I think my BT meds are giving me headaches

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cogito
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   Posted 1/25/2012 12:14 PM (GMT -6)   
Hi All,

I have been getting more headaches lately and think they correlate with my hydrocodone use -- 4-6hrs after taking a dose, I end up with a headache, made worse if I take another. I haven't found this when I use oxycodone.

I wasn't having this problem a year or more ago, but seems to have started to emerge in the past few months.

I do recall, from 4 or more years ago, if I took more than a small dose, I would have a headache the next day. But that was resolved by drinking more water. Water still seems to help, but I'm wondering if others have had this issue -- some change in the way their bodies metabolize the opioid after taking it regularly for a number of years.

I'll talk to my PM about it, but I wonder if he'll see it as bizarre or if some change in how the body responds (beyond just tolerance) is a known phenomenon.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

Screaming Eagle
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   Posted 1/25/2012 2:15 PM (GMT -6)   
 
     Good afternoon Cogito!
 
         ...I really don't know, but it seems like you have a possible handle on what may be causing it. Is there a chance they can switch you back over to oxycodnone..and see if the same symptom shows up?
 
       It could be tied to teeth problems and or a slight case if TMJ as well...and you say it comes on at the end of your med cycle.
 
     It's interesting, and I hope you find the cause, and a simple solution can be implemented to cure it. Headache's can be hard to deal with, and send a person straight to bed.
 
      Take care,
 
     SE wink
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cogito
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Date Joined Oct 2010
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   Posted 1/25/2012 2:36 PM (GMT -6)   
Hi SE,

I don't think it is TMJ (I don't have that problem thankfully). But I wonder if the hydrocodone is the direct cause or if it mediated by something else.

I'm now quite confident that the hydrocodone is playing some causal role as the drug holidays I've taken and the various days where I don't take any hydrocodone correlate with my hypothesis.

The headache issue also seems to have started in the early Fall, roughly when I went through a bout of vertigo. That may or may not be relevant.

My fear is that despite the low dose, some byproduct of the metabolization is causing the symptoms, or as my receptors have adjusted, the hydrocodone itself is now affecting them in such a way as to cause the headaches.

Just a lot of guessing right now.

I would like to stop the hydrocodone for a month to see what happens. But I'll end up using most of my oxycodone instead. My PM is not particularly happy about my taking 2 BT meds, but since I only need an oxycodone refill every 9-12 months, it isn't a big deal for him. However, he might be more troubled if I ask for a refill so soon (the last was in October).

If I were to avoid hydrocodone for at least two weeks, that may be realistic. I might go through 10-15 oxycodones. Or, I might go back to my old routine of not allowing myself to take any BT meds two days in a row.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

Ssinss
Regular Member


Date Joined Jan 2012
Total Posts : 66
   Posted 1/25/2012 4:24 PM (GMT -6)   
Actually I got really bad headaches when I was taking it to, a few hours later. I never looked into it, I would just drink some coffee and chalk it up to everything going on. But now that it was the only thing I took and all 8 times, headache a couple hours after. Wonder if its the brand. This is a generic from Watson.

sos007
Veteran Member


Date Joined Nov 2011
Total Posts : 615
   Posted 1/25/2012 5:03 PM (GMT -6)   
Cognito...I think you might be right, I would definetly talk with your PM and see if you can make that change. If you can go without them until you see your doc I would. I am sending you some positive thoughts and hope you get this is resolved soon.

Take care, Amy
Chronic Pain(nerve), fibro, mild depression and a few others

Ssinss
Regular Member


Date Joined Jan 2012
Total Posts : 66
   Posted 1/25/2012 5:07 PM (GMT -6)   
Was looking around a little, might want to make sure your not taking to much tylenol just a thought.
Abdominal surgeries 7ish (C section x2, Hysterectomy, Laprotomy due to scar tissue, left Colectomy, ventral hernia repair,MRSA, Ventral hernia repair removal, MRSA. Ventral hernia repair laproscopic, last surgery left a hole for months that needed to be packed. The last hernia repair was a placement of a Large abdominal mesh with unusual sensitivity to the tacks.

cogito
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Date Joined Oct 2010
Total Posts : 932
   Posted 1/25/2012 5:38 PM (GMT -6)   
I'm currently using 10/325 so the tylenol is low.

For about 6 years, I never had a problem, but during those years, I almost never took any BT meds two days in a row. Over the last year or so, I've abandoned that rule.

I do plan on discussing it with my PM, but I want to be more sure. Today, I haven't used any BT meds yet and no headache. I already record all my BT med use. I'm now going to start keeping records of my headaches and see whether the correlation holds.

It is very frustrating to lose the benefit that hydrocodone has been offering -- or at least exchanging its shorter term relief for a subsequent headache.

I've tried googling various search strings, but couldn't find any related studies.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

stingray
Regular Member


Date Joined Oct 2009
Total Posts : 175
   Posted 1/25/2012 7:33 PM (GMT -6)   
Hi Cogito
I have never taken hydrocodone but do get headaches from time to time from oxycodone. I find that if I take it before bed I often wake up with a headache. I take straight oxycodone without any additives. If I have to take it before bed I usually take a Tylenol with it and that seems to solve the problem. I also find that drinking lots of water helps although I don't like to do that before bed because I know I'll be making a trip to the bathroom sometime during the night. I would suggest making sure you don't take it on an empty stomach. I'm not sure if sleeping or laying down after taking it has any effect but I try to avoid it if possible. Don't know if that helps any but your not alone in the headache department. Best of luck. Take care.
Stingray
Chronic Back Pain, Anxiety, A little Depression, Left foot problems...foot growing in length and big toe growing out sideways, Osteoporosis,11 surgeries total..right foot twice, right knee 3 times, right elbow, throat/neck, spinal fusion, left elbow, left knee, currently deciding on whether to have surgery on left foot.
Meds: Oxycodone, Oxycontin, Clonazapam
Birthday July 18th

flower123
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Date Joined Apr 2009
Total Posts : 856
   Posted 1/26/2012 4:46 AM (GMT -6)   
Hi Cogito. I think that it could definitely be causing your headaches. It sounds like you're on top of things regarding figuring out if it is (by documenting). I think that is the best way to find out.

If it is indeed causing them, could your doctor possibly make the oxycodone your primary breakthrough/immediate release medication, and prescribe the hydrocodone once every 6-9 months--meaning switching the prescriptions?

I get headaches (migraines and regular ones), and the thing that helps me most for the regular headaches is Excedrin. For some reason, the aspirin helps better than any other OTC/prescription headache medication.

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 932
   Posted 1/26/2012 12:13 PM (GMT -6)   
Thanks for the feedback.

Yesterday, I took only an oxycodone in the evening, and had no headache.
So far today, I've not taken any BT med and my head is still fine.

Pain now is starting to move up so I'm going to take a hydrocodone, and will see if a headache comes with it.

But I'll drink at least 1 liter of water as well over the next few hours.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

cogito
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Date Joined Oct 2010
Total Posts : 932
   Posted 1/26/2012 11:13 PM (GMT -6)   
Despite the liter of water, I ended up with a headache again.

I just did some more research and it does seem that there is about a 1% prevalence of "Medication Overuse Headaches" from opioids.

The threshold seems to be about 12 days per month for more than three months. A year ago, I averaged about 15 days of use per month. Now I'm at about 21. It looks like I may have cross a threshold and triggered the condition.

The only recommended treatment is discontinuation, though there are some other options, depending upon the cause of the headache (some studies connect it to serotonin levels impacting dilation/constriction of blood vessels in the brain, others to inflammation).

I also found:
Recent studies indicate that having lower than normal levels of the mineral magnesium can influence serotonin and nitric oxide release, blood vessel size, and inflammation. It’s also thought that people with mitral valve prolaspe have lower than normal levels of magnesium.

Which is further pertinent to my situation.

So, it looks like I will have to discontinue or at least cut my hydrocodone use by roughly 50%.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

Chutz
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Date Joined Jan 2005
Total Posts : 9090
   Posted 1/27/2012 1:15 AM (GMT -6)   
Hi Cognito~

This caught my eye since I was having this problem a couple of years ago. My B/T meds often gave me headaches that were fairly substantial and could drag on much of the day. So, I talked to my doc about the meds and headache issue. What he told me is that it's not unusual for headaches to be a side effect of taking pain medications. The remedy he told me was to take some 'Tylenol'. I almost started laughing, and so did he, but as unusual as it sounds...something as innocuous as acetaminophen would get rid of a head ache caused by narcotic pain meds... it worked for me. I still get them but now and then, not every time I take my B/T meds, and when I take the Tylenol it goes away. Weird, but it works for me anyway.

Chutz
Moderator ~ Fibromyalgia and Chronic Pain forums
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cogito
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Date Joined Oct 2010
Total Posts : 932
   Posted 1/27/2012 10:44 AM (GMT -6)   
Thanks for the suggestion.

The headaches also correlate with my moving from 10/500 to 10/325 hydrocodones. So upping the tylenol may help.

But I've now added 800mg of magnesium as a supplement and if that or the tylenol does not help, I'm going to have to significantly cut back hydrocodone for BT pain.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

Chartreux
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Date Joined Aug 2006
Total Posts : 9664
   Posted 1/27/2012 11:10 AM (GMT -6)   
Yes, it could be the headaches being cause from you going from 10/500 to 10/325...that
would make sense...so maybe getting a small bottle of tylenol and just take one to see if that
helps...and then also bring this up at your next doctor's appointment.
I take two 10/325 (norcos) every day for my pain, one in the a.m. and one in the p.m and
I asked my doctor if I can take an additional tylenol for my monthly cycle pain and was okayed
for that...just be careful on the amount of tylenol your getting okay...as there is tylenol in other
things like: Thera flu...So what Chutz said does make sense...and I hope your doing better soon...
Many many well wishes and remember to report this to your doctor and I sure hope your
doing better without anymore headaches soon...however, if the headaches continue even after trying
what is suggested then get in to your doctor asap...headaches can have other causes...sudden accute
very bad painful headaches could indicate a stroke, not wanting to scare you....
**********************************************
* So many dx's I could write a book* "It would be nice if we could use the edit button in real life"...
********>^..^<********>^..^<*******

opnwhl4
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Date Joined Dec 2008
Total Posts : 4961
   Posted 1/27/2012 11:40 AM (GMT -6)   
I too get headaches and my PM also said it was from the hydrocodone. I take ibuprophen and that usually helps my headaches.

Take care,
Bill
opnwhl4
Moderator: GERD/Heartburn
Nissen 6/06 and 5/09
#3 on 8/24/11

JoJoGal
New Member


Date Joined Jan 2012
Total Posts : 14
   Posted 2/2/2012 12:34 PM (GMT -6)   
I take oxycodone, but have also taken hydrocodone. If you read the pamphlets that come with both, one of the possible side effects is headaches. I too get migraines, and there are times when I need a little bit stronger Oxycodone for BT pain. It does not have Tylenol and I often end up with a nasty headache. Because the migraine meds don't work for me my doc gives me a few 15mg morphine for the month. Not just for migraines but also more severe BT pain that has me looking for something other than oxy for relief. It seems unbelievable that a pain med can cause pain, but it does. If I try to take more oxy for a headache I end up with a full blown headache.

I wish you luck in finding a way to overcome this and will think good thoughts your way. I hope you are your dr come to an agreement that will continue to help with your pain. Let us know what he says/does, and how it works.

Jody

cogito
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Date Joined Oct 2010
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   Posted 2/2/2012 1:33 PM (GMT -6)   
I'm really at a loss regarding what is going on... and have been vacillating between the opioid hypothesis and something related to cervical issues.

The headaches are compounded now with a feeling of fullness/pressure in the head, and some vertigo -- which I went through during the summer. I had a negative CT scan.

With the recurrence of these symptoms, I'll all the more frustrated. Over the last week, I've cut back on BT use, without any improvement. I find myself apprehensive about taking any meds, but just can't work while in so much pain.

I stayed in bed today until noon, until my dog started to nudge me because she wanted out.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

Lindaloo
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Date Joined Sep 2006
Total Posts : 1713
   Posted 2/4/2012 3:00 PM (GMT -6)   
Hi Cognito,

Just wanted to chime in and add my two cents.

I find that any long acting pain med gives me a headache, like oxycontin or other meds. For my everyday pain due to back problems and fibromyalgia, I take 15mg oxycodone. But whenever I get a headache due to whatever I encounter during the day, I take aspirin, excedrin, motrin or tylenol, etc.

I am wishing you good thoughts and sending a prayer your way. God bless you and I hope your pain goes away with a solution soon.

God's blessings.

Lindaloo
Believe in yourself. Be kind to fellow humans and animals. Take time to smell the flowers and the coffee.

And by all means, when you are down, ask me for help. I will be there.



Linda

cogito
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Date Joined Oct 2010
Total Posts : 932
   Posted 2/4/2012 4:55 PM (GMT -6)   
Thanks Linda.

The OTC analgesics haven't really made a difference.... and I'm still even not sure about the cause. Yesterday, I took no BT meds, but had a headache & head pressure. I'm beginning to migrate back to the hypothesis of my PT, that it is caused by the cervical scoliosis, somewhere impacting neck proprioceptors or even bloodflow to the brainstem.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

Friedspine
Regular Member


Date Joined Feb 2012
Total Posts : 21
   Posted 2/5/2012 8:23 AM (GMT -6)   
Hi, I had some really bad headaches on Oxycontin with using hydrocodone for BT pain when I had my first low back surgery in 2007. My ortho spine specialist said it was something called a "rebound headache"? Google it, maybe that's what's going on? Just a guess cause it happened to me back then. Wishing you a headache free day, Linda
Had neck pain for many years, bone spurs but in 2000 a accident caused disk at C5/C6 to hern Fusion surg was a success. In 2005 I was rearended. Fusion C5/C6 was altered I had to undergo rhizotomy. It worked! But low back had issues since the 2005 accident, had a L4/L5 discectomy 2007. 2008 back to work. Was hit as a pedestrian 2009. Another fusion this time at L4/L5 DX is FBS and CRPS.

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 932
   Posted 2/5/2012 1:07 PM (GMT -6)   
Thanks but they are different from rebound headaches.

When I first started hydrocodone in 2005, I recall having them -- at that point 10mg was a big dose. They would hit me the next day.

But these occur just hours after taking the BT med.

Nevertheless, I'm still not sure if the meds are the cause or not. But something is triggering nearly daily headaches, a feeling of pressure in my head and a bit of vertigo.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray
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