Do you believe that we
have survival instincts? Surely, this is one of the controversial psychological
and physiological topic that garnered controversy. Nowadays, it is almost
explainable by a solid scientific proof.
Pain and stress are
two of the aspects of our fight-and-flight mechanism that can force us to do
something about what is causing them. At times, they come as a powerful
combination when pain is the root cause of stress. However, there can be these
unfortunate times that no matter how much we desire to remove the pain, we can
do nothing. One such instance is during gout attacks. Surely enough, the pain indicates
that something is not supposed to be in there, but we are left helpless. We
can’t just cut our limbs off to remove the pain. Hence, the idea of taking
multiple medications to ease the pain was born (even if those medications were
not prescribed at all).
This article aims to
answer the question “can I take colchicine and ibuprofen together?”
Ibuprofen
Ibuprofen is a
non-steroidal anti-inflammatory drug. Ibuprofen lessens your pain by messing up with your enzymes. To
understand this, we should first understand how pain works.
Throughout our body,
there are nerve cells called nociceptors. These nerve cells are like an alarm
system of your body. Whenever something undesirable happens (such as when
neutrophils can not ingest uric acid crystals, which is impossible for them to
ingest anyway), they fire signals to the brain if the undesirable happening
breached the “pain threshold”. Take a look at this scenario:
I have a 5L container
of water (think of this as the “amount” of pain). If I will transfer them all,
of course I need containers totaling 5L in volume. Unfortunately, I only have containers
with 3L in total (think of this as the pain threshold). If I try to transfer
all of the water, some of them will spill (breaching the threshold) and I will
be forced to do something (pain signal to the brain).
Now, what if for some
unexplained reason, one of my containers vanished and I only have 2L containers
left? The water will spill faster as I only have less space, and I will be
forced to do something earlier. (pain threshold lowers and signals are fired
earlier) That is what happens when enzymes are fired to the nociceptors. For
instance, when the neutrophils fail to dissolve uric acid crystals, this causes
them to release arachidonic acids which will then trigger the release of prostaglandins
which will be manufactured by Cox-1 and Cox-2 into several other substances
that triggers pain and inflammation.
If the above statement
ever dizzied you, you can take a look below:
Neutrophils fail to
dissolve crystals-> Arachidonic acids released -> Prostaglandins released
-> Prostaglandins processed by cox1 and cox2-> pain and inflammation
kicks in
Itching to answer the
question “can I take colchicine and ibuprofen together” yet? Chill. To have a
sensible answer, we should understand the mechanism of ibuprofen first.
Ibuprofen stops your
pain by binding with cox1 and cox2 thus disrupting the transformation of
prostaglandins. Hence, pain and inflammation fails to start. On the other hand, colchicine binds
with neutrophils disrupting its reproduction. It also disrupts the cytoskeleton
of the neutrophils thus it can not try to dissolve the crystals. No neutrophil
problem means no pain.
Can I Take Colchicine and Ibuprofen Together?
Now, for the most
awaited answer. YES! You can, but it will not be as effective as increasing the
dose. Statistically speaking, colchicine and ibuprofen has no proven
interaction. However, since the neutrophils no longer respond to the uric acid
crystals, arachidonic acids will not be released. They will not reach the point
where prostaglandins are processed by cox1 and cox2, the same point where ibuprofen
attacks. This will only cause the ibuprofen to bind with enzymes in some other
parts of the body thus causing unnecessary numbness. Furthermore, both of them
has side effects so it is unwise to improvise taking them.
In short, the answer
to the question “Can I take colchicine and ibuprofen together” is:
Yes, you can, but it is like wearing two layers
of socks. Minus the placebo effect, it will be ineffective. It is highly
unlikely that your doctor will tell you this because there is no statistic
defining the drug interaction between colchicine and ibuprofen, but
theoretically it is counterproductive.
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