Diclofenac long term anyone?

[toomuch2young]

I was wondering if anyone else is taking diclofenac on a regular permanent basis and if you do, have you also been prescribed omeprazole or a stomach protector? I take 50mg 3 times daily.

When I was first given it 12 months ago at a hospital discharge they sent me with omeprazole as well and said important to take one daily when taking diclofenac, to prevent stomach ulcers.

My gp gave me repeat prescriptions for it but when I asked him he didn't think omeprazole was required.

Obv I dont want to argue with gp but I want stomach problems even less!

An advice or opinions?

If you don't get any indigestion or heartburn then maybe you just tolerate it well? Having it with meals helps too.

Not everyone taking it will get stomach ulcers of course, but some gastric irritation is common.

I was on diclofenac for quite a while and was told to make sure I took the tablets with food. I remember my GP giving me dire warnings about long-term use and stomach problems but at the time I didn't care, I just needed my back to stop hurting. He never prescribed a stomach protector though - am wondering now why not if he was so concerned about the effects of diclofenac!

Has the Dr prescribed enteric coated pills? If your pill box says ec at the end then you don't need anything to protect your stomach as the pills are designed not to disolve in the stomach.

I was prescribed omneprazole to take with diclonfenac for my first frozen shoulder 5 years ago .
But not for this one .

I personally think ( experience of friends and family ) that you should take omneprazole .

I wonder if cost is a factor ,as it's quite expensive .

I'm really sorry to suggest this but if you're on diclonfenac long term I would revisit GP and explain about your heartburn and indigestion .

If you aren't having problems, then omeprazole isn't needed. I get heartburn after a day of NSAIDs, so do need it

If you're concerned and your GP doesn't want to px omeprazole or similar, have you thought about asking for the diclofenac in suppository form? Works much better and eliminates the worry about it upsetting your stomach.

I was prescribed lansoprazole with diclofenac when dislocated shoulder.

I do think it's better to be safe than sorry.

long term diclofenac has been linked with heart disease. In other countries, you can have max 2 year on the stuff before you have to go on something else.

I would definitely recommend taking omeprazole or similar. The number needed to treat to prevent NSAIDs related problems is only 3 so it is a very effective treatment and There are 12,000 hospital admissions and 2,600 deaths from NSAIDs related complications according to bandolier.

I have been taking it for 8 years and never had any issues but my friend who is a doctor told me to ask for a stomach protector and I now also take Lansoprosol.

Hi I have fybromyalgia and was prescribed diclofenac years ago along with omeprozole to stop the stomach problems, as it can cause ulcers. My doc was insistent that I took both together, I could not take one without the other as it gave me severe stomach pains, eventually I gave up the tablets and use the diclofenac cream version which does not seem to upset my stomach so much. Obviously if you pay for prescriptions it is a pain, but my doc prescribes 2 months at a time and this make it a bit easier on the pocket.

Ok thanks for the advice and opinions. Just to clear up I haven't been having any indigestion problems just was worried about longer term effects.
Will mention to gp next time definately or see if my neuro will do it.
I have a pre payment cert so cost isn't an issue to me I already rattle so whats one more

I took Diclofenac for nearly a year for back pain. My stomach is an absolute mess now. Pretty much constant stomach pains and under investigation for stomach ulcers. I do take something for it now, but it feels like too little too late!

You shouldn't need omeprazole long term with diclofenac unless you have other risk factors - elderly, indigestion, stomach ulcer history or are taking other medications like aspirin.

Why not, PenguinFeet? I was told the opposite by my consultant, though Diclonfenac on its own had given me a stomach ulcer.

Agree with you Imperial. I work for the NHS and one of our priorities at the moment is safe prescribing of non-steroidal anti-inflammatories because of the sort of evidence cited upthread. We recommend Lansoprazole or Omeprazole with all NSAIDs and generally Ibuprofen and Naproxen are safer than Diclofenac.

I'm on tramadol and my gp rang me after I was there and advised me to take lapramazole? too, if you get 2 or nore prescriptions a month the £10 dd (if in England) prepayment certificate is worth considering saves me a fortune!

Related but slightly off topic - HP's prescribing drugs need to be a bit more vigilant about interactions between what someone is already taking .

I read leaflets ,and google ,so I know that it's not ( for example ) recommended to take SSRI AD's with stuff like diclofenac.

But lots of people don't .

Also, diclofenac in suppository form can still upset your stomach. I was crippled with stomach pain after taking it and read the leaflet where it tells you this can happen. This was even with the omeprazole.

Ooh, I have been on it for years, 75mg slow release twice a day, and lots of other pain type pills too.

I take nothing stomach protecting. Is this not great then, should I be asking GP next time?

Can the effects not be sudden and build up instead?

I used to take this med years ago but it stopped helping my pain so my PM dr suggested celebrex instead. I also used to take Lanzoprazole as I'm also on other medications & the combo upset my stomach. Lanzoprazole eventually stopped working & I'm now on Pantoprazole. Stomach issues now generally under control and so is my pain.

If you have any stomach issues/heartburn then you need to look to taking a stomach lining protector & also take all NSAIDs after eating. Best wishes OP

lookbut
If it has 'EC' on the box you are taking something to protect your stomach.

Well I'm definately asking about it next appointment. Mine don't say ec on the box and defo don't fancy supositories. Its only effective NSAID for me as naproxen makes me vomit an ibuprofen doesn't work effectively.
I worry about interactions too as Im also taking 3 other prescription drugs. Good job stopped citalopram! Nightmare!!

Thank you again and hopefully other people will benefit now and can ask the doctors!!

EC means that it has an enteric coating on the tablet. This is supposed to remain intact in acid (in the stomach) and dissolve in alkaline (in the small intestine) but there is some debate about the effectiveness of these coatings. There seems to be a lot of evidence that they are not particularly effective so many drugs (like prednisolone) are no longer used in the coated form.

More modern practice seems to be to prescribe uncoated tabs with a stomach protectant.

I will be asking too next time I go. No 'EC' on any of my boxes and there are a few, hence my concern.

Thank you.