Hi I had a tooth taken out last Wednesday and been taking paracetamol 5 days now to ease the pain.I am on 60mg of Edoxaban and wondering if there is any other stronger painkiller I could take till the pain settles down?Thanks


Speak to your dentist or GP

by Gemita - 2023-01-29 08:21:00


I sometimes take Co-codamol which has 30 mg codeine and 500 mg paracetamol when I need something stronger, but you should really be speaking to your dentist to see whether he wants to see you to check whether your healing is going as expected?  Did he give you any antibiotics to take following extraction?   

Ibuprofen is good for swelling and inflammation but may not be safe for those with certain heart conditions, so would advise you to ask your dentist/doctors if you are still looking for pain relief.

The Co-codamol tablets, lower dose 30mg codeine/500mg paracetamol are available over the counter in the UK, but I would still first ask your dentist whether this level of pain is really normal after this time.  It should be easing now?

I do recall I developed a "dry socket" which is a painful condition that can occur 3-4 days after a tooth is extracted.  This can happen because of a failure of a blood clot to form around the extraction site, or because of its premature dislodgment, leaving the underlying bone and nerve tissue exposed and unprotected.  By the way, I am also on Edoxaban

Good advice, Gemita

by Lavender - 2023-01-29 10:26:00

At this point you need to recheck with the dentist. When I worked in dental care, we advised the patient to alternate Tylenol and ibuprofen. We also recommended ice packs ease pain and swelling. Nowadays, ibuprofen is known to cause issues for many and shouldn't be taken unless your doctor approves.

A dry socket can be very painful but is easily remedied by a dentist. 

Hope you improve soon!


by Sylvia1 - 2023-01-29 10:43:58

Thanks for your input Gemita.The dentist did not give me antibiotics which I was surprised as he said the tooth was full of infection-just took my £200 as I had done privately as couldn't wait 6 months.My sister had dry socket after tooth extraction so know how painful it can be.If not improved and still giving me pain I will pop back to see the dentist 

Pain Killers with Anti -Coagulants

by IAN MC - 2023-01-29 11:32:56

I assume that you are now back on the anti-coagulant, Edoxaban

( assuming it was stopped for a time around your tooth extraction )

if so  , you really should avoid taking any N.S.A.I.D  e.g. ibuprofen, diclofenac , naproxen, or even  high-dose aspirin as these would all increase your chances of a gastro-intestinal bleed if taken with a blood-thinner ( anti-coagulant ) . I think the fact that anti-coagulants limit your choice of painkiller is a massive disadvantage of having to take them.

I think Gemita's sugggestion of co-codamol is as good as  anything  if good old paracetamol doesn't work for you.

Best of luck Sylvia


PS  Many dentists  are cutting right back on antibiotic usage because of antibiotic-resistance worries.


Anti coagulants

by Sylvia1 - 2023-01-29 18:13:20

Thank you Ian.I never came off Edoxaban but will definitely pop to chemists tomorrow to get some co-codamal if still in pain or get an appointment to see the dentist to check all is okay 

"hot" salt water ?

by Gemita - 2023-01-30 03:58:25

Angry Sparrow, with respect, I would be concerned about recommending rinsing the mouth with hot salt water when someone has dental pain.  Perhaps you could kindly provide details of when this might be beneficial please?

Sylvia, personally, I wouldn't start any home treatments without seeing a dentist first if your pain continues.  In any event, I woudn't rinse my mouth with either hot or cold salt water but "warm" salt water if I had dental pain and this was recommended.   Any extreme water temperature could worsen symptoms.  

I am surprised that your dentist removed a seriously decayed tooth without providing antibiotic cover.  In fact my dentist wouldn't consider extracting my infected tooth without first giving a course of antibiotics to help treat/control the infection, but perhaps the recommendations have changed since my extraction a few years ago?  

I recall I withheld Edoxaban the previous evening prior to extraction and started it again one day after my extraction.  However, my doctors said stopping Edoxaban wasn't necessary, so who to believe?  I am on a lower dose of Edoxaban in any event (30 mg) for low body weight (under 60kg).  I see you are on the higher dose of 60 mg.

I hope you are feeling better this morning.

No rinsing

by Lavender - 2023-01-30 08:55:25

I have to add that rinsing with anything could dislodge a blood clot that naturally is the bandaid over the hole where there tooth was removed. No rinsing!  Please just call your dentist before using home remedies. 

Lavender, My Dentist Said That Too

by Marybird - 2023-01-30 14:01:41

I had a molar extracted a number of years ago, and recall taking Tylenol and Tylenol PM ( at night to help me sleep) afterwards. If I recall the dentist told me to not take aspirin or NSAIDS, as these could exascerbate bleeding. He might have prescribed a short duration of an opioid medication but didn't after I told him those give me severe nausea and vomiting.

I also recall written post-extraction instructions NOT to "swish" or vigorously rinse where the tooth was pulled, not to brush the area or use a straw for drinking, to avoid dislodging the clot where the tooth was extracted. In the event the clot was dislodged, the instructions were to go back to the dentist and he would put some sort of gel- like material into the gap where the tooth was to replace the clot. 

When I had that tooth extracted I wasn't taking an anticoagulant, so there wasn't that worry. But I started taking Eliquis in June 2021, and asked the dentist's staff about possible precautions for various dental procedures. They told me that they didn't require stopping the anticoagulant for cleanings, fillings, or even tooth extractions, It sounded as though they used special material ( no idea what it might be) to minimize bleeding during those procedures for patients on anticoagulation. 




by Sylvia1 - 2023-01-30 18:25:09

Thank you for all your input-at last the pain is subsiding and I am no longer taking paracetamol.Gemita I write on behalf of my husband (he has early signs of vascular dementia and struggles to word things but he is happy for me to ask on his behalf).Do they prescribe Edaxaban on body weight then I didn't realise as my husband weighs 13 stone(sorry using old measures).Does anyone else take Rampiril as he has been taking it for 10 years and got email from doctors to get bloods tested and just wondered why?Thanks

That is good news Sylvia

by Gemita - 2023-01-30 18:56:33

So pleased the pain is subsiding.  

I am sorry to hear about your husband with early signs of vascular dementia.  I appreciate the problems you will be going through since hubby has had several strokes.  

They can prescribe Edoxaban in lowish doses (15 mg or 30 mg) for the elderly (over 80) due to things like poor kidney function where the medication could build up and then cause gastric/urinary bleeding if it is poorly eliminated.  They check the medication Ramipril for kidney function too I believe.  They did for my husband.  Depending on your husband’s kidney function, they may adjust doses of some of his meds, including Ace Inhibitor, Ramipril.  10 years on Ramipril needs assessing - reason for blood test I would think.  

With early signs of vascular dementia Edoxaban will be an important med, so maybe they won't be able to reduce his dosage, but these are all questions for your doctors Sylvia.  Good luck.  I know how difficult it is to manage complex health problems xx

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