When Taking Opioid Pain Medications:

Keep your medicine in a safe place. Keep it locked if possible. Be very cautious with entrusting friends or family with the location of your pain medications.

Opiate pain medications can not be called in to the pharmacy or refilled. Make sure you have enough pain medicine to last until your next visit when you see your doctor. If you need to increase your pain medicine, let your doctor know and we can write a new script. Otherwise, you will run out of pain medicine too soon.

Do not sell or give away your pain medications. These medicines can be very dangerous when taken by others.

You may need to take Senokot or a generic senna laxative anywhere from one to up as many as twelve tablets a day to help prevent and treat constipation caused by opiate pain medications. In the same manner opiate pain medication can put your bowel “to sleep,” it can also affect your ability to empty your bladder.

You should only receive prescriptions for opiate pain medications from one doctor. Do not ask other doctors who are not prescribing these medications to write for or refill these medications. Fill your prescription at the same pharmacy and do not use multiple pharmacies. If you switch pharmacies let us know. Doctors and the DEA now have online access to information about where you are filling your pain medication and who is writing for it.

Do not take more than 4000 mg of tylenol a day. Doses higher than this can cause liver injury. Other names for Tylenol are acetaminophen and APAP. Medicines like Lortab and Percocet contain tylenol. Look on the bottle of your medication. Usually the tylenol dose in these medicines is either 325 mg or 500 mg. Often it is abbreviated as APAP. If you are taking Lortab 5/500 mg, this means there is 500 mg of tylenol in every tablet you take. You should not take more than eight of these a day (8 x 500 mg = 4000 mg). If you need stronger pain medication, let your doctor know as the opiate pain medicine portion of the tablet can be increased without increasing the amount of tylenol.

If your body is used to pain medication and you go without your pain medication for more than 12 to 24 hours you can start to experience withdrawal symptoms. This can cause a flare of your pain, restlessness, anxiety, gooseflesh, yawning, abdominal cramping and diarrhea. If you go for a period of time off of your pain medication, do not start your pain medication back at the same dosages you were when you stopped. This can cause oversedation as your body will have lost its tolerance to opiates. Start back gradually.

If you experience nausea with opiate pain medication, it will usually fade after several days. Prochlorperazine (Compazine) 5 to 10 mg every 6 hrs may help with nausea.

Other medications that can alleviate pain include NSAIDs, such as ibuprofen and tylenol. NSAIDs can be as effective as opiate pain medications for certain types of pain, such as pain from cancer involving the bones. Painful numbness, burning, and tingling, usually in the fingers and toes is called neuropathic pain. Neuropathic pain has been difficult to treat but may respond to medications such as Neurontin, Lyrica, Cymbalta, or methadone. Steroids have potent anti inflammatory properties and can help with pain. Other modalities for pain management include radiation treatments, steroid injections and nerve blocks.

Common Pain Medication: Dosages, What they Contain, How to Take

Lortab

5/500 mg, 7.5/500 mg, 10/500 mg

Hydrocodone/Tylenol

1 to 2 tablets every 6 hours as needed for pain

Percocet, Endocet

5/325 mg 7.5/325 mg, 10/325 mg

Oxycodone/Tylenol

1 to 2 tablets every 4 hrs as needed for pain

Norco

5/325 mg 7.5/325 mg, 10/325 mg

Hydrocodone/Tylenol

1 to 2 tablets every 4 hrs as need for pain

Ultram, Tramadol

50 mg, 100mg

1 to 2 tablets every 4 hours as needed for pain, this medicine can sometimes be tolerated by patients who have difficulty tolerating opiate pain medication

Oxycodone (no tylenol)

15 mg, 30 mg

1 to 2 tablets every 4 hrs as needed for pain

MS-IR (Morphine immediate release)

15 mg, 30 mg

1 to 2 tablets every 4 hrs as needed for pain

MS-Contin, (Morphine sustained release)

15 mg, 30 mg, 60 mg

1 tablet twice a day, do not take as needed

OxyContin (Oxycodone sustained release)

10 mg, 20 mg, 40 mg, 80 mg

1 tablet twice a day, do not take as needed

Methadone, Dolophine

5 mg, 10 mg

1 tablet twice a day, this medicine has a long half life, over sedation can occur days after increasing the dosage

Fentanyl Patch, Duragesic Patch

12.5 mcg, 25 mcg, 50 mcg, 75 mcg, 100 mcg

Change the patch every 72 hours, dosing changes may take 12 hours to take affect

Dilaudid

2 mg, 4 mg, 8mg

Hydromorphone

1 to 2 tablets every 4 hours as needed