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Arthritis meds.

Discussion in 'Diving Medicine' started by kona Mark, Mar 14, 2019.

  1. kona Mark

    kona Mark Garibaldi

    # of Dives: 1,000 - 2,499
    Location: Wilbur, Washington
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    Hi
    I am looking for some information on safe RX meds to try for arthritis and CPPD. Doctors are wanting me on leflunomide. I tried Methotrexate but had reaction. My concern is taking and diving. We dive a lot 100 plus dive in summer months. Doctors don't seem to want to advise me on this Any suggestions/ advise/ help etc.. Thanks in advance,Mark
     
  2. The Chairman

    The Chairman Chairman of the Board

    # of Dives: I just don't log dives
    Location: Cave Country!
    52,930
    19,267
    113
    Great question, but moved to a more appropriate forum! I deal with arthritis and limited movement every dive. it sucks, and I would love to find a med that would ease my pain and be safe. Celebrex was wonderful in alleviating all the pain, and then I was allergic to it.
     
  3. flyboy08

    flyboy08 ScubaBoard Supporter ScubaBoard Supporter

    # of Dives: 500 - 999
    Location: NYC
    2,635
    1,539
    113
  4. Duke Dive Medicine

    Duke Dive Medicine Medical Moderator Staff Member

    2,138
    1,604
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    Hi Mark,

    Unfortunately there isn't much research on medication and diving, so the questions typically center around the underlying disease process, i.e. why you're taking the medication, how that disease process could affect diving, and whether the side effects of the medication could present problems during diving. Things that raise eyebrows right away are opioids, depressants like benzodiazepines, certain chemotherapy medications, and medications that can lower the seizure threshold. I'd recommend you review the common side effects of leflunomide with your physician and discuss whether those could be problematic. If you haven't started taking the drug yet, you'll want to wait until you've been stable on it for a while to see how it affects you, since individual responses vary widely. Sorry there's not a more specific answer for you.

    Best regards,
    DDM
     
    Akimbo likes this.
  5. lowflyer

    lowflyer ScubaBoard Supporter ScubaBoard Supporter

    # of Dives: 200 - 499
    Location: SW
    314
    164
    43

    A multitude of questions come to mind regarding your arthritis situation, the answers to which would determine whether Leflunomide is indicated in your treatment and whether there are alternatives.

    Leflunomide requires careful monitoring. The potential but rare side effects of Leflunomide that would affect diving would be elevated blood pressure and pulmonary fibrosis. More common side effects involve liver and skin, etc. Regular blood work and physical exams are mandatory taking this drug, which would be stopped if side effects emerged.

    The short answer is that if you have no side effects from Leflunomide you should be able to dive. Impossible from afar to suggest alternatives. If you are seeing a rheumatologist, he would be in the best position to advise, not the internet. Luck be with you!
     
  6. Asheron

    Asheron Nassau Grouper

    # of Dives: 200 - 499
    Location: NORCAL
    85
    26
    18
    I have been on Enbrel for many years and never had a problem. Information is pretty scant.
     
  7. drk5036

    drk5036 Angel Fish

    # of Dives: 25 - 49
    Location: Sapporo, Japan
    59
    21
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    Maybe you're beyond what NSAIDs can help with, but I've had Reactive Arthritis (a different kind of beast), and for me at least, diclophenac (voltaren) has been much more effective than other NSAIDs such as ibuprofen, naproxen, or celebrex. If you feel some relief with NSAIDs, try asking your doctor to try diclophenac. Max daily dose is 150 mg. Switching from 2400 mg/day of ibuprofen to 75 mg per day of diclophenac, i experienced tremendous relief. 100 mg / day and I could live my life basically as normal. Just one person's experience.
     
  8. Protondecay123

    Protondecay123 Nassau Grouper

    # of Dives: 0 - 24
    Location: Arkansas
    192
    98
    28
    I had what was initially diagnosed as Psoriatic Arthritis. I progressed from Sulfasalazine monotherapy to Methotrexate with Naproxen to keep the outbreaks of pain, redness and swelling at bay. I switched my Rheumatologist to the VA. She got me on a Gluten Free diet and I'm almost 1 year free of the dual therapy regimen ( I take no meds what so ever) with no outbreaks. She was suspicious that it was reactive arthritis because my feet and knees were always where the outbreaks were. Never my hands. I was completely shocked that something like gluten in my diet could be causing all of that pain, redness and swelling.
     
  9. drk5036

    drk5036 Angel Fish

    # of Dives: 25 - 49
    Location: Sapporo, Japan
    59
    21
    8
    Really? How did you start, just cold turkey (no pun intended) gluten free? And how long till you saw results? Right now my condition is 99% of normal, but if I have issues in the future it’s worth keeping in mind...
     
  10. Protondecay123

    Protondecay123 Nassau Grouper

    # of Dives: 0 - 24
    Location: Arkansas
    192
    98
    28
    Well it started by switching diet for about a month and then removing the Naproxen mainly because of kidney issues on long term use. I was without Naproxen for about 3 months with no outbreaks and then stopped Methotrexate. That was almost a year ago and still no outbreaks. The usual spot was my left anterior tibialis tendon insertion (enthesis) on the navicular for an outbreak. But i had to give up beer. That hurts.
     

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