Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.

Are Painkillers Safe to Take With Blood Thinners?

Tuesday, 03 Sep 2013 05:28 PM

By Peter Hibberd, M.D.

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Question: What can I take for arthritis pain? I take Tikosyn and Coumadin daily.

Dr. Hibberd's answer:
 
Arthritis treatment is tailored to the type of arthritis you have. I assume you have simple non-destructive non-erosive osteoarthritis, and usual the usual treatment recommendation when on Coumadin is to avoid aspirin, ibuprofen, and other NSAID drugs because the combination can increase gastrointestinal bleeding risks. 
 
Tikosyn is a powerful heart drug used to treat irregular heartbeat. It must be started or restarted in the hospital, and you have to avoid all drugs that may interact negatively with it, including many prescription and non-prescription medications. Among them: Tagamet, verapamil, Bactrim and sulpha drugs, oral antifungals, water pills, some antihistamines, and Compazine.
 
You can, however, consider Tylenol — 500 milligrams, four times a day — for pain relief. If this is insufficient, you will need to consider other options with your physician. Liniments may be safe, but there are many prescription oral, topical, and injectable agents that can be helpful despite your restrictions.
 
Make an appointment with your doctor for a review of your options or ask for a rheumatology consultation as well as a referral to a physiotherapist. 

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Dr. Hibberd's advice is based on more than 28 years of hospital work in emergency medicine and surgery.
 
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