Naproxen (from Diclofenac Sodium)

Hi,

After being on Diclofenac Sodium for over 3 years I haved switched to Naproxen. I have Ankylosing spondylitis.

After just 4 weeks I have found that the Naproxen does not manage the pain/symptons as well as the Diclofenac Sodium and that my heart rate has noticably increased to the extent that I'm now running around 45 to 60 seconds a mile slower

Anyone else had a similar experience or is it just me? Is this a typical (side) effect of Naproxen?

I'm seriously thinking about going back on to the Diclofenac Sodium despite its bad press. 

Hi there.
I'm certainly not medical, but....
Mr B Team has AS, and when he moved from diclofenac to naproxen he basically stopped taking it coz it didn't seem to help at all.  I know that is not evidence it doesn't work (far from it!!!) but just goes to reinforce that some meds work for some people in some circumstances and you are right to conisder whether it's the drug for you.
Is it your GP changing things or are you properly under the care of a hospital rheumatologist?  Maybe there are other options apart from going back to diclofenac - maybe the new anti-tnf  generation of drugs if you're lucky in the postcode lottery and your doctor is allowed to prescribe?

Also, just wanted to say am mega-impressed you keep running with AS - that can't be easy.  I took Mr B Team out once and thought I'd killed him he was in so much pain .

The B Team,

Thanks for your reply. Very interesting.

I actually asked my GP for a change, with having being on the diclofenac for well over 3 years albeit I have not really suffered greatly with the side effects. Tinnitus has been the main one that had plagued me. No known gastric or internal problems that I know of.

I was taking 2 x 50 mg of the diclofenac daily that pretty much kept me in check with mild/liveable discomfort. 2 x 250 mg daily of the Naproxen is taking me back the bad dark days of constant sciatic nerve pain. I have now upped my dosage to 3 x 250 mg and that seems to be more effective.

I am under the care of a Rheumatologist. I last saw him in Jan 08 and not due to see him again until Jul 09. So, my GP is my best course of action for a change in meds.

I'm sure that there will be other options other than the diclofenac and naproxen but I don't know what they are. My GP has always been very sympathetic to my wishes and opinions in the past so I's sure he'd change my meds again if I asked, but I'd rather go back with a recommendation than chance ending up back on something less effective again!

Completely understand - and glad that you have a good GP.  Not sure if you know about NASS - National Ankylosing Spondylitis Association?  They have links to some quite good information on their website about medications, and if you become a member (I think about £15 per year) they send out a really good newsletter a few times a year.  If you go to AS Research link down the left hand side of their website, it takes you to another website, and from the choice down the left hand side of that is a link to some information about medication (bit convoluted, but you get there in the end!).  If you become a member, you can log in via the website and by doing that you can access back copies of the newsletter.  I think most newsletters have some information about medication, so as a whole give you quite a good picture - more comprehensive than the website.   Email me if there's any problem with you joining, and I can send you copies of the newsletters.  Sorry, you probably already know about this and are a member so apologies for witteirng if I'm telling you about stuff you already know about.

 I also don't think there would be a problem with asking to see your rheumatolgist earlier to discuss medication options - I guess you were given a long gap to next appointment coz you were ok on diclofenac?  I wonder whether they would expect you to go back to discuss any major treatment changes - your GP can ask for an earlier appointment for you.  Not saying your GP isn't a good Dr, but they can't possibly be up to date with the latest situation with treatments for what is a comparatively rare condition.  Also, hopefully this year, NICE guidance should come out to say what standard treatments should be - that will hopefully change the access to treatments for a lot of people who are in areas where commissioners wouldn't pay the cost of expensive drugs - this may lead ot a change in your area that your rheumatologist will be aware of.

And another little thought, maybe 4 weeks isn't a long time in the big scheme of things - not sure if it's one of those drugs that takes time to build up in your system until it is properly effecitve?  Especially as a slightly higher does does seem to be having more of an effect?  I have no idea, so that may be gobbledegook!

And another thing - maybe it's not the naproxen raising your heart rate, maybe the diclofenac was artificially lowering it? .  Whatever, I'm sure your GP will want to know about any possible side effects, espeically if it's something to do with your heart potentially.

Thanks for the advice. I'm not a member of the NASS, but I really should be. I will join.

I haven't dug that deeply into AS as the symptoms have largely been controlled enabling me to churn out 50 to 70 miles a week with no adverse effect until I changed meds recently.

Plenty of food for thought. Once again, thank you for your time.

Hi Guys,

A little late in the year but i to suffer with AS too.  I am able to contact a nurse specialist via a hotline when things are really bad.

I also find that with GP's I am often telling them about the condition and asking them to prescribe stuff for me.  At the mo. I'm managing on 600mg ibuprofen, diclofenac doesn't always work for me, I think i may have got too used to it previously.

The NASS also organise hydrotherapy sessions with physios which are specific to sufferers.

But you probably know that already

hiya

Diclofenac IS more effective than naproxen

but as nadia says, management of AS isnt just about the painkillers