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The most powerful prescription-only Anti-Inflammatory? Piroxicam 20mg, Naprosyn 1000mg, Indomethacin 25mg, Ketoprofen 200mg, Ketorolac 10mg?

I'm currently medicated with Piroxicam 20mg, once a day. Before that, I was on Ketorolac, but my GP said that you cannot be on that one for more than 5 days- 7 days maximum. Are the other three anti-inflammatories stronger than Piroxicam? Is there an anti-inflammatory as powerful as Ketorolac, that can be used for long-term chronic pain conditions? Any other anti-inflammatories stronger than Piroxicam that I can use long-term that have not been listed here? I have chronic pain, so I need a once a day Sustained release dose. If I have to I can dose twice a day- but it needs to be strong. I won't touch Opiate analgesics. Too addictive. Thanks for your help folks.

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The NSAID class of drugs kill over 20,000 people a year. The problem with them is that they can cause severe ulcerations of the stomach, and the gastrointestinal tract. The pill forms will sometimes attach themselves to the lining of the GI tract and "burn" a hole in it (ulceration). This can cause you to bleed internally. If it ulcerates an artery then you can bleed to death very quickly. I would be very wary of taking any high powered form of the NSAID class of drugs over a long period of time. I cannot take them at all without severe discomfort. If you have to take them for any length of time then be sure to eat first and to drink plenty of water with each dose.

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The only form of NSAID that I can take is injectable Toradol. It can only be administered in a clinical setting and is not available through prescription. The injectable form is inserted in the buttocks muscle region. This form of dosage allows it to go through the GI tract slower and is less likely to cause GI tract discomfort. Your doctor cannot give you but only a few shots of this medicine a month. However: Toradol does come in a pill form that is available by prescription. I have never taken that form but I would assume that the same GI tract risks would apply. You might try the pill form of the Toradol and see if it provides you any relief. Good Luck.
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Pain is typically caused by nerve damage or more often, inflammation. Non- steroidal anti-inflammatory drugs work well to reduce inflammation dramatically - but they can wreak havoc with your stomach and GI tract - I know doctors that co-prescribe a drug that protects your stomach - but there's no guarantee this will work for you in particular. I get why you are avoiding opiates - they actually don't kill the pain like NSAIDs - they change your cognition of the pain signals. I've had some powerful opiates for different problems over the years, for ear-infections to broken bones playing sports - they never "took" with me as far as instigating addiction - but that's not true of most people - prescription pain killers have now exceeded abuse over heroin and cocaine combined. Talk to your doctor about your concerns for organ damage (ulcerations) to your stomach - as well as explore another highly effective non-addictive pain management therapy: accupuncture. It has worked for me and several people I know that have chronic pain - only alleviated without external drugs - by accupuncture treatments.

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