A Short Guide to Fibromyalgia

By Daniel J. Wallace; Janice Brock Wallace | Go to book overview

10
Medicines for Fibromyalgia

ARE ASPIRINS OR NSAIDS BENEFICIAL?

NSAIDs and aspirin block the actions of a chemical known as prostag⁃ landin that is responsible for some of the pain and inflammation of arthritis. Most fibromyalgia patients are familiar with these prepara⁃ tions, which are listed in Table 11. Preparations such as Advil, Aleve, or Orudis KT are available without a prescription.

Although these drugs are not dramatically effective in managing fibromyalgia, placebo-controlled, double-blind trials have shown that ibuprofen (the active ingredient of Advil and Motrin) and naproxen (Naprosyn, Aleve, Naprelan) in combination with other fibromyalgia remedies decrease pain in patients with the syndrome. They also alle⁃ viate premenstrual syndrome complaints, joint aches, and headaches. Doctors managing fibromyalgia patients recommend that these agents be used in any of several ways. First, they may be used on an occa⁃ sional as-needed basis for pain breakthroughs. In this instance, blood counts need to be checked once or twice a year. Second, an NSAID may be prescribed on an ongoing, regular basis. In this case, patients should visit their doctor every three to four months and have labora⁃ tory testing, including a blood count, and liver and kidney function screening. Third, pharmacists are now making NSAIDs as gels or salves (particularly diclofenac and ketoprofen) that can be applied to painful areas. Aspirin-containing preparations such as BENGAY have been available for some time.

NSAIDs and aspirin are not without side effects. Patients who take these agents on a regular basis may experience fluid retention, bloat⁃ ing, upset stomach, diarrhea, or constipation. Ongoing administration requires checking patients for gastrointestinal ulcers, liver and kidney function, and rashes. The newer generation of selective cox-2 block⁃ ing NSAIDs (e.g., celecoxib, rofecoxib) are probably safer than older agents by producing fewer gastrointestinal bleeds or ulcers. In 1998, in the United States, 3 percent of regular NSAID users annually had

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