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Having ankyllosing spondylitis and crohns disease. Suggest some effective medicine

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Hi, I have Ankyllosing spondylitis and Crohns disease diagnosed within the last 4-5 years. The AS is severe and progressing quickly with enthesitis throughout my peripheral limbs and no movement left in the ribs, chest and lumbrel region of my spine, My Crohn's is currently in remission. I have taken Humira for three years and am on 40mg injections every 10 days and I also inject 25 mg Methotrexate every week and take naproxen 250-500 mg 2 or 3 times a day. I initially was on Remicade infusions but had an adverse reaction after the fourth dose (reported). I have been taking endocet 5mg for a year and a half which helps with chronic pain but I am up to 8-10 per day. I would like to try Enbrel but Rheumy says to stay with Humira. What other pain medication options are there as Oxycontin are no longer available and Oxyneo is hard to get with all the new rules.
I forgot to mention I am allergic to Sulfonamides , so no sulfasalazine or Celebrex
I just want some relief from constant pain. And I do stretch and do light exercise when possible.
Posted Wed, 15 Aug 2012 in Bones, Muscles and Joints
 
 
Answered by Dr. Anil Grover 1 hour later
Hi there,
Thanks for writing in.
I am a medical specialist with an additional degree in Cardiology.
What I gather from your mail which I read with diligence is that now the disease is in remission, you are being given Endocet (apparently you have some tolerance to it) and you want a good substitute pain medication. The available medicine (with usual rules for narcotic analgesic, it is only on prescription and to be used by the patient it is written for; one has tendency to develop dependence and tolerance) is :
Roxicodone
Generic Name: Oxycodone
Brand Name: Examples include OxyIR and Roxicodone
If you have been prescribed narcotic analgesics before then there is little chance of allergy to it. You can speak to your doctor if he is willing to prescribe. Again use it as and when needed basis to avoid dependence. Unfortunately, it is strong analgesics with severe withdrawal symptoms so be careful. Pharmacist will list all the side effects once it is prescribed.
If there is any other query I will be happy to answer.
With Best Wishes
Dr Anil Grover,
Medical Specialist & Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Above answer was peer-reviewed by
 
Follow-up: Having ankyllosing spondylitis and crohns disease. Suggest some effective medicine 2 hours later
you say the disease is in remmission , which one? the autuimmunne diseases I have that are in remmission are pemphigus and the crohn's ileitis. My Ankylosis Spondylitis is not in remmision and is quite active all the time causing alot of pain despite the Biologic Humira which is not working as well as it used too and the same with the DMARD methotrexate. And I cannot take large doses of NSAID's before I irritate my bowels. My rheumatologist does not want to try the other two available Biologics, Enbrel or Simponi because they are not approved for Crohns disease, but crohns is not the problem now. I do get relief from the Endocet but worry about all the acetaminephen that it is combined with causing liver problems at prolonged usage. What about hydromorphone or fentanyl.
 
 
Answered by Dr. Anil Grover 1 hour later
Hi there,
My mistake. Sometime you type opposite of what you mean. I apologize for the same.
I am beginning to get the picture and wish you luck to fathom these illnesses too.
Fentanyl is a narcotic analgesic and you are not allergic to this group. If your doctor prescribe it should be taken for you have a point about liver disease. I checked on net for Canada and availability of the drug. What I gather is only for transdermal patches you have to hunt for pharmacy where it is available but the drug is otherwise available with usual stipulations of doctor's prescription and to be used by the person for whom it is written. The kind of precautions you would expect with a narcotic analgesics. Please go ahead, if in this century we can not relieve a patient of most irritating symptom PAIN it is shame on us medical professionals.

Again regretting the mistake I made, if you have any question I shall happily answer it. (and thanks for correcting me) Regards
Best Wihses

Dr Anil Grover,
Medical Specialist & Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Above answer was peer-reviewed by
 
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