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 moreSee 1 more doctor answer
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 moreSee 2 more doctor answers
Chronic impactions and constipation bc of long term opioid use, tried miralax, (polyethylene glycol) lactulose, no help. How's methylnaltrexone?
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
So call your doc: This is the HT public information site.We are thousands of volunteer docs based primarily in the US who answer medical questions.We do not offer treatments. State medical boards require a physician/patient relationship,a retrievable record,recent exam with vital signs for prescribing.Failure to do so can lead to loss or restriction of license. It may seem minor to you but it is not. ...Read moreSee 1 more doctor answer
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 isnt 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 moreSee 2 more doctor answers
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 moreSee 1 more doctor answer
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