Discussions that mention morphine

Pain Management board

Hi to all! I got great magazine at my PM DR office (at HSS). Due to the rules, unfortunatelly i can't give you the name , but it's related to us, CP patients: treatments, medications, pain stimulators, etc.

I read interesting article about meds interaction with Opiates and want to share this with you. A lot of us take meds which CAN interact with narco meds, but for some reason DRs still prescribe them to us.

1. Central nervous system (CNS) depressants, antihistamins, tranquilizers, other prescription pain relievers, seizure med., muscle relaxants, sleeping pills, some anesthetics.

2.Monoamine oxidase (MAO) inhibitors, such as Nardil or Parnate (either one combined with Demerol is especially dangerous).

3. Tricylic antidepressants.

4. Anti-seizure medicines, such as Tegretol, Neurontin, which may lead to serious side effects when combined with Darvocet or Darvon especially.

5. Muscle relaxants, such as Flexeril and others.

6. Sleeping pills, like Ambien, Lunesta and others.

7. Blood thinning drugs like Coumadin.

8. Naltrexone (Trexan, Revia) which cancels the effect of opioids.

9. Rifadin

10. Azastam (AZT) or Retrovir which can cause serious side effects when combined with Morphine.

Now I wonder if some reaction to some meds we have (like Fentanyl patch for example) in reality is a reaction to combination of meds we are taking?
Who knows?

I am pretty sure if some of us discuss this apticle with their DRs, the answer will be not to worry.... But than what is this article written by a very reputable DRs is about??:confused:

Have a great day today!:)
Good job Moldova.

What I understand to be the major issues are:

• never take opioid partial agonists or antagonists with full agonists like morphine, fentanyl, oxycodone, etc. The offending meds would be buprenorphine (Suboxone), Stadol, pentazocine (Talwin), Naltrexone, Naloxone, etc. These meds will usually send us into immediate withdrawal.

• some meds like the antidepressant SSRIs (Prozac, Celexa, Serzone, etc) can affect the performance of opioids. Usually they will reduce the potency of the opioids. Other antidepressants like the tricyclics (Elavil, Nortriptlyne, amitryptline, etc) can increase the potency of opioids.

•anti-seizure meds can make opioids either more or less potent depending on which one.

• Demerol and Darvon produce nasty metabolites when used chronically and should be avoided. When taken with Nardil or Parnate the results can be terrible.

Looks like we read similar stuff, although you've got a few I hadn't heard of.

Thanks again Moldova,