Pain Meds on Prednisone

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Pain Meds on Prednisone

Question:

What can I take for pain when I am on prednisone? Can I take over-the-counter medicine like Advil, Tylenol, or Motrin?

Answer:

Prednisone is a corticosteroid medication that has powerful anti-inflammatory properties. If your pain is due to inflammation, pain may be rapidly relieved with prednisone treatment; additional pain therapy may not be necessary in these situations. For example, people with rheumatoid arthritis often take a low dose of prednisone to relieve pain from inflamed joints. Often (but not always), people with rheumatoid arthritis taking prednisone need no additional pain relievers. Side effects, such as increased blood sugar, weight gain, weakened bones and immuno-suppresion, are an important limitation to steroid therapy.

Just about any pain reliever can be taken with prednisone. However, for the medications you asked about, it's important to know about some interactions. For example, non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (the active ingredient in Advil and Motrin), are associated with an increased risk of stomach ulcers, and this risk is increased even more when combined with prednisone. If prednisone treatment is going to last for more than a week or two, many doctors will avoid the addition of an NSAID. Or, if prescribing both medications, they may recommend an additional medication, such as omeprazole (Prilosec) to protect the stomach.

Acetaminophen (Tylenol), tramadol (Ultram) and codeine-type medications can be taken with prednisone if needed. Keep in mind that many pain relievers, such as Percocet, Ultracet and Vicodin, also contain acetaminophen.

You are wise to ask about drug interactions and to be concerned about medication side effects when taking something as powerful as prednisone. Talk to your doctor about what medicines you can take and which you should avoid.

Robert Shmerling, M.D., is associate physician and clinical chief of rheumatology at Beth Israel Deaconess Medical Center and an associate professor in medicine at Harvard Medical School. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program and has been a practicing rheumatologist for over 25 years.

Last updated:	July 20, 2009