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Arthritis Pain Reliever May Aggravate Ulcer

Q. Five years ago I developed duodenal ulcers after taking Fosamax for six weeks. I was also taking ibuprofen for headaches at the same time.

Last year, after taking baby aspirin for a few months, an endoscopy revealed more ulcers. I was diagnosed with H. pylori and treated with antibiotics.

I have bad osteoarthritis pain in my right knee and hip and would love to take ibuprofen instead of Tylenol, but I don't want to take omeprazole long-term and don't want to risk another ulcer.

Since the H. pylori is gone, could I risk the ibuprofen? Or is there some other agent I could take that would relieve the pain without causing ulcers?

A. The combination of Fosamax with the nonsteroidal anti-inflammatory drug (NSAID) ibuprofen was a prescription for trouble. Both medications can cause ulcers. A study of Fosamax together with a different NSAID, naproxen, showed that ulcers were more likely in women taking both medicines (Archives of Internal Medicine, Jan. 8, 2001).

Helicobacter pylori (H. pylori) is a stomach infection that increases the risk of ulcers. Even without H. pylori, you might still be susceptible to ulcers if you take aspirin or an NSAID.

We are sending you our Guides to Digestive Disorders and Alternatives for Arthritis, with information on arthritis drugs that are less likely to cause ulcers as well as non-drug approaches to relieve arthritis pain. Ask your doctor about either Disalcid or Trilisate, anti-inflammatory drugs that are less likely to cause stomach irritation.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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