Paracetamol or Ibuprofen ?
Hi all, a quick question as seems conflicting info generally, I have been told not to take Ibuprofen now i am on Glivec for headaches and pain generally as it can react / interact, however every thing I have read over the past few weeks says not to take Parecetamol does anyone know which is right, can you take either or both ?
Thanks Nigel
I take paracetamol or ibuprofen without worrying and I am PCRU.
I have had occasion to take the maximum recommended quantity of 30/500 co-codamol for some time and became dependant on the codeine without realising it. When I stopped, I wondered what was happing to me and discovered that it was withdrawal symptoms. My GP said I should have stopped it gradually, but, by that time, I was so far through that I carried on. Now I am very wary about taking codeine, although I do in small quantities on occasion, because it works.
Be careful with codeine. It is a Class B drug and is addictive.
John
John... I absolutely agree that we should all (CML or not) beware of codeine and thank you this post about your own experience. It is so easy to become dependant and I am amazed that this drug is available without prescription.
The issue of painkillers like paracetamol used in combination with TKI therapy is to do with the fact that both class of drugs are synthesized by the liver. Taking imatinib is a must on a daily basis- so you can think of this as the essential that must come first. When suffering from acute (rather than chronic and therefore long term) pain then taking paracetamol to deal with short term will not cause too much stress on the liver, so you need not worry too much.
However, long term or regular use of paracetamol (tylenol in the US) is not recommended because the liver will be overly stressed. I am not too sure how pain relief from brands like nurofen (ibuprofen) work--- whether they are synthesized by the liver or work in some other way. I suggest trying wikipaedia to find out.
Quick fixes for pain relief are one thing and you should not really be overly concerned.. it is the use of paracetamol (and related drugs) over the long term that is the danger-
BUT
from what I can gather the advice is definitely NO to codeine and any product that contains it.
Best wishes,
Sandy
This is one of those questions I've never had a consistent answer to.. even from CML specialists and haematologists!
Some say avoid paracetemol because it is, like Glivec, metabolised in the liver. The implication is that the two together might put a strain on it. That's common advice in the US I know. Certainly long term use of paracetemol is not a good idea generally as it isn't good for the liver but short term is I think OK. I've certainly taken it.
Others say avoid ibuprofen because, while it is my understanding that it is not metabolised in the liver, it is, like Glivec, a stomach irritant. Long term use of ibuprofen is also bad for the kidneys (completely unrelated to Glivec). Again, I've taken this short term too.
A third group say either is OK when you have a cold or need pain relief (and for that they work quite differently - ibuprofen best for muscle pain and headaches as it's an anti inflammatory; paracetemol seems, for me at least, to be best for general malaise and temperature control), but it's a good idea if you do not take the maximum daily dose. Most of the consultants I have seen have said this. I guess there may well be some people who are more susceptible to the liver issue, so should take ibuprofen, and others to the stomach issue, so should take paracetemol. That's something to discuss with your consultant.
One day I am sure we will get advice on what really is the best course! For the moment, I do use painkillers much less often than I did before CML.
Best
Richard
