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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Trigeminal Neuralgia

I was recently diagnosed with trigeminal neuralgia ......I was prescribed tegretol And oxycodone in ER After seeing primary dr we switched oxycodone to NorCo. Can I take these two together ? When pain hits and I have already taken my tegretol I need to know it s safe to take NorCo Thank you
Tue, 18 Oct 2016
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General & Family Physician 's  Response
Hi & Welcome.
I can understand your concern.
Carbamazepine (Tegretol) with Baclofen is the standard treatment

Tegretol should not be taken along with Norco (Hydrocodone & acetaminophen) because:

1. Tegretol is a potent liver enzyme inducer, it increases the breakdown and thus reducing the blood levels of Hydrocodone thus reducing its efficacy in relieving the pain.

2. Additionally, if you have been receiving treatment with Hydrocodone along with Tegretol may cause you to experience unpleasant withdrawal symptoms such as watery eyes, runny nose, sneezing, yawning, excessive sweating, goose bumps, fever, chills, flushing, restlessness, irritability, anxiety, depression, pupil dilation, tremor, rapid heart beat, body aches, involuntary twitching and kicking, abdominal cramping, loss of appetite, nausea, vomiting, diarrhea, and weight loss.

3. If you have been receiving both medications, discontinuing Tegretol may increase the blood levels of Hydrocodone, which could lead to an overdose.

In view of the above, I would advise you to consult a neurologist/physician
to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications.

Hope these answer your query.
A feedback is appreciated.
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Suggest Treatment For Trigeminal Neuralgia

Hi & Welcome. I can understand your concern. Carbamazepine (Tegretol) with Baclofen is the standard treatment Tegretol should not be taken along with Norco (Hydrocodone & acetaminophen) because: 1. Tegretol is a potent liver enzyme inducer, it increases the breakdown and thus reducing the blood levels of Hydrocodone thus reducing its efficacy in relieving the pain. 2. Additionally, if you have been receiving treatment with Hydrocodone along with Tegretol may cause you to experience unpleasant withdrawal symptoms such as watery eyes, runny nose, sneezing, yawning, excessive sweating, goose bumps, fever, chills, flushing, restlessness, irritability, anxiety, depression, pupil dilation, tremor, rapid heart beat, body aches, involuntary twitching and kicking, abdominal cramping, loss of appetite, nausea, vomiting, diarrhea, and weight loss. 3. If you have been receiving both medications, discontinuing Tegretol may increase the blood levels of Hydrocodone, which could lead to an overdose. In view of the above, I would advise you to consult a neurologist/physician to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Hope these answer your query. A feedback is appreciated.