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Arthritis (Expert Forum)
Pain medication
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions and support regarding arthritis issues such as: Arthritis, Autoimmune Disease, Bursitis, Fibromyalgia, Gout, Juvenile Rheumatoid Arthritis, Lupus, Myositis, Neuralgia, Osteoarthritis, Polymyalgia Rheumatica, Rheumatoid Arthritis, Sciatica, Tendinitis, Vasculitis.
Pain medication
by wub, Oct 07, 2004 12:00AM
I am 79 years old and in excellent health. No allergic reactions to medication. However, due to a period of atrial fibrillation 10 years ago (no recurrence), and a very short duration
1 minute) brain embolism at that time, I have to keep my PTINR between 2 and 3. For that reason I take 7 mg of Warfarin and
60 mg of Diltiazem daily. I need to treat arthritic pain. Celecoxib, rofecoxib and valdecoxib are all listed as counterindicated if you are taking Warfarin. However, I have found that a relatively small daily dose (200mg) of Celebrex (celecoxib)is sufficient. Will this significantly change the INR level or have other unwanted effects? Over the counter drugs are not potent enough (Acetaminophen etc.) What do you suggest that I take as the most effective prescription or non prescription medication for athritic pain in this situation?
1 minute) brain embolism at that time, I have to keep my PTINR between 2 and 3. For that reason I take 7 mg of Warfarin and
60 mg of Diltiazem daily. I need to treat arthritic pain. Celecoxib, rofecoxib and valdecoxib are all listed as counterindicated if you are taking Warfarin. However, I have found that a relatively small daily dose (200mg) of Celebrex (celecoxib)is sufficient. Will this significantly change the INR level or have other unwanted effects? Over the counter drugs are not potent enough (Acetaminophen etc.) What do you suggest that I take as the most effective prescription or non prescription medication for athritic pain in this situation?
Doctor's Answer
by Kevin Pho, MD, Oct 09, 2004 12:00AM
, Oct 09, 2004 12:00AM
Although Celebrex does reduce the incidence of GI bleeding, it is certainly possible that it can affect the INR and/or increase bleeding risk. It is recommended that close monitoring by your physician (both for bleeding and an increased INR) be enforced if you intend to use Coumadin with Celebrex.
You may want to consider another class of medication if this combination is not feasible - including Ultram or Ultracet.
You may want to discuss these options with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
You may want to consider another class of medication if this combination is not feasible - including Ultram or Ultracet.
You may want to discuss these options with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
