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Suggest Alternate Pain Medication To Manage Pain

Posted on Mon, 6 Apr 2015

Question: I currently take Norco as needed through out the day & evening along with a nerve damage pill. I have 6 bad disc and as I went to have back surgery found that I also have Stage 3 Kidney disease that is currently teetering on stage 2! So I will not be able to have back surgery with out damaging my kidneys further. My question is I do not need my pain meds as much as I take them though due to my long use of these meds (over 20 yrs.) my tolerance and addiction has me take them to not feel depressed and unmotivated! Can I switch to another pain med that has the same pain relief but less dependent? Its really destroying my life with the up and down depression! I do try daily to not take them as much but the depression and fatigue with out them is unbearable! Thanks, XXXXXXX

Answered by Dr. Seikhoo Bishnoi (21 minutes later)

Brief Answer:
Non-opioid pain medicines can help in controlling pain

Detailed Answer:
Hello thanks for asking from HCM for your health related queries

I can understand your concern. Norco is a pain medicine consists of Acetaminophen and Hydorcodone. The drug is an opioid drug and it is a good pain killer but associated with risk of development of tolerance and dependence. You have started abusing the drug and this has resulted in dependence. So to bring you out of that drug there are two main issues that should be addressed-

- One is to prevent the withdrawal of Norco.
- Second is to control the pain with some non-opioid pain killer.

- For preventing withdrawal of Norco, best is to reduce the intake of tablets gradually over about 4 weeks. This will prevent any severe withdrawal symptoms. Alternately opioid patches can be used. Buprenorphine is a good pain killer and its patches control pain as well as this would help in preventing withdrawal. Patches are relatively less dependence producing. Taper with Buprenorphine is easier as compared with Hydrocodone. Discuss with your doctor for help.

- For pain medicines like Amitryptiline, Nortryptiline can be utilised. These medicines are also available with combination of Pregabalin or Gabapentin. The drug combinations are good in controlling intractable pain. Medicines like Flupirtine can also help in controlling pain. The medicine when taken regularly result in good pain relief and this is also not a dependence producing drug. All these are prescription medicines and should be taken with prescription only. These drugs are safe and free of any serious side effects. Pregabalin will help in reducing the craving due to opioids also.

Thanks, I hope this helps you. Please ask again for more doubts.

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

Follow up: Dr. Seikhoo Bishnoi (6 hours later)

Are any of these drugs more toxic to my Kidneys than Norco? I was took off of Vicodin due to the ibuprofen content in it.

Answered by Dr. Seikhoo Bishnoi (1 hour later)

Brief Answer:
These drugs are not neurotoxic so no need to worry.

Detailed Answer:
Hello again

Flupirtine is relatively safer than Norco considering Renal damage. The drug is metabolised with liver metabolism. Doses should be reduced in severe renal damage.

Other drugs Amitryptiline, Nortryptiline or Pregabalin can be used in renal damage but with dose adjustments. The drugs are primarily metabolised by liver so they are safe.

Thanks

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