A winning combination

Ten years ago, before I had a mastectomy I asked my friend Beth, a registered, nurse if she could recommend any over-the-counter (OTC) pain relievers that might assist me with pain management after surgery. I wanted to avoid taking opioids because they constipate me. She suggested I take an extra strength acetaminophen and ibuprofen every four hours. I told my doctors what she suggested, and they allowed me to try it.

Twenty-four hours after surgery I was back at the nursing home and found the extra strength pain reliever combination controlled my pain. I continued to take it for another two weeks then switched to regular strength pain relievers.

Eight years ago, I had surgery to remove cancerous lymph nodes. Again, I took extra strength acetaminophen and ibuprofen together to manage the pain.

Seven years ago, following chemotherapy and radiation, I began Faslodex injections to reduce my estrogen levels to deter the development of breast cancer cells. My monthly shot increased to twice a month and was injected in either my hips or thighs.

The injection sites got black and blue, swelled, and hurt. My resulting lower estrogen level caused joint pain. I explained to my oncologist how well the acetaminophen and ibuprofen combination helped my pain, and he said I could continue to use it during my treatments.

Two years ago, my need for pain relivers diminished after I completed treatment. I switched to regular strength pain relievers and only took them before bed.

More than two months ago, my nurse told me the pharmacist no longer wanted me to take acetaminophen and ibuprofen together. I asked why and she explained the pharmacist felt I was double dosing. I checked online for warnings about taking acetaminophen and ibuprofen in combination but found none. There were, however, warnings about taking multiple doses of the acetaminophen and ibuprofen combination.

I was concerned about changing the pain relievers I had relied on for so many years. They have worked well for me. My care team now gives me one ibuprofen at 4 p.m., an acetaminophen at 6 p.m., and another ibuprofen at bedtime. Since it is the same pain relievers just dosed differently, it still works.

I realize that my need for pain relievers may decrease and increase at different times. Even though I question the pharmacist’s concerns about double dosing, as long as it is effective for pain relief, I can live with the dosage timing change.

Topics: Clinical