Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

Advil - limits to dosage and duration?

Posted by Jan on 9/15/00 at 12:35 (028293)

I am PF-er for 1 year and have tried: massage, ice, rest, orthotics, velcro boot (for 3 months), ultasound, electro-stim, indocin (for 1 week), vioxx (12.5 mgs for 2 weeks) and stretching all to no avail.

If I take 1600 mg of advil I have some pain reduction. When I was first diagnosed, my primary care practitioner said 'try up to 2400 mg for 1 week.' I was in an acute stage at that point and continued to walk around so of course, it didn't help.

However, now that I've reduced walking, advil does help. But of course, a week is not long enough. Is there a limit to the dosage and the length of time I can take nsaids? My pod. says it's just a matter of breaking the inflamation cycle by whatever means works.
Can that mean nsaids? Or are nsaids simply masking pain and really not helping solve the problem?

I've had to do several courses of relafan for pleurisy before. Can I just approach PF the same way, with longer term nsaids at higher doses? What are the long term consequences?

(ps, so far it's not bothering my stomach but I did notice when the effects of alchohol were magnified but I can do without that anyway.)

Re: Advil - limits to dosage and duration?

Dr. Biehler on 9/15/00 at 12:45 (028294)

As with all NSAIDs the stomach is usually where the problems start with gastritis and internal bleeding. This is a very serious problem in the elderly. Other then that, NSAIDs do have an effect on your other organs and if you are going to be taking them long term you need frequent blood tests to monitor your liver enzymes and to make sure other organ systems are not been effected. This is assuming you are not already suffering from some other system problems like heart, etc. While taking the NSADs you have to remove the cause of the problem of your pf either through tapping,strapping,orthotics, etc. if you don't you are just wasting your time and making it easier to injure your foot.

Re: Advil - limits to dosage and duration?

T. Hurst on 9/15/00 at 20:09 (028333)

I am on 2400 mg ibruprofen per day every since my surgery 7 weeks ago. All of my docs have ok'd this dosage as being below that which can impact your liver. I have too many side effects from other anti-inflamatory drugs. I don't plan to do this forever, but for the short-term. I tried this before surgery also to alleviate pf symptoms, with little effect from either the ibuprofen or the perscription anti-inflammatories. Like Dr. Beihler said - you have to address the cause. Have you tried custom orthodics? I think they are key - this won't go away unless you can prevent the pulling on the fascia.

Re: Advil - limits to dosage and duration?

Jan on 9/15/00 at 20:26 (028336)

Yes, of course I'm still doing the required orthodics, ice, rest etc. So am I still wasting my time with the nsaids if I'm doing all the other stuff and those 'treatments' haven't worked?
Surgery's my last resort and at this point, the only thing I haven't tried.

Re: Why would a person be on this drug when Vioxx and Celebrex are available?

Beverly on 9/16/00 at 17:26 (028399)

Perhaps I am missing something. I am just a patient and not a medical person. But why would anyone be put on such high doses of Advil or IBU when safer drugs like Vioxx and Celebrex are available?
Beverly

Re: Ibuprofen tends to produce less side effects

T. Hurst on 9/16/00 at 20:28 (028423)

I wouldn't think perscription anti-inflamatories, like you mention, would be 'safer' -why? (maybe a doc can answer that). Many people have side-effects to them, like stomach-irritation. From what I know, liver problems can develop with either, but are repeatedly reported with the perscription anti-inflams. I view ibuprofen as a relatively safe, cheap, effective way to deal with pain and promote healing. It's funny, I got a migraine a couple days ago and stopped my ibuprofen because I was taking excedrin (acetominophin and aspirin combo). All of the sudden my feet hurt!!! I thought the ibuprofen was just preventitive on my part, but evidently it is keeping the pain at bay. Since I'm not a doc....and this ibruprofen regime is working (2400 mg/day)...HOW LONG CAN I CONTINUE THIS? It's been 7 weeks so far.

Re: Ibuprofen tends to produce less side effects

wendyn on 9/16/00 at 20:37 (028424)

Advil works better for your pain than tylenol because it also helps with inflammation. Any anti-inflammitories including over the counter versions - can have risks and side effects. The new prescription Vioxx and Celebrex are different and are supposedly less likely to cause GI bleeding.

Perhaps one of the good doctors can help with safe dosing...but isn't this something you've talked about with your own doctor? If you just had surgery - the surgeon should have discussed pain treatment with you at some point.

I doubt that there is any guarantee safe point on a high dose of IB, the longer you're on and the more you take - the more the risk.

Re: Ibuprofen tends to produce less side effects

Dr. Biehler on 9/17/00 at 07:20 (028448)

Ibuprohen: dose 400 mg ever 4 to 6 hours as needed. A dose greater than 400 mg has not been shown to provide greater relief from pain. For self medication a dose of 200 mg should be used and not to exceed 1200 mg a day unless directed by your doctor and should not exceed 10 days.

Re: Advil - limits to dosage and duration?

Dr. Biehler on 9/15/00 at 12:45 (028294)

As with all NSAIDs the stomach is usually where the problems start with gastritis and internal bleeding. This is a very serious problem in the elderly. Other then that, NSAIDs do have an effect on your other organs and if you are going to be taking them long term you need frequent blood tests to monitor your liver enzymes and to make sure other organ systems are not been effected. This is assuming you are not already suffering from some other system problems like heart, etc. While taking the NSADs you have to remove the cause of the problem of your pf either through tapping,strapping,orthotics, etc. if you don't you are just wasting your time and making it easier to injure your foot.

Re: Advil - limits to dosage and duration?

T. Hurst on 9/15/00 at 20:09 (028333)

I am on 2400 mg ibruprofen per day every since my surgery 7 weeks ago. All of my docs have ok'd this dosage as being below that which can impact your liver. I have too many side effects from other anti-inflamatory drugs. I don't plan to do this forever, but for the short-term. I tried this before surgery also to alleviate pf symptoms, with little effect from either the ibuprofen or the perscription anti-inflammatories. Like Dr. Beihler said - you have to address the cause. Have you tried custom orthodics? I think they are key - this won't go away unless you can prevent the pulling on the fascia.

Re: Advil - limits to dosage and duration?

Jan on 9/15/00 at 20:26 (028336)

Yes, of course I'm still doing the required orthodics, ice, rest etc. So am I still wasting my time with the nsaids if I'm doing all the other stuff and those 'treatments' haven't worked?
Surgery's my last resort and at this point, the only thing I haven't tried.

Re: Why would a person be on this drug when Vioxx and Celebrex are available?

Beverly on 9/16/00 at 17:26 (028399)

Perhaps I am missing something. I am just a patient and not a medical person. But why would anyone be put on such high doses of Advil or IBU when safer drugs like Vioxx and Celebrex are available?
Beverly

Re: Ibuprofen tends to produce less side effects

T. Hurst on 9/16/00 at 20:28 (028423)

I wouldn't think perscription anti-inflamatories, like you mention, would be 'safer' -why? (maybe a doc can answer that). Many people have side-effects to them, like stomach-irritation. From what I know, liver problems can develop with either, but are repeatedly reported with the perscription anti-inflams. I view ibuprofen as a relatively safe, cheap, effective way to deal with pain and promote healing. It's funny, I got a migraine a couple days ago and stopped my ibuprofen because I was taking excedrin (acetominophin and aspirin combo). All of the sudden my feet hurt!!! I thought the ibuprofen was just preventitive on my part, but evidently it is keeping the pain at bay. Since I'm not a doc....and this ibruprofen regime is working (2400 mg/day)...HOW LONG CAN I CONTINUE THIS? It's been 7 weeks so far.

Re: Ibuprofen tends to produce less side effects

wendyn on 9/16/00 at 20:37 (028424)

Advil works better for your pain than tylenol because it also helps with inflammation. Any anti-inflammitories including over the counter versions - can have risks and side effects. The new prescription Vioxx and Celebrex are different and are supposedly less likely to cause GI bleeding.

Perhaps one of the good doctors can help with safe dosing...but isn't this something you've talked about with your own doctor? If you just had surgery - the surgeon should have discussed pain treatment with you at some point.

I doubt that there is any guarantee safe point on a high dose of IB, the longer you're on and the more you take - the more the risk.

Re: Ibuprofen tends to produce less side effects

Dr. Biehler on 9/17/00 at 07:20 (028448)

Ibuprohen: dose 400 mg ever 4 to 6 hours as needed. A dose greater than 400 mg has not been shown to provide greater relief from pain. For self medication a dose of 200 mg should be used and not to exceed 1200 mg a day unless directed by your doctor and should not exceed 10 days.