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I Am Taking Alprazolam 0.5mg Tablets With Hydrocodone/Acetaminophen 10-325 TB, I Have Taken This Combination For 10 Years My Anathesistolist Wants Me To Stop Taking Alprazolam,Can You Please Give Me A Second Opinion?

Posted on Thu, 23 Mar 2023

Question: I am taking Alprazolam 0.5mg tablets with Hydrocodone/Acetaminophen 10-325 TB, I have taken this combination for 10 years but the Hydrocodone was 10-7.5 mg prescribe by my family doctor without any reactions or problems. I am now in Pain Management and the Doctor which is an Anathesistolist and he wants me to stop taking Alprazolam, Please give me a second opinion. I have acute lower back pain which has not responded to all these procedures, epidural's no good. Do you have a problem with this combination of drugs. I only take Alprazolam once or twice a week for anxiety. Your response will be apprecated.

Answered by Dr. Michelle Gibson James (56 minutes later)

Brief Answer:
unfortunately there is a risk of interaction

Detailed Answer:
HI,

Unfortunately there is a risk of interaction between these medications.

The hydrocodone and the alprazolam increase the toxicity of each other with increased chance of sedation and the potential to affect breathing. Acc Medscape professional drug interaction checker.

The fact that you use the alprazolam only intermittently and the dose is very small decreases the chance of these symptoms or side effects occurring but the possibility remains.

You would need to balance this potential risk with benefits and decide if you will continue using it.

I hope this helps, feel free to ask any other questions.
Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Michelle Gibson James (54 minutes later)

Could you define risk, major, maybe, etc. When I first went to pain management I was only given hydrocodone, I came back in 2 weeks stating this is not helping and was then given Oxycontin. Came back in 2 weeks to get prescriptions refilled and told I was having reactions such as swelling all over, so he took me off and put me on a form of morphine and again I had similar reactions, taken off and now given Brutrans 5cm patch to wear, came back and said I think it is fine and then was given a larger patch Brutrans 10cm, again I had reactions of swelling everywhere on body. I am now only on hydrocodone 10-325, 5 times a day, I have ask my Doctor for 6 a day but he profoundly refuses. Several times I have thought about going to emergency room but the pain passed. I have been to a neurosurgeon and a Spine surgeon only without much possible help because of my chronic problem. How do I get my pain management Doctor to give me one more Hydrocodone pill, I need for sleeping. Any recommendations would be helpful.

Answered by Dr. Michelle Gibson James (26 minutes later)

Brief Answer:
need to emphasize that the current regimen is still associated with pain

Detailed Answer:
HI

Having chronic pain can be very debilitating and based on what you have said above, they have tried various medications with no effect on your pain or side effects.

As you implied the hydrocodone can help with sleeping because it helps with pain relief and causes drowsiness.

Hydrocodone/acetaminphen can be given every 4 to 6 hours so the potential is there for the doctor to give another dose unless there is a particular reason against it eg some persons cut down on the acetaminophen to protect the liver

I would frankly let your doctor know that at present the pain is not controlled on the present frequency of pain med, you are having break through pain and it is affecting your ability to rest and function on a daily basis.
If he is not willing to increase the frequency then either add another medication or change the current medication so that your pain control is optimized and you can rest comfortably.

As stated because you use a low dose of alprazolam and it is used infrequently, the risk is low but it cannot be quantified exactly.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Michelle Gibson James (13 minutes later)

I forgot to tell you that when they added Oxycontin, Morphine and the Brutrans patch, as added pain relief, I was also taking the Hydrocodone 5 times a day. I do not want any more needles in my back. I feel like a pin cushion. But I do think, that 1 more Hydrocodone for the night would greatly help. I am going to a group of Pain Doctors, would it be unwise if I ask for a change of Doctor. My current doctor(Anesthesiologist) has not even looked at my MRI?

Answered by Dr. Michelle Gibson James (7 hours later)

Brief Answer:
if you are not comfortable then you can ask for a change

Detailed Answer:
HI

Sorry the delayed reply

I agree with the needles, I don't think I would like that either.

If you are not comfortable with your doctor or do not think that you are being managed as you would like that you can definitely request another physician.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Michelle Gibson James (13 hours later)

Thanks for your insight into my condition. Appreciate all of your input. I think I will ask for a change in Doctor. My referral from my private doctor was for a different doctor but I could not get in due to backlog. I will check and see if there is an opening. Again, thank you for your advice and recommendation.

Answered by Dr. Michelle Gibson James (2 minutes later)

Brief Answer:
no problem

Detailed Answer:
Sincerely wishing you all the best

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar