I have extensive bone mets that do cause me alot of pain, I’ve tried morphine (both liquid and slow release) but it makes me too queasy/drowsy so ive just been taking co-codamol and ibuprofen, this is not working enough so i saw doc who said to replace the ibuprofen with Naprosyn which i have to take twice a day, have only been taking for couple days but its still not giving me great relief… Has anyone else had experience of this pain med??
Im not sure whether to give it a while longer or go back to doc for something else!!
naproxen is basically the same as ibuprofen its not any stronger but like ibruprofen it works well in combination with paracetamol or paracetamol combination meds… and different meds can suit different people better so if it doesnt work for you there are alternatives like diclofenac and indometacin (according to the BNF this is superior to naproxen) but it may just be trial and error to get the right one for you… 60% respond to any NSAID nad the other 40% may respond better to one than another.
what strength of co-codamol are you on?.. they come in 3 strengths, 8, 15 and 30/500… so you can ask for the higher dose ones if your not already on them and you can take it 4 times daily…
naproxen is 250mg and can take it up to 4 times a day unless your taking 500mg twice a day… dont take more than 4 tablets in a day… but it maybe the dosage that needs to be adjusted rather than the meds.
also with NSAIDS like naproxen and ibuprifen they can cause abdo problems so always take after food, but if you develop symptoms you may have to stop them… or sometimes are given with omeprazole or similar to help prevent this.
lots of analgesia cause constipation too so you may need to be written up for lots of laxatives as the same time to help with that.
have you tried tramadol? its opiod based but not as many side effects as morphine so this may be an alternative.
can you ask to be referred to the pain team or are you already seeing them? if not they are experts in getting the right analgesia for you.
well it’s pain that has woken me up at this unearthly hour! Like you I have extensive bone mets, plus this wretched tumour beside my lower spine which is entwined around the nerves there. It is that really more than the bone mets that is at the root of my pain probs so I have tried quite a range of pain meds. I know we are all very different in the meds we need to get control of the pain. I also found I couldn’t get on with the liquid & slow release morphine specifically MST & oromorph. I did find I got on better with oxycodone - again the liquid & slow release forms. This worked ok for a while but then found I was needing a lot more, and the main problem for me was the sleepiness. I get on quite well with fentanyl patches now with relief for breakthrough pain with the tabs you put under the tongue or in the cheek. There is a range of strengths with the patches and they stay in place for 3 days before having to change them. But unfortunately for us I believe that bone is quite hard to control. Is yours in a specific area and have they suggested radiotherapy for it. I know some have really good relief from that. I have also had epidural nerve blocks for the spine pain. For me these haven’t really worked but it is all trial & error I think. Lucy suggested the pain team - my hospital has a very good one but I have more recently used the macmillan hospice near me to help with the pain control - they are very good and helping with this and may be worth asking your onc or gp for a referral.
Am hoping my pain relief is kicking in now so will say goodnight - if you want to chat more about anything do ask either here - or a pm.
I managed to speak to doctor and have altered meds, I already have the 30/500 co-codamol 6hrly but have gone up to 500mg naprosyn twice daily (it was originally 250mg which wasnt enough!) and oramorph for bedtime(which im not keen on but it does help with sleep), so far so good…well last night and today have been feeling much better.
Dawn i did have radiotherapy to the lumber region about 6mths ago, it helped for a while but doesnt feel like its made a difference now as pain is back, plus my recent mri has showed that the whole of my spine/ribs/pelvis/femurs etc is ‘full’ of cancer, so dont think radiotherapy would help. I guess its just getting my pain under control, was just unsure as to whether Naprosyn was any good…but will give it a go for a bit and if its not helping enough il go back again, its all trial and error i suppose til i find something that works for me.
Take care Tracey xx