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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.
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?Good information to share. I would caution, however, that acetaminophen (Tylenol) is far more dangerous than ibuprofen when taken to excess.
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?
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.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.
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?
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!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.
I saw MANY people taking it...mostly Americans.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.
nksDThabHi 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 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.
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.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.
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.
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.
Next time go the the Farmacia and ask for ranitidina - it's Zantac and is available OTCnksDThab
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!
Thanks Tara! Now I've gotta file that away where I can remember it!!Next time go the the Farmacia and ask for ranitidina - it's Zantac and is available OTC
Hi thereHi 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 think David’s hit the nail on the head: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!
You have my sympathy, my wife has lived with this for about thirteen years.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.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.
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.
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 .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 .
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 .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.
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.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
Good news for pilgrims but care still needed. We prefer to apply a little of the gel if needed rather than take tablets.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.
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!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 GillHi 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.
RosanneHi 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 !!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.
Yip Samui. But now back in SA. Hoping to so again mext year with my daughter.Haha - also just realised I moved you to Samoa instead of Samui ..... I’ve probably got that wrong too. Predictive text !!
Hopefully next year. Will pop you a fb message. XxRosanneHow 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!!
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.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.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 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.
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
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.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
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.
Right, you want to give your patients the lowest effective dose while being cognizant of long term effects in chronic use. The less you can get away with the better.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.
Indeed.The less you can get away with the better.
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.
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