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MidlineNotFine 04-07-2007 07:37 AM

Hydrocodone & Neurontin Questions
Hello all,

I've posted about midline abdominal pain in the past. Still nothing found. Neurologist thinks it's smooth muscle spasms/pain b/c all of my tests without finding a culprit. I have a GE working on this too.

To my questions, my Neurologist put me on Hydrocodone 5/500 initially. I would average probably 2 1/2 pills a day (pain levels and bouts vary by day) but the tylenol was hard on my stomach (I do have a Dx of gastritis) even with food or milk. A helpful person on this board suggested I talk to my doctor about a lower APAP mix which I did. I was moved to 10/325 and I break them in half. Helped a lot with stomach irritation but it definitely seems the 5/500 worked on pain a lot better than 5/162.5 but Tylenol has never been a good pain reliever for me for anything as far back as I can remember. So now I'm actually averaging more hydrocodone each day for the same relief 15-20 mg/d (I even break the pills into quarters - as best I can anyway). Does this sound "familiar"? I am guessing the Tylenol may be a catalyst which would explain why the 5/500 worked better even though Tylenol never seemed to work on any pain in the past?

My second question pertains to Hydrocodone and Neurontin taken together. I am up to 600 mg of Neurontin per day and am titrating up to 900 mg. I know the Hydrocodone is working and am guessing the Neurontin is not yet b/c I am still having uprisings of pain that require the Hydrocodone. Has anyone moved from Hydrocodone to Neurontin and explain to me how that process went/felt? Assuming the Neurontin works at some to be determined level, will I just wake up one day and just not have pain or is it more complicated than that?

Btw - a Neurologist is treating my pain for two reasons. For one, I have a new GE and he's not comfortable treating my pain outside of anti-spasmodics (I've tried them all - they don't work). Also, my Neurologist is also a sleep specialist and Dx'd me with apnea and possible narcolepsy so it's good having him on top of the side effects. When I move up on Neurontin it triggers "sleep attacks" so we have to balance/watch things carefully.

Thank you!

ozzybug 04-07-2007 08:49 AM

Re: Hydrocodone & Neurontin Questions
Hey Midline-
I take both Neurontin & Norco (hydrocodone w/less of the APAP). The Neurontin deffinitely takes some time to really build to a steady level in your system, and this is why they titrate us up. As you know, different people tolerate medications differently, therefore some require higher doses and some require less. I am currently at 1500 mgs of Neurontin a day and I am so glad I really gave it a fighting chance. I have seen huge improvement with my nerve pain levels.

My PM started me at a low dose taken in the evenings. This helped alot with the drowsiness. He was able to titrate me up, and incorporate some daytime dosing as well. I may have missed it, and if so, please forgive me, but I didn't see mention of how long you have been on the Neurontin. Has it been just a short time? If so, please do give it a good amount of time. I remember starting to see some improvement in about a couple of weeks, but again, my PM was titrating me up rather quickly. I'm also 5'2", and weigh 117 lbs, so my body definitely reacts fairly quickly to most medications.

I've not had any problems in taking the Norco along with the Neurontin, but I do stagger them, so I don't take them both at the same time. I allow at least a couple of hours between taking them. My doctor never told me I couldn't take them together, but once I found a schedule that helped and didn't make me overly drowsy, I just stuck with it. Some people notice results very quickly, and some people don't really show noticable results for a bit longer. Most of it depends on your body make-up, the actual dose of the medication and also how quickly your body is able to accept the titration schedule.

If the tylenol (APAP) in the hydro is too rough on your system, you might be able to speak with your doctor about a compounded hydro without the APAP in it. Some doctors are ok with doing this, and if you have a compounding pharmacy in your area, it might be worth a try. I have suffered with IBS since childhood and I understand exactly what you say about the tylenol messing with your stomach. There are many meds that really would help my pain levels, but because of the IBS they can't be used. Too much violent intestinal trauma.

I don't know that I've actually answered any of your questions, and if not, please forgive. Keep checking back though. There are so many people here who know so much more than I do. I just wanted you to know that your are not alone. Take care, and please keep us posted. :wave:

MidlineNotFine 04-07-2007 10:50 AM

Re: Hydrocodone & Neurontin Questions

Thank you for replying. I have been taking the Neurontin for just over a month. I have not noticed a difference yet, but I'm only at 600 mg per day. And b/c my doctor prescribed the pills in 300 mg doses, a move up is 300 mg which given my sleep disorders makes the jump harder. I think I will ask for a prescription for 100 mg doses so I can titrate more slowly. Moving to 600 mg had significant side effects for me so I actually had to go back down to 300 mg and alternate days at 300 mg and 600 mg for a little while.

The Norco (or 10/325) is much better on my stomach and I think it was you who suggested it b/c of my issues with the APAP. My doctor is very opiate averse so I don't think he would be open to another change accept to take me off of hydrocodone altogether. I'm not even sure what to expect when I request a refill in the next couple weeks even though the hydrocodone has been a big help. Regardless, I'll keep with the Neurontin - in part b/c it has helped others according to their posts and b/c I don't have much choice! :)

And since you brought up pain medication and it's relation to IBS, aside from my midline pain I've had a lot of post gallbladder surgery issues with digestion in general and the hydrocodone has actually helped with that too. I had heard codeine could have that effect so I guess this is the same. I do not look forward to the return of my completely out of whack system when I come off the hydrocodone b/c that has been a significant benefit with regard to how I feel and where I feel I can go and what I can do each day.

Another quick question - should I expect withdrawals from 15-20 mg of hydrocodone on average per day when I go to zero? Just need to know what to expect. If no refill on what I have now, that will be just in time for my family's vacation!

Thanks! This helps!

ozzybug 04-07-2007 01:03 PM

Re: Hydrocodone & Neurontin Questions
Hey Midline-
Deffinately ask your doctor about the 100 mg Neurontin. I actually take the 100 mg doses during the day, and then take a 300 mg at dinner and then a 300 mg at bed time. I could take both of the 300 at dinner, but then I'd be asleep by 6:30 pm, and that's no good for me. Like I said, it all depends on how your body reacts, but splitting the daytime doses in 100 mgs 3x a day, it just works better for me.

I'd say, if you are on 600 mg a day, that is what I would consider a low dose, so this could be why you aren't really noticing it helps much. I'm not an expert- this is just my opinion.

As for coming off the Norco- if you have been taking them on a regular basis for several months, then yes, I would imagine your body will deffinately withdraw. Even though you aren't taking and exhorbitant amount, your body is used to having this medication, and if you stop taking it abruptly, then it will rebel against that. If your doctor wants to take you off them, you may want to ask him to taper you so that any withdraw discomfort can be reduced. It's no fun to be in chronic pain, but to add withdraw on top of that would only serve to create more discomfort. I'm sure your doctor could understand your not wanting to stop the hydro cold turkey.

As for your problems post gallbladder- did your surgeon put you on any kind of suppliments/digestive enzymes? If not, and you are having problems it might be worth looking into. My cousin & Aunt take a powder suppliment every day since they had theirs removed. They mix it with water. Not sure of the exact one they take, but Creon 10 is one of them. It really has kept them from having the problems some people have after having their gallbladders removed. Maybe check in the Digestive Disorders boards for more information on this?

Good luck with the Neurontin. I do hope you will be able to titrate easily and start noticing a marked difference. Again, keep checking back because there are people on her who can give you more information on all this stuff!

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