Doctor insights on:
Why is methylnaltrexone only used for very sick palliative care patients? There are some very constipated post op patients
Limited studies: The best studies for effectiveness for methylnatrexone is for patients with opioid-induced constipation (it works on the same receptors as opioids like morphine). As many sick palliative care patients require opioids this is typically the group that would benefit if standard laxatives (many which are over the counter) do not work. Postop patients constipation or ileus may not be due to opioids. ...Read more
Would my family doctor be reluctant to prescribe me relistor (methylnaltrexone) for constipation from methadone maintenance? I've been clean for 4 years.
Constipation: Hi, no reason I can think of except that he is an individual and it is certainly true docs come in all colors and prejudices. ...Read more
I use oxymorphone ER for pain. I have constipation tried oc's & linzess, amitiza, relistor (methylnaltrexone). I use enema evry 3 days. Is this safe 4 long term usage?
Constipation: You don't say why you're using the narcotic or how much time or how much. Constipation is a serious problem over a long time. Using laxatives or any thing of the sort can can lead to dependence on those medications. You end up in later years being very miserable. Of course if you're legitimately taking opiates constipation is a side effect. Minimize the problem. ...Read more
Intractable pain, scs implanted, high morphine equivalent for survival. Severe constipation. Switched to relistor (methylnaltrexone). Worked 3 times, now 7 days can't go. Was on 12 osmoprep, 2 miralax & 3 colace. What now?
Constipation: You need to seek out the md who manages your scs. It needs to be adjusted. Also morphine may need to be changed to a different drug. Your body may not have the same response to fentanyl or oxycontin. You have to drink at least 8 glasses of water a day and eat foods high in fiber. In addition to the colace and MiraLAX (polyethylene glycol) the medicines are not substitutes for diet they are in addition. ...Read more
Chronic impactions and constipation bc of long term opioid use, tried miralax, (polyethylene glycol) lactulose, no help. How's methylnaltrexone?
Get help: Methylnaltrexone is part of the answer. You'll also need medical support and counselling to successfully and permanently come off the opiates. ...Read more
There are none...: Even the strongest opiates only "take the edge off" for people in chronic pain. Meds are only one part of dealing with the pain. A useful tool, but pain is so necessary for survival that we are not "allowed" to monkey with it much. In acute pain, the transition from miserable to less miserable can be great. In chronic pain, it's just part of the plan. ...Read more
Sometimes: Sometimes they are. For the most part, expired drugs simply lose potency once past their expiration date. There are, however, some drugs that actually become harmful if taken after they expire. As such, it is best to throw out any medications you have after a year. ...Read more
ASPRIN: Actually no one has decided on 'safest'. Asprin has been around since before you were born and unless you take too much (yes, too much of anything isn't good) most people are okay with it. If the pain it too severe for asprin you need to know what causes it. Good diagnosis is called for. See the dr. ...Read more
Applies to skin: Topical just refers to how a medication is applied. In this case to the skin and is meant to treat local skin problems. Some meds are applied to the skin but are meant to be absorbed into the body in which case we use the term "transdermal" since it is meant to pass through the skin to affect the whole body. ...Read more
Why R you depressed?: If your depression is affecting your life and/or those around you and you have trouble dealing with it or not knowing how to etc. It is very reasonable to seek help, either from a therapist, your physician/nurse, or both. Psychotherapy may be adequate for some, others may need both meds (many choices, depending on your symptoms/needs) and therapy. Consult doc. Good luck. ...Read more
RSD, or: Complex regional pain syndrome can be difficult to treat and each patient needs to be treated differently. Opioid medications are definitely not the first option. Consider medications that affect nerve pain most, like neuromodulators such as gabapentin. Clonidine has been found to help some as well. Stellate ganglion blocks can be diagnostic/therapeutic. Consider topical ketamine creams as well. ...Read more
Antacid: An h2 blocker (like Pepcid (famotidine) or its generic) once or twice daily, provides relief for many after about a week. If this fails, a proton pump inhibitor (ppi--like Prilosec or its generic) will often work where h2's have failed. If both fail after at least one week trial of each, see your dr or a GI dr for eval. ...Read more
Elimiron: Elmiron (pentosan) is a medication that is fda approved for ic (interstitial cystitis). The main way it works is not truly known, but it may help with coating the lining of the bladder. In ic, inflammation may be the main cause of pain. Have you seen a doctor in regards to this? Hopefully, you can get the proper testing and see if this med would work well for you. ...Read more
Some people do: ADD medications, stimulants in particular may change the way you feel. Some feel calmer or less restless or agitated. Some feel more focused. Some feel increased restlessness. But in short, yes, stimulants can make you feel differently than prior to taking them. ...Read more
Clarify, please!: Do you want to know how to treat addiction? There are many addicting drugs out there and the medical treatment is different for all of them. But for all of them Narcotics Anonymous or Alcoholics Anonymous are extremely helpful and can often be the only treatment required. Often these programs, which are free, have success rates equal to many inpatient and outpatient costly rehab programs. ...Read more
Drug reaction: If you are having an adverse reaction to a medication, stop the medication and call your doctor. ...Read more
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