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Author: Admin | 2025-04-28
Intravenous (IV) infusiondenosumab (Prolia, Xgeva), twice a year subcutaneous injectionzoledronic acid (Reclast), an annual IV infusionNSAIDs (Non-Steroidal Anti-Inflammatory Drugs)Without exception, all of the prescription NSAIDs cause or worsen reflux. In my practice, Celebrex and Voltaren are worst (but it may just be that they are the most commonly prescribed). Again, all the prescription NSAIDs are problems for the refluxer. Of the over-the-counter options, naproxen is the worst, while the best is acetaminophen (which is not an NSAID and does not cause reflux). The second best choice would be ibuprofen. But it also matters how often you are taking them. If you are taking and NSAID once in a while, it’s probably not going to be a problem for your reflux; but if you are taking them daily, even multiple times a day, then your reflux will get worse … and if you didn’t have reflux before, heavy use of NSAIDs may be the tipping point..Prescription NSAIDScelecoxib (Celebrex)diclofenac (Voltaren)fenoprofen (Nalfon)indomethacin (Indocin)ketorolac tromethamine (Toradol)meclofenamate sodium (Meclomen)diflunisal (has a lot of adverse drug interactions)flurbiprofen (Ansaid)Over-The Counter NSAIDsnaproxen (Aleve)salicylic acid aka aspirinibuprofen (Advil, Motrin)naproxen (Aleve, Anaprox, Naprosyn)Muscle RelaxantsIt appears that all of the muscle relaxants cause reflux by relaxing the lower esophageal sphincter. Of those below, cyclobenzaprine and methocaramol seem to be the worst. I have not included diazepam (valium) on the list, because it doesn’t cause reflux. cyclobenzaprine (Flexeril, Fexmid, Amrix)chlorzoxazone (Parafon, Lorzone)carisoprodol (Soma, Vanadom)metaxalone (Skelaxin, Metaxall)methocarbamol (Robaxin)orphenadrine (Norflex)tizanidine (Zanaflex)Antibiotics & SteroidsOver the years, many of my reflux patients have reported that the
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