hydrocodone question

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aimsgirl16
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Date Joined Jun 2008
Total Posts : 1434
   Posted 2/5/2011 9:38 PM (GMT -7)   
Hey friends :)
 
I have been give hydrocodone's 10-500 to take as needed with pain. I took one the other night and it really helped with the pain tremendously! It knocked me out, which was a good thing and help me get some much needed rest. I have kidney issues due to lupus and have to get up about every hour to use the bathroom. My question is, is it normal to stand up and then fall down because your legs give out under you? I had to crawl to the bathroom and crawl back to bed. The next time I stood up a bit more slowly and had to walk real slow but I could feel my legs getting very shaky.
 
Is that a normal side effect of hydrocodone or is this something I should let my doc know? I was going to cut the pill in half and see if it happened again but I realized it didnt have a line to cut it in half and figured that probably wouldnt be the best idea!! What are your thoughts on this??

Amy
Kidney Diseases & Disorders and Lupus Moderater
Cyclosporine, Prednisone, Lisinopril, Mobic, Vitamin D 50,000 units
PRN: Imitrex, hydrocodone, Ambien, Flexeril, Ultram,

If God brings you to it, he will get you through it!!

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 836
   Posted 2/5/2011 10:00 PM (GMT -7)   
You should talk to your doctor about it! It does sound out of the ordinary.

If you haven't taken many opioids in your life and have no tolerance built up, then 10mg is a
somewhat strong dose, but not that huge. 5mg or 7.5mg is typically the starter dose.


Note also that many opioids inhibit the release of vasopressin, which in turn increases your frequency of urination. I do not know if this would become a problem for you given your kidney disease, but perhaps you should explore it with your doctor.

You might also want to google "opioids and kidney disease". The first hit is a pdf that looks relevant.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs)
RT hip and SI joint damage from car accident
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .5mg ativan as needed for sleep.

aimsgirl16
Forum Moderator


Date Joined Jun 2008
Total Posts : 1434
   Posted 2/5/2011 10:08 PM (GMT -7)   
Thank you, I will deffinatly google that. I very seldom use opioids. The only other time I can remember using them was for the case of shingles and I dont remember anything from that time. I got these from my PCP, who i hardly see. They were orignally prescribed for migraines but I called to see if I could take them on bad pain days and they said it shouldnt be a problem. I will email my rhuemy and see what she thinks/suggests! Thank you for the advice and the idea to google that :)
Amy
Kidney Diseases & Disorders and Lupus Moderater
Cyclosporine, Prednisone, Lisinopril, Mobic, Vitamin D 50,000 units
PRN: Imitrex, hydrocodone, Ambien, Flexeril, Ultram,

If God brings you to it, he will get you through it!!

kissmyAS
New Member


Date Joined Feb 2011
Total Posts : 3
   Posted 2/6/2011 12:27 AM (GMT -7)   
I agree with Cogito. Relatively speaking, that's a high dose for someone not used to narcotics. I've never lost my ability to walk when taking hydrocodone (though it has made me a little shakey before), so I'd call your doctor to check out that side effect and possibly get a more appropriate dose (or more likely, instructions to cut the pill in half).

A lot of people say hydro/oxycodone helps with sleep. I've also heard that narcotics have a negative impact on sleep because they prevent you from reaching REM. I don't know if that's true or not but it might be a good question to ask. I have insomnia anyway, so it's impossible for me to tell if my meds keep me up.

Hopefully you'll find the right dose or a different drug that gives you some good relief and much needed sleep!

gmmaddox
New Member


Date Joined Feb 2011
Total Posts : 4
   Posted 2/6/2011 11:21 AM (GMT -7)   
I am a 61 year old female, who has chronic HCV, fibromyalgia, insulin dependent diabetes 2(brought on by HCV therapy) osteoarthritis of spine, hands ankles and knees,and it seems a TKR is in my immediate future. Two years ago, I was sent to a Pain Clinic, and the Dr. there suggested putting me on Fentanyl patch. My family Dr.(who referred me to the pain clinic),said whatever the Pain Specialist said, is what would happen fo me. Now my Doctor is totally ignoring that advice, and will not even give me anything for pain, beyond an occasional Tramacet. I don't want to take much of that, because I already have cirrhosis. I don't know where to turn, or whose opinions to trust anymore. Any suggestions would be appreciated. I was still working full time at a drugstor, but have had to stop. I will be trying to go back next week on a part time basis(until knee surgery). I really don't know how long I can continue to push myself through all my pain, and just try to keep going, without some meds to help me. I have to wear a knee brace just to be able to keep going.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 11529
   Posted 2/6/2011 12:37 PM (GMT -7)   
Hi and welcome to Healing Wells chronic pain forum. I am sorry that you have to be here but very glad that you found us. Wow, you sure do seem to have a lot on your plate right now.

May I suggest that since you are new to the forum that you start your own intro thread so that all of the members will see it and be able to give you a proper hello and welcome aboard. By posting here as you have I am afraid not many people will see it and respond in the normal manner.

Was it your PCP writing your scripts for Fentanyl? Did he take you off or what? Perhaps you need to be referred back to a pain mgt dr and let them take over your care for pain control. I have found that most people on here end up with a pain mgt dr because the PCP's as a rule do not want to get involved in giving patients pain meds for long term use.

Anyway, I wanted to welcome you aboard and please start your own intro thread. Take care.
Moderator Chronic Pain Forum

Post Edited (straydog) : 2/7/2011 2:04:24 PM (GMT-7)


cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 836
   Posted 2/6/2011 12:38 PM (GMT -7)   
aimsgirl16, here's a link which ranks opioids relative to safety for people with kidney disease. Note that not all opioids are listed and also that issues may differ for different diseases: http://www.eperc.mcw.edu/fastFact/ff_161.htm

kissmyAS, I happen to be among the small percentage of people who cannot sleep after taking an opioid. According to my PM, about 10% of people have this reaction. Though my initial uses of Nucynta did get me to sleep and I fell asleep once after taking 10mg of Oxycodone, in general, I cannot get to sleep for about 6 or 8 hours after taking an opioid (and have tried all but morphine and methadone).

gmmaddox, I'm fairly new, and don't want to step on the shoes of the senior members of this board, but as this is your first post, welcome to the site. It sounds like you need to see some specialists: a new PM doctor and a hepatologist. Tramacet contains acetaminophen which is notoriously hard on the liver. Also many opioids are converted by the liver and some won't have any benefit without that conversion (prodrugs). I believe tramadol and hydrocodone are among them. So given your cirrhosis, you probably should consult with a PM who is familiar with the role of the liver in the metabolization of opioids and/or see a hepatologist.

Of course, googling opioids and cirrhosis should also give you some useful info.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs)
RT hip and SI joint damage from car accident
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .5mg ativan as needed for sleep.

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 3614
   Posted 2/6/2011 3:20 PM (GMT -7)   
Hi Amy -

I'm not surprised the PCP won't give you anything for pain. He is undoubtedly asuming the pain clinic is taking care of that and won't add to whatever they're giving you.

Try cutting the hydrocodone in half. That's the usual starting dose if you haven't been on opioids before.

I hope you aren't taking 50k units of vitamin D daily. That's probably a toxic dose.
Beware of serotonin syndrome. You are taking two drugs that raise your levels: tramadol and Flexeril. I can't even take the lowest dose of the two on the same day or I get twitches, muscle spasms, turn red and my temperature goes way up. Hydrocodone can interact with them too and cause trigger the syndrome.
Alcie
 
 

aimsgirl16
Forum Moderator


Date Joined Jun 2008
Total Posts : 1434
   Posted 2/6/2011 3:32 PM (GMT -7)   
Hey Alcie,

My PCP is the person that prescribed the hydrocodone to me. I think you are getting 2 people mixed up, which I would too!!! I think I am going to stay away from hydrocodone until I call my PCP and see what they think. Whats another few more days without any relief? As for the Vit D at 50,000 IU, I take that twice a week. Due to my kidney problems, we can not get my Vit D level up. My nephrologist tested it about 3 weeks ago and it was at a level 9!! I have been taking the Vit D for almost a year now with no improvement. Some tests it will jump up to 12 or 13 but usally stay below 10!

I only take tramadol every so often to see if it will work. So far it has done nothing for my pain so I don't like to keep putting things in my system that doesnt work. My rhuemy thinks it should work so I keep giving it the benefit of the doubt. The flexeril is takin on a as needed basis. usually 2 or 3 times a month, nothing like I used to. I used to take tramadol 2 pills every 6 hours and a flexeril at bedtime. But that was before prednisone was introduced to my life...

Thank you for all the answers and concerns :) I appreciate it so much!!
Amy
Kidney Diseases & Disorders and Lupus Moderater
Cyclosporine, Prednisone, Lisinopril, Mobic, Vitamin D 50,000 units
PRN: Imitrex, hydrocodone, Ambien, Flexeril, Ultram,

If God brings you to it, he will get you through it!!

gmmaddox
New Member


Date Joined Feb 2011
Total Posts : 4
   Posted 2/6/2011 3:43 PM (GMT -7)   
dependent diabetes 2(brought on by HCV therapy) osteoarthritis of spine, hands ankles and knees,and it seems a TKR is in my immediate future. Two years ago, I was sent to a Pain Clinic, and the Dr. there suggested putting me on Fentanyl patch. My family Dr.(who referred me to the pain clinic),said whatever the Pain Specialist said, is what would happen fo me. Now my Doctor is totally ignoring that advice, and will not even give me anything for pain, beyond an occasional Tramacet. I don't want to take much of that, because I already have cirrhosis. I don't know where to turn, or whose opinions to trust anymore. Any suggestions would be appreciated. I was still working full time at a drugstor, but have had to stop. I will be trying to go back next week on a part time basis(until knee surgery). I really don't know how long I can continue to push myself through all my pain, and just try to keep going, without some meds to help me. I have to wear a knee brace just to be able to keep going.

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 3614
   Posted 2/6/2011 6:07 PM (GMT -7)   
Amy -
Yes, I read about a pain doc, thought it was you writing. I hope you are cutting pills with a pill cutter, not a knife. Cutters with the rubber V-shaped edges do a pretty good job of holdiing even odd-shaped pills in place. You might even be able to quarter the pills.

Your rheumy is right about tramadol - that is if you are having trouble with fibro muscle pain. If the pain seems more like arthritis or joint pain the Vicodin (hydrocodone) might work better. The only thing about hydro is you may get tolerant to it pretty quickly. I use the tramadol partly because I haven't had much problem with tolerance in a year, and I get Vicodin tolerant in a month. Since I can't take anything else because of sensitivities, I want to save Vicodin for surgical pain.

Tramadol regular (instant release) only works for about 4 hours. There is an extended release, also generic, that is supposed to work 12 hours, seems to be good for about 10 for me. I take that at night, or I have to get up take another pill and sit up for 45 minutes waiting for it to work. Regular tramadol also wakes me up, keeps me awake if I take it at night, which the extended does not do. ER is not as good as the IR for pain, but better than nothing, which is all I have left.

Cogito -
You had some interesting points. I should look up my drugs and see how they are metabolized.
Alcie
 
 

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 836
   Posted 2/6/2011 9:52 PM (GMT -7)   
Alice,

Here's a link to a table of the active metabolites for opioids as well as the key metabolizing enzymes:
http://www.currentclinicalpractice.com/ccp_article.asp?id=6207

The details below the table are also quite interesting.



Also, there are 24hr tramadol formulations of tramadol. In generic form, they have 100mg and 200mg. Brand (Ultram ER) goes up to 300mg. All, however, are expensive ($300 or so for 90 of the generics and $800 for 90 of the brand).
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs)
RT hip and SI joint damage from car accident
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .5mg ativan as needed for sleep.

Mr J
New Member


Date Joined Feb 2011
Total Posts : 4
   Posted 2/7/2011 1:40 AM (GMT -7)   
Hi Aimsgirl16,

You may want to request a pain management Dr to treat you I have been in treatment for 8yrs. I take 1-2 of half your does every 4-6hrs as needed with 1-10mg of of methadone which is to make you feel some what better & the Hydrocodone is to take the edge off your pain. The key is you take as directed and not take more because you still may hurt. The treatment is to help control our pain level. I also use the Lioderm Lidocaine Patch 5%. These are all for lower chronic back pain. I also have had your issues and have adjusted whith the right combination. The key is have control of thr drugs do not let them control you.

Mr J.
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