Are you Canadian? Methocarbamol is RX-only in the States.
Yes, but replace with NyQuil or anything OTC for the doubled acetaminophen does.
Meloxicam does last longer than ibuprofen. But while it may work better for you than ibuprofen does, there’s great variability as to which NSAID works best for a given person. I’ve had many patients tell me meloxicam was crap for their pain, and wanted ibuprofen, or naproxen, or indomethacin, or ketoprofen, or aspirin or sulindac or piroxicam or salsalate instead. It can be tough figuring out which of the myriad NSAIDs out there helps an individual the most. Everyone seems to swear by a different one, and diss others as ineffective.
Clinical studies have backed this up; there’s no single NSAID that stands out as better for pain relief for a general population.
If one does (I’m recently diagnosed with Stage III Chronic Kidney Disease) what’s safe safer safest to take for pain?
Yeah, I know something to ask one of my many specialists at our far too busy appointments . . . but you’re here and so is this thread so I’m asking anyway.
The safest oral med would be acetaminophen. All NSAIDs are all too capable of worsening renal function, particularly when there’s already significant renal disease there.
My own kidneys bounce between stage I and II, so I avoid all NSAIDs (save for 81 mg low dose aspirin for my coronary artery disease, which my nephrologist, my urologist and my cardiologist agree is necessary for me).
Discuss with your nephrologist whether or not topical NSAIDs like diclofenac (Voltaren) cream might be acceptable for occasional use.
I do wonder about the state of research/development involving acetaminophen (aka paracetamol) variants. My very superficial review of the topic does show that studies are ongoing regarding the various possible uses of derivatives of Acetaminophen, but I don’t see anything that’s close to being on the market. However, I may have overlooked such cases.
Mobic is a VERY powerful anti-inflammatory, but it is not that good for pain. But yes, it lasts 24 hours, you take it once a day. And yeah, it is most definitely a NSAID
Much obliged.
Yeah, I was a bit shocked by the 17K deaths/disabled number…that’s getting up into smoking cigs territory, and almost into private vehicle range.
I suppose there are likely many people who mix and match various OTC medications somewhat recklessly…may be driving up the numbers, unfortunately.
Will look into a renal panel next time I see the doc…and probably not a bad idea for another liver panel. Liver was fine last I heard…slight inflammation, interpreted as likely from carrying a bit of extra weight…but that could have been five or slightly more years ago (heavy drinker, but I don’t use acetaminophen, nor really any other medications to speak of in any quantity), and don’t recall kidney news from the gals down at the lab, so was probably a while ago.
Again, many people would disagree with that statement about its efficacy for pain.
Yeah! My dad was taking Mobic daily for who knows what (he had a ton of chronic pain). Not sure how well it did for him. When I was dealing with some weird neck pain last year came across this stuff in my “big bag of drugs I mean to dispose of since dad died*” and I took it and it COMPLETELY fixed my pain. Like, ibuprofen wouldn’t touch it but Mobic made it disappear**.
My brother and my SIL both have pain flare ups and I told them about this wonder drug and both had already tried it and it did nothing for them. I was super sad for them because boy, did this totally eliminate my pain.
- I did end up properly disposing the other drugs and told my doc about my bottle of Mobic
** I’ve gone to PT now for my neck and barely need NSAIDs
It does fine for joint pain, etc, but IMHO it does nada for headaches.
But as my Doctor said, it reduces inflammation so much is actually helps heal.
It only reduces inflammation if taken regularly for 2 to 3 weeks at a minimum, and there are some studies indicating that reducing the inflammation actually delays healing in certain circumstances.
And while it may not help your headaches, other people swear it’s the best thing for their headaches. As I’ve explained, individual patient experiences vary widely.
I’ve noticed that just talking to friends about the OTC pain killers they choose to take. People have surprisingly (to me, anyway) varied experiences with them.
A couple of my friends claim acetaminophen has no effect on them whatsoever. While I agree drugs have different effects on different people, I have my doubts.
Which I do, I take it nearly daily, and it is to control my arthritis.
Yeah, every so often I’ve been told i can’t take NSAIDs, “but you can take Tylenol”. My response (not out loud) is, “fuck you”. I could also take tic tacs. Less dangerous, and the strong flavor might distract me from my pain.
Yeah, for me, it seems just plain ol’ aspirin works the best. Tylenol seems to do okay with fever, not so much with pain. Naproxen I’ve taken for my back when I’ve had back pains and also for headaches when I couldn’t find anything else, and I swear it does nothing for me. Ibuprofen is my go-to when aspirin is not available, but it seems to work about half as well.
Very clearly, drugs are a matter of mileage varying a lot. I always assumed NSAIDs were pretty interchangeable (and I knew Tylenol was not one), but this thread shows me I’m not the only one for whom one works better than another.
Acetaminophen works for me for pain, but has a tendency to put me to sleep. I never said I was normal. 
Dorjan, this is all I really needed to know. Thank you.
Not an entirely bad idea. Clinical studies in analgesics are notoriously difficult because of the size of the placebo effect. I went looking for a useful cite and found this -
A wide and tantalizing body of research dating back to the mid-1950s has suggested that placebo
may play an important role in pain treatment (11,12). In randomized trials, patients improve on
placebo for a variety of pain conditions (13). Although controversial (14,15), this finding indirectly
suggests placebo effects administered via placebos promote analgesia. Disentangling the placebo
effect from other factors (e.g., assessment reactivity, passage of time) is critical to how we interpret
Randomized Clinical Trials.
(source)
- and I also found this, which is something I hadn’t come across.
The placebo effect has long confounded pharmaceutical company efforts in the development of new analgesic products. Experience has shown that while oral analgesic trials elicit some placebo response among subjects, placebo response rates tend to increase with transdermal gel or cream products and become excessively large with transdermal patch products. Thus, the placebo effect has become increasingly frustrating as drug companies seek to take advantage of the popularity and established safety of transdermal delivery systems. While transdermal opioids and amides have been successful in achieving market approval (likely because they are inherently stronger drugs and, in the case of opioids, are designed to work centrally and achieve a higher drug blood level) the same cannot be said of transdermal nonsteroidal anti-inflammatory drugs (NSAIDs).
(source)
Particularly interesting to me as achilles problems and arthritis have reduced me to scatter-hoarding ibuprofen gel. I don’t know about the US, but ibuprofen gel (and diclofenac gel) are OTC in the UK. So if your problems are like mine, why not join me in benefitting from a huge placebo effect (and a little bit of actual analgesia)?
(Slightly interesting aside: I have seen a (randomized, blinded) clinical study in which acetaminophen beat out morphine. Impressive, huh?)
j
I’ve heard great things about homeopathic placebos