Months after I stopped taking ibuprofen the hives wouldn't go away. Eventually, after months of taking very expensive medication (thank heavens for drug plans), it has finally gone into remission.

All of this to say - we pilgrims take a lot of Ibuprofen. And we tend to think of it as a very safe medication (which I'm sure it is). But it may have side effects. If you start seeing hives, your ibuprofen may be the cause. I would advise switching right away to acetaminophen for your pain relief needs, as it is not a NSAID. When I look up ibuprofen on the Internet, I see similar advice on the medical websites. For example, drugs.com says "Stop using ibuprofen and call your doctor at once if you have: ... the first sign of any skin rash, no matter how mild."

I share this here because I wish I had known to look out for this when I walked my Camino.

Thanks for sharing your experience with Ibuprofen.
I know Pilgrims suffer from all kinds of physical pain.
I suffer from osteoarthritis in both my feet and have walked 3 Camino's. I have taken some Ibuprofen, but not that often.

My first Camino was very painful in the latter stages.
The 2nd one I tried heat pads and that did alleviate a lot of the pain.
My 3rd Camino (you learn as you go along) I tried Capsaicin Cream, which is recommended on the Arthritis UK web site. This is a prescription only medicine. It comes from the pepper plant, and I only use it for walking distances or when the pain flares up. If you do use it, a word of warning, wash your hands really well. You do not want it, to come in contact with your eyes or any other sensitive part of your body.

It is great for David posting his problem with Ibuprofen. I just would not have known this. You have probably helped a lot of Pilgrims.
 
Camino(s) past & future
Camino Frances 2016
#29
Good information to share. I would caution, however, that acetaminophen (Tylenol) is far more dangerous than ibuprofen when taken to excess. Due to the severe risk of liver failure, Tylenol/acetaminophen use needs to be carefully monitored and not taken beyond the recommended dosage. Coupled with alcohol consumption, even the recommended dosage can be too much. Suicide attempts using overdoses of acetaminophen are sadly common; and sadder still is that many of these attempts do not die right away as failure of the liver can be a delayed reaction.

Taking the recommended dosages of both ibuprofen and Tylenol together can provide better relief. Of course, those with liver damage or disease must not take any level of acetaminophen.
Just a thing - for anyone from Australia who is after pain relief (as apposed to anti-inflammatory drugs), our version of acetaminophen is good old panadol (paracetamol). It's common in Oz to take ibuprofen with panadol - quite effective however, as all the other posts state, there are long term affects even if drugs are taken as specified on the packaging. I personally never take aspirin as its a bit tough on the gut. I also don't like to take ibuprofen for all the reasons listed here. However, severe inflammation requires REST, perhaps ICE too hey and yes, possibly drugs. Just saying.
 

zzotte

Active Member
Camino(s) past & future
2012 Camino Frances, 2014 Lourdes to SDC, 2016 Camino del Norte
#30
Thanks for sharing David unfortunately some of us takes this over the counter meds for granted I definitely be more careful for now on I hope you have recovered

Zzotte
 

Janade

New Member
Camino(s) past & future
(May 2018)
#31
As someone who has an auto-immune disease and who uses prescription NSAIDs to control pain and inflammation during flare ups, I will be taking my meds on my camino, per my doctor's advice. However, I would never take daily NSAIDs (or any other medication - prescription or over the counter) without first talking to my doctor about it. My suggestion would be for those in the planning stages to consult with their personal physician, who can educate and advise them as to the risks and benefits of medication and the proper dosages to take - based on their medical history. While I'm sure posters mean well sharing their personal experience and other information, and while that information is interesting, I'd be cautious about making medical or medication decisions based on it.
 

Charles Zammit

Active Member
Camino(s) past & future
Camino Frances , St Jean Pied de Port - Finisterra May/ June 2017
Le Puy en Velay - Ales May 2018
#32
My doctor recently changed my maximum ibuprofen dose from 800mg to 600mg three times a day. I guess he might know something. I rarely get that high.
I have trouble processing the thought of such extreme doses . Constant pain is a cross I bear but the maximum dose I have ever been prescribed is 2x50 MG per diem of Voltaren enteric , much the same as Ibuprophen .
I was also amazed at the 1000mg Paracetamol tablets available in France , twice the maximum allowable in Australia , certainly something to be aware of s the risk of overdose to the unwary is so high .
MisterH if your pain is this great I can only offer my commiseration and hope that one day it will be less .
 

davebugg

"When I Have Your Wounded" - Dustoff Motto
Camino(s) past & future
Camino Frances...
Sept. 2017: SJPdP to Burgos
Sept./Oct. 2018: SJPdP to Santiago de Compostela
#33
As someone who has an auto-immune disease and who uses prescription NSAIDs to control pain and inflammation during flare ups, I will be taking my meds on my camino, per my doctor's advice. However, I would never take daily NSAIDs (or any other medication - prescription or over the counter) without first talking to my doctor about it. My suggestion would be for those in the planning stages to consult with their personal physician, who can educate and advise them as to the risks and benefits of medication and the proper dosages to take - based on their medical history. While I'm sure posters mean well sharing their personal experience and other information, and while that information is interesting, I'd be cautious about making medical or medication decisions based on it.
Good advice. I think that the information given is not posted so much as medical advice as it is a medical caution. A large percentage -- if not the vast majority -- of NSAID users are not doing so based on a care provider's instruction or recommendation, but are doing so casually with over-the-counter purchases on the advice of media commercials. Feel some discomfort, pop a pill.

Taking NSAIDs over-the-counter is generally OK, as long as common sense and the dosing instructions are followed. Many, however, prescribe to the notion that if some is good, than more must be even better. It is to this casual attitude toward OTC meds that I believe most of the postings have been addressed. For those taking meds under a doctors instruction, I do not see this thread as being directed at them. :);)
 
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Camino(s) past & future
Moissac to Santiago Spring 2005 was the first foray.
#34
Lots of good info up there and a great opening post. Personally I don't ever think of any drug as safe. Every drug packet comes with a leaflet and if you read any of the leaflets you would most likely become a little scared. The tip with any over the counter drug is that if you feel any odd symptoms stop using them straight away, and if it is a prescribed drug inform your doctor that day.

Doing first aid out on Camino I meet quite a number of pilgrims who have really harmed themselves and the main reason is two-fold, firstly they have carried on rather than resting and, secondly, they have taken such as Ibuprofen for days and days - masking their symptoms rather than addressing the cause of the initial problem and therefore allowing them to carry on until they are really damaged.

Rather than tailor their Camino to the ability of their bodies they flood themselves with anti-inflammatories and pain killers and then walk on as if they are gods. I have even known pilgrims who start a strong course of daily Ibuprofen a week before they start Camino to 'prepare' themselves - crikey!!

An anti-inflamatory such as Ibuprofen has marvellous short term benefits - if one can tolerate them - reduction in pain, blocking of inflammation - but that is what they are for, immediate and short term help, and if one needs to use them then one should also stop walking until one is healed and then start again slow with short distances when recovered. This mad rushing onwards - the base line is this, a lot of pilgrims are crazy!

Is it a lack of understanding about drugs? An unwillingness to read a leaflet? A belief that a pill solves all? I even know pilgrims who carry strong anti-biotics with them, brought from home, and at the first sign of any "illness" they start popping them, regardless of what the 'ailment' is, regardless of whether it is the correct anti-biotic, regardless of the harm anti-biotics do to our stomach flora and immune system. I say again - the base line is this - a lot of pilgrims are crazy!
 
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TaraWalks

Peregrina without a skateboard
Camino(s) past & future
Camino Frances 2016 & 2018, planning for Le Puy 2019/2020ish and for some shorter Caminos stacked
#36
nksDThab

Thanks David. I haven't heard of the hives side-effect, but I too was taking ibuprofen almost every night, though I would not take it during the day, as I wanted to be able to feel if I was getting a hot spot on my feet. After about 3 weeks I got a bad case of acid reflux, feeling like I needed to burp but couldn't, followed by really bad heart burn. It was from the ibu, and it lasted the rest of the way to Santiago. I was searching for Rolaids or the Spanish equivalent, but there were none to be found in any of the farmacias until I happened past a little health foods type store in Melide. I considered it another Camino small miracle!
Next time go the the Farmacia and ask for ranitidina - it's Zantac and is available OTC :)
 

TaraWalks

Peregrina without a skateboard
Camino(s) past & future
Camino Frances 2016 & 2018, planning for Le Puy 2019/2020ish and for some shorter Caminos stacked
#38
No worries!
 

Gillyweb

Active Member
Camino(s) past & future
Villafranca - Santiago (2013)
SJPP - Santiago (2014)
Portugues (2017)
#39
Hi all,

Just a word of warning from my own experience on the Camino.

I was on the Camino in the summer of 2016 and I had the usual range of challenges: some plantar fasciitis, minor tendon issues and heat rash on my legs and feet at the beginning, minor blister problems part way through, and knee problems throughout. But the one issue I wasn't expecting was a bad case of hives. It really hit in the latter part of my Camino and persisted after the Camino was over. It got quite bad and spread widely. I didn't know what it was? Some sort of bug bites (was I infested)? An allergic reaction? When I got back, I ended up going to several specialists and eventually it was diagnosed as chronic urticarea (hives).

Apparently, a common cause of chronic urticaria is non-steroidal anti-inflammatory drugs (NSAIDs - like Ibuprofen). Of course, like many pilgrims, I was downing ibuprofen regularly to get me through my daily walks with my bum knee. Little did I realize what I was setting myself up for. Once chronic urticarea sets in, it doesn't want to let go. Months after I stopped taking ibuprofen the hives wouldn't go away. Eventually, after months of taking very expensive medication (thank heavens for drug plans), it has finally gone into remission.

All of this to say - we pilgrims take a lot of Ibuprofen. And we tend to think of it as a very safe medication (which I'm sure it is). But it may have side effects. If you start seeing hives, your ibuprofen may be the cause. I would advise switching right away to acetaminophen for your pain relief needs, as it is not a NSAID. When I look up ibuprofen on the Internet, I see similar advice on the medical websites. For example, drugs.com says "Stop using ibuprofen and call your doctor at once if you have: ... the first sign of any skin rash, no matter how mild."

I share this here because I wish I had known to look out for this when I walked my Camino.
Hi there
When I walked the Francés in 2013 a lovely South African girl who was now living in Samoa was injured and taking a lot of Ibuprofen. About a week after she started she began to burn quite badly in the sun and developed a sun rash. Now this girl knew her sunshine and her tolerance to it, but even with high factor sun cream her skin kept burning. Eventually we checked the side effects of the Ibuprofen and discovered it can also cause photosensitivity which can persist for life in extreme cases. She I believe, several years later, still can’t take the sun the way she used to. It seems these drugs are powerful with a number of unpleasant potential side effects.
 
Camino(s) past & future
Camino Frances - April-June, 2016
Portuguese Lisbon-Santiago - October, 2017
#40
On my first Camino I was popping ibuprofen like candy, as well as using voltaren and ibuprofen cream. By the time I got home my hiatal hernia (which I can usually control without drugs) was giving me daily trouble. My doc wanted me on stomach drugs, but I politely declined. A nightly dose of aloe juice finally healed it after a month or so. Needless to say I avoided ibuprofen the 2nd Camino, took an occasional tylenol but still used the volteran. Also, pre-Camino I did a lot of strengthening and balance work with a physical therapist and gait specialist which helped my knees and feet a lot.
 

annakappa

Veteran Member
Camino(s) past & future
Part frances jun 07/rest frances may- jun 2008/Frances sept-oct 2009/ Sanabres Oct 2010/Frances sept-oct 2011/Aragones Sept-Oct 2012. Hospitalero Sept 2010, Amiga in Pilgrim's Office Oct 2013. Part Primitivo Oct 2013. Portugues from Porto June 2015.
#42
Lots of good info up there and a great opening post. Personally I don't ever think of any drug as safe. Every drug packet comes with a leaflet and if you read any of the leaflets you would most likely become a little scared. The tip with any over the counter drug is that if you feel any odd symptoms stop using them straight away, and if it is a prescribed drug inform your doctor that day.

Doing first aid out on Camino I meet quite a number of pilgrims who have really harmed themselves and the main reason is two-fold, firstly they have carried on rather than resting and, secondly, they have taken such as Ibuprofen for days and days - masking their symptoms rather than addressing the cause of the initial problem and therefore allowing them to carry on until they are really damaged.

Rather than tailor their Camino to the ability of their bodies they flood themselves with anti-inflammatories and pain killers and then walk on as if they are gods. I have even known pilgrims who start a strong course of daily Ibuprofen a week before they start Camino to 'prepare' themselves - crikey!!

An anti-inflamatory such as Ibuprofen has marvellous short term benefits - if one can tolerate them - reduction in pain, blocking of inflammation - but that is what they are for, immediate and short term help, and if one needs to use them then one should also stop walking until one is healed and then start again slow with short distances when recovered. This mad rushing onwards - the base line is this, a lot of pilgrims are crazy!

Is it a lack of understanding about drugs? An unwillingness to read a leaflet? A belief that a pill solves all? I even know pilgrims who carry strong anti-biotics with them, brought from home, and at the first sign of any "illness" they start popping them, regardless of what the 'ailment' is, regardless of whether it is the correct anti-biotic, regardless of the harm anti-biotics do to our stomach flora and immune system. I say again - the base line is this - a lot of pilgrims are crazy!
I think David’s hit the nail on the head:
By continually popping pills to stop the pain, one is only masking the real symptom and therefore carry on until really damaged! This is not the same as taking a painkiller for one or two days... but NOT over a period of time!
 

tpmchugh

Veteran Member
Camino(s) past & future
Camino Frances (2013)
Camino Frances (2015)
#43
Hi all,

Just a word of warning from my own experience on the Camino.

I was on the Camino in the summer of 2016 and I had the usual range of challenges: some plantar fasciitis, minor tendon issues and heat rash on my legs and feet at the beginning, minor blister problems part way through, and knee problems throughout. But the one issue I wasn't expecting was a bad case of hives. It really hit in the latter part of my Camino and persisted after the Camino was over. It got quite bad and spread widely. I didn't know what it was? Some sort of bug bites (was I infested)? An allergic reaction? When I got back, I ended up going to several specialists and eventually it was diagnosed as chronic urticarea (hives).

Apparently, a common cause of chronic urticaria is non-steroidal anti-inflammatory drugs (NSAIDs - like Ibuprofen). Of course, like many pilgrims, I was downing ibuprofen regularly to get me through my daily walks with my bum knee. Little did I realize what I was setting myself up for. Once chronic urticarea sets in, it doesn't want to let go. Months after I stopped taking ibuprofen the hives wouldn't go away. Eventually, after months of taking very expensive medication (thank heavens for drug plans), it has finally gone into remission.

All of this to say - we pilgrims take a lot of Ibuprofen. And we tend to think of it as a very safe medication (which I'm sure it is). But it may have side effects. If you start seeing hives, your ibuprofen may be the cause. I would advise switching right away to acetaminophen for your pain relief needs, as it is not a NSAID. When I look up ibuprofen on the Internet, I see similar advice on the medical websites. For example, drugs.com says "Stop using ibuprofen and call your doctor at once if you have: ... the first sign of any skin rash, no matter how mild."

I share this here because I wish I had known to look out for this when I walked my Camino.
You have my sympathy, my wife has lived with this for about thirteen years.
 
Camino(s) past & future
Several and counting...
#44
"Of course, like many pilgrims, I was downing ibuprofen regularly"
"On my first Camino I was popping ibuprofen like candy"
and more. Please understand I am not being critical of individuals.
I am not going to get drawn into this discussion. I am a physician. It alarms me to see so much medical advice offered here, I am quite certain with the best of intentions. And I see it quite often on the forum. And I often see antiobiotics being recommended too.
I would never give prescribing advice on a forum to anyone. If I am going to prescribe, I need to talk to the patient, and if it is a new patient, examine the patient. I need to know their past history, and their current medication. I need to have access to up to date information on drug interactions and contraindications.
I do not ever prescribe for myself, though I am very well qualified to do so. I have never prescribed for myself, even when living in relatively remote areas of Africa.
If I am unwell, I seek medical advice, or discuss with a pharmacist, or a nurse practitioner. On occasion I have needed to do so on various Caminos. It is not difficult to find qualified help. For those who are lucky enough to be members of the EU such treatment is free.
I am a runner. I am getting to be "of a certain age." If have a painful hip, or knee or foot, I rest it. The thought of "popping ibuprofen" to allow me to run on a damaged joint is anathema to me, and to those who taught me therapeutics a long time ago. I think they were right.
 
Camino(s) past & future
(2009): Camino Frances
(2011): Sevilla-Salamanca, VdlP
(2012): Salamanca-SdC, VdlP
(2014): SJpdP-Astorga
(2015): Astorga-SdC
(2016) May Pamplona-Moratinos; Sept.:Burgos-SdC
(2016): August/Sept: Camino San Olav (Burgos-Covarubbias), Burgos-Sarria
(2017): May: Portuguese; Sept: Pamplona-SdC
#45
Ibuprofen is not good for your stomach, and it lowers your testosterone level as well. Maybe OK on the Camino, but...;)
 

nathanael

Active Member
Camino(s) past & future
Via de la Plata
#46
Hi all,

Just a word of warning from my own experience on the Camino.

I was on the Camino in the summer of 2016 and I had the usual range of challenges: some plantar fasciitis, minor tendon issues and heat rash on my legs and feet at the beginning, minor blister problems part way through, and knee problems throughout. But the one issue I wasn't expecting was a bad case of hives. It really hit in the latter part of my Camino and persisted after the Camino was over. It got quite bad and spread widely. I didn't know what it was? Some sort of bug bites (was I infested)? An allergic reaction? When I got back, I ended up going to several specialists and eventually it was diagnosed as chronic urticarea (hives).

Apparently, a common cause of chronic urticaria is non-steroidal anti-inflammatory drugs (NSAIDs - like Ibuprofen). Of course, like many pilgrims, I was downing ibuprofen regularly to get me through my daily walks with my bum knee. Little did I realize what I was setting myself up for. Once chronic urticarea sets in, it doesn't want to let go. Months after I stopped taking ibuprofen the hives wouldn't go away. Eventually, after months of taking very expensive medication (thank heavens for drug plans), it has finally gone into remission.

All of this to say - we pilgrims take a lot of Ibuprofen. And we tend to think of it as a very safe medication (which I'm sure it is). But it may have side effects. If you start seeing hives, your ibuprofen may be the cause. I would advise switching right away to acetaminophen for your pain relief needs, as it is not a NSAID. When I look up ibuprofen on the Internet, I see similar advice on the medical websites. For example, drugs.com says "Stop using ibuprofen and call your doctor at once if you have: ... the first sign of any skin rash, no matter how mild."

I share this here because I wish I had known to look out for this when I walked my Camino.
Thanks for sharing that I wasn't aware of the side effects. I have knee problems possibly from too many Caminos. Now what I do is have both knees injected with cortisone a month before I leave and am fine. I also off and on take Tylenol arthritis pain and it helps. Nevertheless thanks for the info. Buen Camino.
 
#47
Drugs have side effects. Some are very common (10% or more), some are uncommon (1% or less). I doubt that anyone gets them all!! For ibuprofen:

General
The most frequently reported adverse effects were gastrointestinal (GI) in nature and included nausea, vomiting, flatulence, and diarrhea.

Patent Ductus Arteriosus: The most frequently reported adverse effects were sepsis, anemia, intraventricular bleeding, apnea, GI disorders, impaired renal function, respiratory infection, skin lesions, hypoglycemia, hypocalcemia, and respiratory failure.[Ref]

Gastrointestinal
Very common (10% or more): Nausea (up to 57%), vomiting (up to 22%), flatulence (up to 16%), diarrhea (up to 10%)
Common (1% to 10%): Dyspepsia, abdominal discomfort, epigastric pain, heartburn, abdominal distress, indigestion, constipation, abdominal cramps/pain, fullness of GI tract, bloating, GI hemorrhage, melena
Uncommon (0.1% to 1%): Abdominal distention, dyspepsia, gastritis
Very rare (less than 0.01%): Peptic ulcer, perforation, hematemesis, mouth ulceration, exacerbation of colitis, exacerbation of Crohn's disease
Frequency not reported: Dry mouth, duodenitis, esophagitis, gastric ulcer, duodenal ulcer, GI bleeding, glossitis, rectal bleeding, stomatitis, eructation, gingival ulcer, pancreatitis

Patent Ductus Arteriosus:
Very common (10% or more): GI disorders non-necrotizing enterocolitis (22%)
Common (1% to 10%): Necrotizing enterocolitis, intestinal perforation
Frequency not reported: Abdominal distension, gastroesophageal reflux, gastritis, ileus, inguinal hernia
Postmarketing reports: GI perforation[Ref]

Cardiovascular
Very common (10% or more): Hemorrhage (up to 10%), hypertension (10%), hypotension (10%)
Very rare (less than 0.01%): Cardiac failure
Frequency not reported: Congestive heart failure, tachycardia, arrhythmia, myocardial infarction, palpitations, vasculitis, sinus bradycardia, angina pectoris, thrombotic events

Patent Ductus Arteriosus:
Frequency not reported: Tachycardia, cardiac failure, hypotension[Ref]

Nervous system
Very common (10% or more): Headache (up to 12%)
Common (1% to 10%): Dizziness, nervousness
Very rare (less than 0.01%): Cerebrovascular accident
Frequency not reported: Syncope, drowsiness, paresthesia, somnolence, tremors, convulsions, coma

Patent Ductus Arteriosus:
Common (1% to 10%): Intraventricular hemorrhage, periventricular hemorrhage
Frequency not reported: Convulsions[Ref]

Renal
The number of total renal events in preterm infants within 30 days of therapy following IV use was 21% and included increased blood urea (7%), renal insufficiency/impairment (6%), reduced urine output (3%), increased blood creatinine (3%), renal failure (1%), and increased blood urea with hematuria (1%).[Ref]

Very rare (less than 0.01%): Acute renal failure, renal papillary necrosis, interstitial nephritis, nephrotic syndrome, renal failure, renal insufficiency
Frequency not reported: Cystitis, azotemia, creatinine clearance decreased, glomerulitis, tubular necrosis, nephrotoxicity

Patent Ductus Arteriosus:
Very common (10% or more): Renal events (21%)
Uncommon (0.1% to 1%): Acute renal failure[Ref]

Hematologic
The incidence of total bleeding events within 30 days of therapy with IV use in preterm infants was 32%. This percentage included grade 1 and 2 intraventricular hemorrhage (15%), grade 3 and 4 intraventricular hemorrhage (15%), and other bleeding (6%).[Ref]

Very common (10% or more): Anemia (up to 36%), eosinophilia (up to 26%), neutropenia (up to 13%), thrombocythemia (up to 10%)
Common (1% to 10%): Hemoglobin decreased
Very rare (less than 0.01%): Leukopenia, thrombocytopenia, agranulocytosis, hemolytic anemia, aplastic anemia, pancytopenia, hematocrit decreased
Frequency not reported: lymphadenopathy, bleeding episodes

Patent Ductus Arteriosus:
Very common (10% or more): Anemia (32%), total bleeding (32%), intraventricular hemorrhage (29%), Neutropenia, thrombocytopenia[Ref]

Dermatologic
Common (1% to 10%): Rash, maculopapular rash, pruritus
Very rare (less than 0.01%): Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis
Frequency not reported: Ecchymosis, purpura, alopecia, sweating, photosensitivity, angioedema, exfoliative dermatitis, urticaria, vesiculobullous eruptions, Henoch Schonlein vasculitis

Patent Ductus Arteriosus:
Very common (10% or more): Skin lesion/irritation (16%)[Ref]

Metabolic
Very common (10% or more): Hypokalemia (up to 19%), hypoproteinemia (up to 13%), blood urea increased (10%), hypernatremia (10%), hypoalbuminemia (10%)
Common (1% to 10%): Appetite decreased, fluid retention
Frequency not reported: Appetite changes, hyperglycemia, hypoglycemic reaction, acidosis

Patent Ductus Arteriosus:
Very common (10% or more): Hypoglycemia (12%), hypocalcemia (12%), blood creatinine increased, blood sodium decreased
Common (1% to 10%): Hypernatremia
Frequency not reported: Feeding problems, hyperglycemia[Ref]

Other
Very common (10% or more): Bacteremia (13%), blood LDH increased (up to 10%)
Common (1% to 10%): Peripheral edema, wound hemorrhage, tinnitus, hearing impairment, edema, fatigue
Very rare (less than 0.01%): Aseptic meningitis, vertigo, exacerbation of infection-related inflammations
Frequency not reported: Fever, infection, sepsis, weight changes, asthenia, malaise, pseudo-tumor, hearing loss, drowsiness

Patent Ductus Arteriosus:
Very common (10% or more): Sepsis (43%)
Common (1% to 10%): Edema, fluid retention
Frequency not reported: Various infections[Ref]

Respiratory
Very common (10% or more): Bacterial pneumonia (up to 10%)
Common (1% to 10%): Cough
Very rare (less than 0.01%): Asthma, bronchospasm, dyspnea, wheezing
Frequency not reported: Apnea, respiratory depression, pneumonia, rhinitis, epistaxis

Patent Ductus Arteriosus:
Very common (10% or more): Apnea (28%), respiratory infection (19%), respiratory failure (10%), bronchopulmonary dysplasia
Common (1% to 10%): Atelectasis, pulmonary hemorrhage
Uncommon (0.1% to 1%): Hypoxemia
Postmarketing reports: Pulmonary hypertension[Ref]

Hepatic
Very rare (less than 0.01%): Hepatitis, jaundice
Frequency not reported: Hepatorenal syndrome, liver necrosis, liver failure, abnormal liver function tests

Patent Ductus Arteriosus:
Frequency not reported: Cholestasis, jaundice[Ref]

Hypersensitivity
Hypersensitivity reactions have been reported and may consist of any of the following: a syndrome of abdominal pain, fever, chills, nausea, vomiting, and anaphylaxis; respiratory tract reactivity comprising bronchospasm, asthma/aggravated asthma, or dyspnea; skin reactions, which rarely included exfoliative and bullous dermatoses, Stevens-Johnson syndrome, toxic epidermal necrolysis, angioedema, pruritus, and urticaria.[Ref]

Frequency not reported: Anaphylactoid reactions, hypersensitivity reaction[Ref]

Ocular
Very rare (less than 0.01%): Visual disturbances
Frequency not reported: Blurred vision, amblyopia, diminished vision, scotomata, changes in color vision, conjunctivitis, dry eyes, diplopia, optic neuritis, cataracts, optic neuritis, toxic optic neuropathy[Ref]

Musculoskeletal
Frequency not reported: Lupus erythematosus syndrome[Ref]

Psychiatric
Frequency not reported: Anxiety, confusion, depression, dream abnormalities, insomnia, emotional lability, hallucinations[Ref]

Genitourinary
Common (1% to 10%): Urinary retention
Very rare (less than 0.01%): Proteinuria, hematuria
Frequency not reported: Dysuria, oliguria, polyuria, menorrhagia

Patent Ductus Arteriosus:
Very common (10% or more): Oliguria, hematuria
Common (1% to 10%): Urinary tract infection[Ref]

Immunologic
Frequency not reported: Serum sickness[Ref]

Local
Common (1% to 10%): Infusion site pain
Postmarketing reports: Transient sensation of burning in mouth/throat

Patent Ductus Arteriosus:
Frequency not reported: Injection site reactions[Ref]

Endocrine
Frequency not reported: Gynecomastia

Patent Ductus Arteriosus:
Common (1% to 10%): Adrenal insufficiency[Ref]


As for hives, it looks like .1 to .3% prevalence:

NSAID-induced urticaria and angioedema: a reappraisal of its clinical management.
Sánchez-Borges M1, Capriles-Hulett A, Caballero-Fonseca F.
Author information
Abstract

Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs), resulting in urticaria and angioedema, is being observed with increasing frequency. Prevalence rates range from 0.1-0.3%, which is partly due to the large size of the exposed (at risk) population. Some predisposing factors for these cutaneous reactions have been identified, among them atopic diathesis, female sex, young adulthood, a history of chronic urticaria and the use of the NSAID for the relief of acute pain. The description of two different arachidonic acid cyclo-oxygenases (COX) about a decade ago, designated COX-1 and COX-2, and the incorporation into the therapeutic armamentarium of more selective enzyme inhibitors for the control of inflammation and pain, has led to an improved understanding of the pathogenesis of adverse reactions to NSAIDs. This has allowed investigators to study 'sensitive' individuals to see if they can safely receive these new pharmaceutical compounds. The reasons why some people react to NSAIDs are not completely clarified. The prevalent theory about the pathogenesis of urticaria and angioedema due to NSAIDs in cross-reactive patients assumes that the inhibition of COX-1 leads to a shunting of arachidonic acid metabolism towards the 5-lipoxygenase pathway, which results in an increased synthesis and release of cysteinyl leukotrienes. Although COX-2 inhibitors are well tolerated by the majority of classic NSAID-sensitive patients, cutaneous reactions to highly selective inhibitors of COX-2 have been described in some of these individuals, casting some doubts about the relevance of such hypotheses. On the other hand, in patients who react to a single NSAID and chemically similar products (single-reactors), specific immunoglobulin E antibodies to haptenated NSAID metabolites have been suspected, although these metabolites are not easily demonstrated by means of routine in vivo or in vitro techniques. Facial (periorbital) angioedema constitutes the most common form of clinical presentation, and one-third of the patients show a mixed clinical pattern of cutaneous (urticaria and/or angioedema) and respiratory symptoms which include upper respiratory tract edema, rhinorrhea, cough, breathlessness and tearing. When necessary, diagnosis is confirmed by means of controlled peroral drug challenges done by experienced physicians in the hospital setting and test results are helpful for clinical management, which will be based on strict avoidance, and the use of alternative tolerated medications. This approach is specially indicated in hypersensitive patients with chronic medical conditions who require continuous NSAID therapy, such as those with arthritis and coronary heart disease.
Count me in as one of the rare ones with ANGIOEDEMA, which simply means facial swellings. I had them occasionally to frequently for nearly 20 years when finally I was referred to Brigham and Women's Allergy Clinic in Boston where it was diagnosed and I was told to stop taking NSAIDS. As a hiker and then a Camino addict (who has two knee replacements), I used Ibuprofen way too frequently (daily on the Camino, several times a day). I stopped taking Ibuprofen and I stopped having facial swellings. Wish I'd known this years ago. All good information here and worth seriously considering.
 

lynee

New Member
Camino(s) past & future
april "2015"
#48
I have trouble processing the thought of such extreme doses . Constant pain is a cross I bear but the maximum dose I have ever been prescribed is 2x50 MG per diem of Voltaren enteric , much the same as Ibuprophen .
I was also amazed at the 1000mg Paracetamol tablets available in France , twice the maximum allowable in Australia , certainly something to be aware of s the risk of overdose to the unwary is so high .
MisterH if your pain is this great I can only offer my commiseration and hope that one day it will be less .
In Australia the usual dose of paracetomol is 1000mg ( 2 x500mg ) every 4 hours up to 8 tablets in total in 24 hours. So in france the dose is probably 1 tablet every 4 hours .
 

lynee

New Member
Camino(s) past & future
april "2015"
#49
Just a thing - for anyone from Australia who is after pain relief (as apposed to anti-inflammatory drugs), our version of acetaminophen is good old panadol (paracetamol). It's common in Oz to take ibuprofen with panadol - quite effective however, as all the other posts state, there are long term affects even if drugs are taken as specified on the packaging. I personally never take aspirin as its a bit tough on the gut. I also don't like to take ibuprofen for all the reasons listed here. However, severe inflammation requires REST, perhaps ICE too hey and yes, possibly drugs. Just saying.
Ibuprofen, voltaren and aspirin all must be taken with food. This reduces the effect on the gut. But take some ranitidine or similar medication with you just in case .
 

lynee

New Member
Camino(s) past & future
april "2015"
#50
Another very serious side effect is gastrointestinal ulcers and bleeding. People have died from it. If you have a history of tummy troubles please be careful.

Another thing I discovered while walking was the dosage of the tablets. In Australia the standard tablet is 200mg. On going to the pharmacy in Logrono they calmly asked if I wanted 400 or 600mg tablets. WOW 3 times our strength. They also come in huge boxes. Make sure you take the correct dosage.

PS: it is still a wonder drug where shin splints are concerned
yes the tablet is 600 mg but if you read the box it is one tablet every 6 hours . In Aus the dose is 200 mg but you take 2 tablets every 4hours , IT works out to be the same dose over 12hours.
 

Tia Valeria

Veteran Member
Camino(s) past & future
Pt Norte/Pmtvo 2010
C. Inglés 2011
C. Primitivo '12
Norte-C. de la Reina '13
C. do Mar-C. Inglés '15
#51
There is a report in today's paper about a new version of Ibuprofen that is safer and about to go on sale in the UK at least. Just in case the full article disappears I quote one phrase here:-
The new ibuprofen — Flarin — goes on sale in Lloyds Pharmacy from today at a cost of £7.95 for 30 capsules, and will be available in other pharmacies from March.
Good news for pilgrims but care still needed. We prefer to apply a little of the gel if needed rather than take tablets.
 

mvanert

Active Member
Camino(s) past & future
Pamplona - Santiago 2014, St. Jean to Estella June 2016, Estella to Santiago April 17, 2018
#52
Hi all,

Just a word of warning from my own experience on the Camino.

I was on the Camino in the summer of 2016 and I had the usual range of challenges: some plantar fasciitis, minor tendon issues and heat rash on my legs and feet at the beginning, minor blister problems part way through, and knee problems throughout. But the one issue I wasn't expecting was a bad case of hives. It really hit in the latter part of my Camino and persisted after the Camino was over. It got quite bad and spread widely. I didn't know what it was? Some sort of bug bites (was I infested)? An allergic reaction? When I got back, I ended up going to several specialists and eventually it was diagnosed as chronic urticarea (hives).

Apparently, a common cause of chronic urticaria is non-steroidal anti-inflammatory drugs (NSAIDs - like Ibuprofen). Of course, like many pilgrims, I was downing ibuprofen regularly to get me through my daily walks with my bum knee. Little did I realize what I was setting myself up for. Once chronic urticarea sets in, it doesn't want to let go. Months after I stopped taking ibuprofen the hives wouldn't go away. Eventually, after months of taking very expensive medication (thank heavens for drug plans), it has finally gone into remission.

All of this to say - we pilgrims take a lot of Ibuprofen. And we tend to think of it as a very safe medication (which I'm sure it is). But it may have side effects. If you start seeing hives, your ibuprofen may be the cause. I would advise switching right away to acetaminophen for your pain relief needs, as it is not a NSAID. When I look up ibuprofen on the Internet, I see similar advice on the medical websites. For example, drugs.com says "Stop using ibuprofen and call your doctor at once if you have: ... the first sign of any skin rash, no matter how mild."

I share this here because I wish I had known to look out for this when I walked my Camino.
It can also raise blood pressure as I recently found out. I have been taking it almost daily for lower back pain and my blood pressure went up and I didn't know why. Since I have to monitor my blood pressure I did some research and found out it can cause this. I stopped taking it and my blood pressure dropped within a week (it takes time to get it out of your system) over 10 points! I can't say that it will be the same for everyone, I can only tell you what I experienced. Talk to your doctor if you have concerns.
 
Camino(s) past & future
June 2014
#54
Hi all,

Just a word of warning from my own experience on the Camino.

I was on the Camino in the summer of 2016 and I had the usual range of challenges: some plantar fasciitis, minor tendon issues and heat rash on my legs and feet at the beginning, minor blister problems part way through, and knee problems throughout. But the one issue I wasn't expecting was a bad case of hives. It really hit in the latter part of my Camino and persisted after the Camino was over. It got quite bad and spread widely. I didn't know what it was? Some sort of bug bites (was I infested)? An allergic reaction? When I got back, I ended up going to several specialists and eventually it was diagnosed as chronic urticarea (hives).

Apparently, a common cause of chronic urticaria is non-steroidal anti-inflammatory drugs (NSAIDs - like Ibuprofen). Of course, like many pilgrims, I was downing ibuprofen regularly to get me through my daily walks with my bum knee. Little did I realize what I was setting myself up for. Once chronic urticarea sets in, it doesn't want to let go. Months after I stopped taking ibuprofen the hives wouldn't go away. Eventually, after months of taking very expensive medication (thank heavens for drug plans), it has finally gone into remission.

All of this to say - we pilgrims take a lot of Ibuprofen. And we tend to think of it as a very safe medication (which I'm sure it is). But it may have side effects. If you start seeing hives, your ibuprofen may be the cause. I would advise switching right away to acetaminophen for your pain relief needs, as it is not a NSAID. When I look up ibuprofen on the Internet, I see similar advice on the medical websites. For example, drugs.com says "Stop using ibuprofen and call your doctor at once if you have: ... the first sign of any skin rash, no matter how mild."

I share this here because I wish I had known to look out for this when I walked my Camino.
I got another terrible side effect. I did my camino in July 2014. At the time I was living in Thailand but I am from South Africa - so I am very used to the heat and sun, and hardly ever got sunburned. However... on camino, even though I was lathering on 50 factor suncream, I got so badly burnt that I was blistering! After research and speaking to a doctor, photo sensitivity in another side effect and can make you burn very easily. The worst part is that the effect can last up to 20 years after stopping the Ibuprofen! Now I can hardly go into the sun, and in fact 2 years later I got skin cancer (all removed luckily) but I too would have not taken it had I known this severe side effect!
 
Camino(s) past & future
June 2014
#55
Hi there
When I walked the Francés in 2013 a lovely South African girl who was now living in Samoa was injured and taking a lot of Ibuprofen. About a week after she started she began to burn quite badly in the sun and developed a sun rash. Now this girl knew her sunshine and her tolerance to it, but even with high factor sun cream her skin kept burning. Eventually we checked the side effects of the Ibuprofen and discovered it can also cause photosensitivity which can persist for life in extreme cases. She I believe, several years later, still can’t take the sun the way she used to. It seems these drugs are powerful with a number of unpleasant potential side effects.
Hi Gill
That would be me!
And it was 2014 not 2013...
I still can't take the sun. They say the effects can last up to 20 years! I actually got skin cancer 2 years later, luckily all removed, but I'm sure it was triggered by that.
 

Gillyweb

Active Member
Camino(s) past & future
Villafranca - Santiago (2013)
SJPP - Santiago (2014)
Portugues (2017)
#56
Hi Gill
That would be me!
And it was 2014 not 2013...
I still can't take the sun. They say the effects can last up to 20 years! I actually got skin cancer 2 years later, luckily all removed, but I'm sure it was triggered by that.
Hi Gill
That would be me!
And it was 2014 not 2013...
I still can't take the sun. They say the effects can last up to 20 years! I actually got skin cancer 2 years later, luckily all removed, but I'm sure it was triggered by that.
Rosanne :) How funny that you found that comment in the whole of this forum !! I’d have tagged you somehow but couldn’t remember your forum name. Sorry to hear about the skin cancer but very very happy to hear it was successfully removed. Yes 2014 was the long walk year for me - 2013 was my shorter Francés. More importantly, when are we going to do it again ???? - without Ibuprofen!!
 

hecate105

Active Member
Camino(s) past & future
2009 Portuguese Estellas 2014 Aurelia 2016 St Davids 2017 Via Augusta/V dl P. 2018 Michael Mary Way
#57
Oh dear, I thought that red wine cured all ills... Didn't think of trying anything else!
Seriously though, after years of being on far too many 'medical' drugs for fibromyalgia - I would only take Solpadeine for toothache/headache and I would use arnica tablets for the everyday aching and bruising of Camino life.
Another thing to watch out for with anti-inflammatories is that some of them are really dangerous for asthma sufferers....
 

Gillyweb

Active Member
Camino(s) past & future
Villafranca - Santiago (2013)
SJPP - Santiago (2014)
Portugues (2017)
#58
Hi Gill
That would be me!
And it was 2014 not 2013...
I still can't take the sun. They say the effects can last up to 20 years! I actually got skin cancer 2 years later, luckily all removed, but I'm sure it was triggered by that.
Haha - also just realised I moved you to Samoa instead of Samui ..... I’ve probably got that wrong too. Predictive text !!
 
Camino(s) past & future
June 2014
#60
Rosanne :) How funny that you found that comment in the whole of this forum !! I’d have tagged you somehow but couldn’t remember your forum name. Sorry to hear about the skin cancer but very very happy to hear it was successfully removed. Yes 2014 was the long walk year for me - 2013 was my shorter Francés. More importantly, when are we going to do it again ???? - without Ibuprofen!!
Hopefully next year. Will pop you a fb message. Xx
 

mbates2

New Member
Camino(s) past & future
(2017)
#61
Hi all,

Just a word of warning from my own experience on the Camino.

I was on the Camino in the summer of 2016 and I had the usual range of challenges: some plantar fasciitis, minor tendon issues and heat rash on my legs and feet at the beginning, minor blister problems part way through, and knee problems throughout. But the one issue I wasn't expecting was a bad case of hives. It really hit in the latter part of my Camino and persisted after the Camino was over. It got quite bad and spread widely. I didn't know what it was? Some sort of bug bites (was I infested)? An allergic reaction? When I got back, I ended up going to several specialists and eventually it was diagnosed as chronic urticarea (hives).

Apparently, a common cause of chronic urticaria is non-steroidal anti-inflammatory drugs (NSAIDs - like Ibuprofen). Of course, like many pilgrims, I was downing ibuprofen regularly to get me through my daily walks with my bum knee. Little did I realize what I was setting myself up for. Once chronic urticarea sets in, it doesn't want to let go. Months after I stopped taking ibuprofen the hives wouldn't go away. Eventually, after months of taking very expensive medication (thank heavens for drug plans), it has finally gone into remission.

All of this to say - we pilgrims take a lot of Ibuprofen. And we tend to think of it as a very safe medication (which I'm sure it is). But it may have side effects. If you start seeing hives, your ibuprofen may be the cause. I would advise switching right away to acetaminophen for your pain relief needs, as it is not a NSAID. When I look up ibuprofen on the Internet, I see similar advice on the medical websites. For example, drugs.com says "Stop using ibuprofen and call your doctor at once if you have: ... the first sign of any skin rash, no matter how mild."

I share this here because I wish I had known to look out for this when I walked my Camino.


I had a problem with my lips. I thought they were sunburned. I always had sunscreen on and it was also my inner lips. Nothing I did helped! This went on from about a week after we started, until we got home. My mouth was raw. I couldn't eat anything hot or spicy. I went to my Dr. and the first thing she asked was what was I using for toothpaste? It was just one of the travel sizes you get at the dentist, but as soon as I was home and started using my regular toothpaste it all went away. I will now only use my regular toothpaste.
 
Last edited:
Camino(s) past & future
This upcoming May 31st through July 1st approximately.
#62
Hi all,

Just a word of warning from my own experience on the Camino.

I was on the Camino in the summer of 2016 and I had the usual range of challenges: some plantar fasciitis, minor tendon issues and heat rash on my legs and feet at the beginning, minor blister problems part way through, and knee problems throughout. But the one issue I wasn't expecting was a bad case of hives. It really hit in the latter part of my Camino and persisted after the Camino was over. It got quite bad and spread widely. I didn't know what it was? Some sort of bug bites (was I infested)? An allergic reaction? When I got back, I ended up going to several specialists and eventually it was diagnosed as chronic urticarea (hives).

Apparently, a common cause of chronic urticaria is non-steroidal anti-inflammatory drugs (NSAIDs - like Ibuprofen). Of course, like many pilgrims, I was downing ibuprofen regularly to get me through my daily walks with my bum knee. Little did I realize what I was setting myself up for. Once chronic urticarea sets in, it doesn't want to let go. Months after I stopped taking ibuprofen the hives wouldn't go away. Eventually, after months of taking very expensive medication (thank heavens for drug plans), it has finally gone into remission.

All of this to say - we pilgrims take a lot of Ibuprofen. And we tend to think of it as a very safe medication (which I'm sure it is). But it may have side effects. If you start seeing hives, your ibuprofen may be the cause. I would advise switching right away to acetaminophen for your pain relief needs, as it is not a NSAID. When I look up ibuprofen on the Internet, I see similar advice on the medical websites. For example, drugs.com says "Stop using ibuprofen and call your doctor at once if you have: ... the first sign of any skin rash, no matter how mild."

I share this here because I wish I had known to look out for this when I walked my Camino.
Exactly how much ibuprofen were you taking? That sounds to be a pretty horrific reaction.
 
Camino(s) past & future
First time pilgrim and walking solo. Leaving SJDP around April 5, 2018.
#63
This is a fascinating thread. So I will have to take ibuprofen with me because I'm worried about pericarditis coming back while on the road (and heavy doses of ibuprofen will help the sudden inflammation until I can get to a hospital). The thread is interesting to me because just last week I saw a dermatologist about what I thought were two spider bite incidents on my right hand last August and November that sent me to the ER both times (extremely fast moving infections going up my arm). The derm has a theory that they were not spider bites but instead drug-induced skin eruptions/lesions, and the only new drug I had been taking every day until the last "spider bite" was... you guessed it... ibuprofen. In my feeble, non-medically trained mind, I thought I was preventing inflammation from coming back by continuing to take ibuprofen every day even though I was no longer sick. When I walk the camino starting April, I will not be taking anything for pain relief; I would rather be sore than get another "spider bite." I will just hope for the best on the peric. I hear wine is a good pain reliever sometimes. ;-)
 

CatherineAnn

CF summer 2016
Camino(s) past & future
Camino Frances (2012)
Camino Frances (2016)
#64
My second Camino in 2016 I had several issues and took a lot of ibuprofen after taking none on my first go. I have had ongoing problems ever since.

I only took one pill at a time and only once a day but it was too much for my system.

There were times when I could have touched it out if I had realized the long term effects.
 
Camino(s) past & future
First one begins August 13 2017!
#65
Hi all,

Just a word of warning from my own experience on the Camino.

I was on the Camino in the summer of 2016 and I had the usual range of challenges: some plantar fasciitis, minor tendon issues and heat rash on my legs and feet at the beginning, minor blister problems part way through, and knee problems throughout. But the one issue I wasn't expecting was a bad case of hives. It really hit in the latter part of my Camino and persisted after the Camino was over. It got quite bad and spread widely. I didn't know what it was? Some sort of bug bites (was I infested)? An allergic reaction? When I got back, I ended up going to several specialists and eventually it was diagnosed as chronic urticarea (hives).

Apparently, a common cause of chronic urticaria is non-steroidal anti-inflammatory drugs (NSAIDs - like Ibuprofen). Of course, like many pilgrims, I was downing ibuprofen regularly to get me through my daily walks with my bum knee. Little did I realize what I was setting myself up for. Once chronic urticarea sets in, it doesn't want to let go. Months after I stopped taking ibuprofen the hives wouldn't go away. Eventually, after months of taking very expensive medication (thank heavens for drug plans), it has finally gone into remission.

All of this to say - we pilgrims take a lot of Ibuprofen. And we tend to think of it as a very safe medication (which I'm sure it is). But it may have side effects. If you start seeing hives, your ibuprofen may be the cause. I would advise switching right away to acetaminophen for your pain relief needs, as it is not a NSAID. When I look up ibuprofen on the Internet, I see similar advice on the medical websites. For example, drugs.com says "Stop using ibuprofen and call your doctor at once if you have: ... the first sign of any skin rash, no matter how mild."

I share this here because I wish I had known to look out for this when I walked my Camino.
Thank you for the heads up. Thankfully I didn't get hives but it sounds like you and I shared everything else. A side effect that could have been very dangerous, that I didn't know about until I returned home and saw my doctor the day after, was high blood pressure. I had no idea.
 

Nevart

New Member
Camino(s) past & future
May 2017
#66
Hi all,

Just a word of warning from my own experience on the Camino.

I was on the Camino in the summer of 2016 and I had the usual range of challenges: some plantar fasciitis, minor tendon issues and heat rash on my legs and feet at the beginning, minor blister problems part way through, and knee problems throughout. But the one issue I wasn't expecting was a bad case of hives. It really hit in the latter part of my Camino and persisted after the Camino was over. It got quite bad and spread widely. I didn't know what it was? Some sort of bug bites (was I infested)? An allergic reaction? When I got back, I ended up going to several specialists and eventually it was diagnosed as chronic urticarea (hives).

Apparently, a common cause of chronic urticaria is non-steroidal anti-inflammatory drugs (NSAIDs - like Ibuprofen). Of course, like many pilgrims, I was downing ibuprofen regularly to get me through my daily walks with my bum knee. Little did I realize what I was setting myself up for. Once chronic urticarea sets in, it doesn't want to let go. Months after I stopped taking ibuprofen the hives wouldn't go away. Eventually, after months of taking very expensive medication (thank heavens for drug plans), it has finally gone into remission.

All of this to say - we pilgrims take a lot of Ibuprofen. And we tend to think of it as a very safe medication (which I'm sure it is). But it may have side effects. If you start seeing hives, your ibuprofen may be the cause. I would advise switching right away to acetaminophen for your pain relief needs, as it is not a NSAID. When I look up ibuprofen on the Internet, I see similar advice on the medical websites. For example, drugs.com says "Stop using ibuprofen and call your doctor at once if you have: ... the first sign of any skin rash, no matter how mild."

I share this here because I wish I had known to look out for this when I walked my Camino.
 

Nevart

New Member
Camino(s) past & future
May 2017
#67
Good information to share. I would caution, however, that acetaminophen (Tylenol) is far more dangerous than ibuprofen when taken to excess. Due to the severe risk of liver failure, Tylenol/acetaminophen use needs to be carefully monitored and not taken beyond the recommended dosage. Coupled with alcohol consumption, even the recommended dosage can be too much. Suicide attempts using overdoses of acetaminophen are sadly common; and sadder still is that many of these attempts do not die right away as failure of the liver can be a delayed reaction.

Taking the recommended dosages of both ibuprofen and Tylenol together can provide better relief. Of course, those with liver damage or disease must not take any level of acetaminophen.
Hi,

Last June I developed a very strong pain in my left ankle approx. 40 km from León. I could not put any weight on my left foot. Also my left calf was very swollen and hard. In León, upon the advice of the pharmacist, I consulted a doctor who diagnosed tendinitis and prescribed Ibuprofen. A few days later, there was no improvement whatsoever. I went to see a physiotherapist. After two treatments for tendinitis he decided I also had bursitis and started treating me for that. After altogether five treatments from him and as I was getting desperate (and depressed) I emailed a friend who suggested I see an osteopath. Google revealed that there were a few of them in León, one of them two street from my hotel. On my first appointment the therapist had one look at me and said right away that there was nothing wrong with my ankle. The problem was that I was out of kilter. The following day, after my first treatment that day, I could already put some weight on my left foot. After two more treatments (treatments were 2-3 days apart) I could walk normally again and he said that I could continue my walk on the Camino.

I wanted to write this to show that the aches and pains we develop in our bodies are often due to mechanical problems that could be easily fixed. Although it is difficult to find any type of help in the villages we cross, except maybe a pharmacy, we can look for it, including manual practitioners, in the few cities we cross.
 
Camino(s) past & future
2013, 2014
#68
Another very serious side effect is gastrointestinal ulcers and bleeding. People have died from it. If you have a history of tummy troubles please be careful.

Another thing I discovered while walking was the dosage of the tablets. In Australia the standard tablet is 200mg. On going to the pharmacy in Logrono they calmly asked if I wanted 400 or 600mg tablets. WOW 3 times our strength. They also come in huge boxes. Make sure you take the correct dosage.

PS: it is still a wonder drug where shin splints are concerned
Yes, the NSAIDs are marvelous for inflammatory conditions. The recommended OTC dose for ibuprofen in the US is 400mg (2 200mg pills). Ibuprofen by prescription is 400, 600, and 800mg. The max recommended 24 hr dosage is 3200mg or 3 x 800, although I never gave my patients more than 2400. The European pill sizes are keeping in line with medically effective doses. Like with most meds, longer term regular use leads to increased side effects! ~Constantine
Another very serious side effect is gastrointestinal ulcers and bleeding. People have died from it. If you have a history of tummy troubles please be careful.

Another thing I discovered while walking was the dosage of the tablets. In Australia the standard tablet is 200mg. On going to the pharmacy in Logrono they calmly asked if I wanted 400 or 600mg tablets. WOW 3 times our strength. They also come in huge boxes. Make sure you take the correct dosage.

PS: it is still a wonder drug where shin splints are concerned
The 200mg over the counter US tablets are woefully small. Recommended doses of Ibuprofen on the box are 400 (2x200), but prescribed ibuprofen is often 600-800.

Max daily dose (24 hours) is 3200mg (16x200!) though I kept my patients to 2400mg.

They are marvelous in inflammatory conditions. But when taken for extended periods, side effects increase.

Remember that NSAIDs affect the kidneys and Tylenol (acetaminophen in the US; called paracetamol in Europe) affects the liver.

~ Constantine
 

Anamiri

Veteran Member
Camino(s) past & future
Camino Frances
#69
Another very serious side effect is gastrointestinal ulcers and bleeding. People have died from it. If you have a history of tummy troubles please be careful.

Another thing I discovered while walking was the dosage of the tablets. In Australia the standard tablet is 200mg. On going to the pharmacy in Logrono they calmly asked if I wanted 400 or 600mg tablets. WOW 3 times our strength. They also come in huge boxes. Make sure you take the correct dosage.

PS: it is still a wonder drug where shin splints are concerned
My grandmother died from it, such severe ulcers that she bled to death. after three days of taking it, prescribed by her doctor for her knee pain. My father and I have both been hospitalised, (My father more than once) both having blood transfusions as we lost so much blood. Despite this being in my medical records I have been almost prescribed NSAIDS many times. I point out that I dont want to die, and refuse the prescription. There is unfortunately not a lot of effective options for those of us with extreme reactions.
 

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