Post phlebetic syndrome

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chmd

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How would you guys treat a middle aged woman with severe leg pain related to multiple dvts who you see after she's been on opioids for years for said pain?

Would you prescribe NSAIDs in someone with an increased risk of thrombosis due to hypercoaguable state (assuming she's anticoagulated)?

What's the role for gabapentin or pregabalin?

Thanks for your help :)

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So she's currently anticoagulated? How long has she been off opioids? I think neurontin or lyrica wouldn't be unreasonable to try. Probably wouldn't put on an NSAID due to added GI risk if already on coumadin. NSAIDs can increase risk of coronary thrombosis but no evidence of increased venous thrombosis
 
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Neuropathic chronic pain. Lyrica. Cymbalta. Savella. Doxepin. Pamelor. Neurontin. Then for post phleb consider clonidine. LSB. Tramadol. Counseling.
 
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