Over the last few years, I have sadly learned that codeine-related drugs (Tylenol III, Vicodin) make me sick (not that i’m allergic – they just make me nauseous and i can’t keep them down). This is not a huge problem, since I have never (knock on wood) had much need for them.
Last summer, though, I had lung surgery. The first day after the surgery, I had a lovely fentanyl epidural and had no pain at all. But then they took that out so I could go home, and gave me Percocet instead – which, I learned, I also cannot tolerate. So i asked if there was anything else I could take, and I was told: Tylenol or ibuprofen. It wasn’t really that big a deal but there were some pretty excruciating moments the first couple of days when I coughed, and it would have been nice to have something a little stronger.
So the question that has drifted through my mind from time to time since then: was there something else stronger they could have given me that was not in the codeine family?
There are a huge variety of opioid painkillers, but those are all narcotics. Fentanyl is too, though. Morphine might have worked better for you, or Dilaudid or one of the other synthetic opioids. Of course, those are often difficult to get a prescription for.
There are also a huge variety of ibuprofen-style painkillers (they’re called non-steroidal anti-inflammatory drugs, or NSAIDs) but they all work pretty much the same for me.
I’m the same as you – Vicodin and most other opiates make me puke voluminously (when you throw up half-digested pills you know your body just won’t tolerate it!). I’m lucky because I do ok with Codeine, another Doper once explained to me why Codeine has lesser puke-inducing properties but I kind of forget why.
Anyhoo, back to the question, there’s Toradol. I don’t know a lot about it except its in the NSAID family, prescription only, and my exBF used to take it for migraines. Also Naproxen (brand name Alleve). I don’t know that its “stronger” than ibuprofen but it is different and as we both know, different drugs have different effects on individuals. Also Ketoprofen, I think that’s more commonly given to dogs but it was OTC for people at one point.
Do they give humans phenylbutazone? I thought they didn’t, but I could be wrong. (Its a common NSAID for horses).
Non narcotic pain killers (analgesics for acute pain relief) basically consist of two things: NSAIDS (ibuprofen, aspirin, piroxicam, phenylbutazone, indocin, ketorolac and many others) and APAP (tylenol).
In general, no one nsaid is superior to another for pain relief. Some individuals may respond better to one over another, though. Toradol is nice in that it can be given by injection IM or IV for more rapid relief.
APAP gives pain relief about as good as NSAIDS, but doesn’t fight inflammation the way NSAIDS do (when NSAIDS are taken for a few weeks in a row).
Tramadol is an effectively an opiate, no matter what the drug reps say.
Some people have terrible nausea and vomiting with one opiate (codeine is well-known for this side-effect) but not with others.
Don’t knock the NSAIDS. When I had my c-section, I was on whatever I was on (vicodin, I think) in the hospital, as well as a regimen of 3 ibuprofen every four hours and 1 Tylenol every 6 hours. On the way home, we lost the prescription for the Vicodin. I was too embarrassed/woozy/annoyed with my husband to go back to the hospital and ask for another scrip. So I kept taking the ibuprofen/Tylenol schedule for the next week or two. It worked just fine - no more pain than when I was taking all three, and I could poop with no problem. Tylenol potentiates, or makes more effective, ibuprofen, so taking a little Tylenol with your ibuprofen is more effective than simply taking more ibuprofen.
The key with non-narcotic pain relief is to use it *before *you need it - say, before the visit to the dentist (check with your dentist first, of course). It’s much easier, for some reason, to prevent pain than to chase it away once it’s there.
NSAIDs inhibit the production of a chemical that, when released by irritated tissue, tickles pain receptors. Inhibiting before it’s released puts you a step ahead.
the schedule for tylenol is every 4-6 hours and ibuprofen every 6-8
Toradol is only by IV/IM, no oral preparations.
fentanyl patches and oral morphine are around, but closely watched.
I’m sorry to contradict you, but that’s not what it says on the label for ibuprofen: dosing every 4-6 hours. Tylenol is also 4-6. I can’t explain why my doctor chose the 6, other than to guess it was to keep me far under the daily limit of 4 grams - from what I understand, the least amount of acetaminophen that’s effective is what should be used to prevent liver problems. Of course, anytime someone is taking this amount - more, in the ibuprofen’s case, then recommended on the patient sheet - you should check with your doctor first for dosing and directions.
Err, I take 5 doses of 2 500/30 Co-codamol caplets every day (for a total dose of 5g of paracetamol and 300mg of codeine), and I have done for about 18 months since they withdrew Co-proxamol from use in the UK. :eek:
I take it for chronic pain, under direction from my GP…
Don’t be sorry, then again don’t expect 1 cap (200mg) every 4 hours to have much effect on inflamatory pain. The presciption strength dosing we use in the ER is 600 to 800 mg 6-8 hours. At that dosing the GI side effect profile is a real concern and thus the longer interval, and physician surveilance. Higher dose ibuprofen is what we use for inflamatory pain such as twisted ankle, broken arm, or post op pain.
Oral Toradol is indicated only as a continuation of Toradol IV/IM, and not as initial therapy. In the ED the setting often dictates parenteral (non-oral) administration of a drug, so that’s why we give it IV in the ED so often.
So my docs had me on three OTC Advil or 600 mg every 4 hours along with 500mg Tylenol every 6 for post-op pain. So yeah, seems a little on the frequent side for the Advil, but not alarmingly so.
And I just checked my written orders just to make sure I wasn’t misremembering from two years ago. That was it. I am obese, if that has any affect on ibuprofen dosing (I don’t think it does, but maybe.)
Well the max recommended dosing of APAP is 4g per day because of the liver damage it can cause, so you might want to ask about an alternative that maybe doesn’t have so much APAP in it (or Paracetamol).
I’ve been wondering this same thing, but for the opposite reason. I found that I have a higher-than-normal tolerance to codeine. Then when I had my wisdom teeth pulled, he gave me hydrocodone. I worked myself up to 70 mg (most of a bottle) before finally getting a small effect. Of course if it takes that much for one dosage, I’m going to need to refill the bottle daily, which the doctor probably won’t appreciate. Luckily in that case, there was little pain anyway (I got lucky) but the next operation may hurt a bit more. So that leaves the harder opiates, like oxymorphone and fentanyl, which aren’t often prescribed. I was hoping there was something that wasn’t an opioid but was pretty potent. You guys seem to be saying there’s not. I guess if it comes to that, I’m screwed. Then again, maybe the Celebrex is why my operation was relatively painless and I’m not giving NSAID’s their proper due. Maybe I’ll ask for that if there’s ever a next time.
This pat March I had a blood clot in my lung and was given a non narcotic pain killer. I’m not sure of the name but they do have them. Ask your doctor. If not I will give you the name. I don’t have the bottle with me right now.