Need a prescription joint pain medication that's safe for someone with heart issues

Any old narcotic would do. Norco is a common one.

As always - there is an upper limit to any drug beyond which it will be toxic.

A narcotic could be good for anything, not specifically for joint pain. How bout Diclofenac? It's an anti-inflammatory that is often prescribed to treat arthritis pain.

Lauram6123 said:

A narcotic could be good for anything, not specifically for joint pain. How bout Diclofenac? It's an anti-inflammatory that is often prescribed to treat arthritis pain.

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Not for patients with heart failure or MI

josephperin said:

Not for patients with heart failure or MI

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Aha. Just noticed that. Thanks for the correction.

Put them on naproxen.

Diclofenac can increase risk of heart attack. Naproxen or nabumetone are some options. I'd also look into other NSAIDs that are not over-the-counter. The Arthritis Foundation has good information on the different drug types: http://www.arthritis.org/living-with-arthritis/treatments/medication/drug-types/

A number of NSAIDS are not safe in patients with heart disease. Vioxx was withdrawn worldwide. Diclofenac went from OTC to prescription in UK for this reason. Nabumetone can also cause heart attacks. Naproxen is OTC.

That said, there are a number of people with heart disease on NSAIDS. They are told, or should be, that there is a possibility of cardiac adverse events. Very often, there is no perfect solution.

I am curious, how does your character plan to fake a heart attack? There are criteria to the diagnosis. I'd imagine the doctor is colluding with him.

If he's taking NSAIDs, then a heart attack might be expected by his son.

Jeff

According to the cardiologist I went to a few weeks ago, aspirin is the only anti-inflammatory that doesn't cause heart and kidney problems with long-term use.

However, aspirin doesn't work nearly as well as the others. I've gone from the "old man" walk to "Planet of the Apes."

Dave Williams said:

According to the cardiologist I went to a few weeks ago, aspirin is the only anti-inflammatory that doesn't cause heart and kidney problems with long-term use.

However, aspirin doesn't work nearly as well as the others. I've gone from the "old man" walk to "Planet of the Apes."

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Your cardiologist is 100% accurate

josephperin said:

Naproxen is OTC.

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Naproxen can also be prescribed.

Steroids help joint pain flares, but injections in clinic would be the more likely use, especially for someone with other issues. You avoid longterm oral steroids if possible.

Gold salts are a little old school but quite effective in about 1/3 to 1/2 of people with arthritis, particularly rheumatoid arthritis. They can be hard on the kidneys or bone marrow (rarely), but there are not cardiac-specific side effects. At least, not heart-damaging--it can slow the heart rate or cause flushing, but that's uncommon, and it isn't damaging to the heart itself. Also, the oral version has fewer side effects than ingested.

There are other oral meds like penicillamine, but those are for even more severe forms of arthritis. If you want something that points to joints, has no cardiac counterindications, and is taken by mouth, I think gold is a reasonable option. This would be most likely used in someone with significant pain who was in the relatively early stages of arthritis.

More on gold for arthritis from UW at http://www.orthop.washington.edu/?q=patient-care/articles/arthritis/gold-treatment.html