'...Non-Steroidal Anti-Inflammatory pain medications (NSAIDS) such as ibuprofen (Motrin), naproxen (Aleve), Etodolac, celecoxib (Celebrex) are all effective medications for mild to moderate pain. However, all these medications also put increased stress on your kidneys. In PAH, the kidneys are already under stress from impaired right heart function. Taking these medications promotes fluid retention and can lead to abrupt worsening in kidney function and increased shortness of breath over a short period of time.
A safer alternative for mild to moderate pain is acetaminophen (Tylenol) (for me, Panadol). Even if you have some degree of liver disease, doses of 2,000mg per day are safe. If you don’t have any liver disease, doses of up to 4,000mg per day are safe. No more than 1,000mg should be taken at a time and no more often than every 6 hours. You should avoid alcohol if you take acetaminophen....'
Antibiotics with PH
'...Antibiotics are one of the most commonly prescribed medications. Unfortunately, most antibiotics prescribed for respiratory infections in the ambulatory setting are given to patients with respiratory viruses. Antibiotics have no activity against viral respiratory infections (except for Tamiflu for Influenza). At the same time, many PAH patients are taking warfarin (Coumadin). Antibiotics interact with warfarin in a way that results in warfarin being far more effective. The net result is that your blood will be too thin and the risk of bleeding will be markedly increased.
The solution to this problem is two-fold. First, avoid antibiotics for the common cold and other minor respiratory complaints such as acute bronchitis. Second, if you are taking warfarin, always remind your doctor and ask if the warfarin dose should be reduced. My practice is to reduce the warfarin dose by 50% for the duration of antibiotic use. I also check blood work to monitor warfarin more often if the course of antibiotics is prolonged....'
(Taken from here.)
- also, some antibiotics increase the efficacy of digoxin (for example), and doses must be adjusted - see below.
