Discussions that mention quinidine

Pain Management board


Matchbox,

Nausea can be controlled easily with Phenergan or Vistaril. Ask you doc about writing a script for either of these meds. I use vistaril now, but did use phenergan for many years. Vistaril is meant more for long term use.

In your list of meds I noticed you are taking Celebrex which is a cox 2 inhibitor. I personally would be very concerned about this med. See info on cardiovascular risks:

· CELEBREX may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. All NSAIDs may have a similar risk. This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk.

· CELEBREX is contraindicated for the treatment of peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery.

Gastrointestinal Risk
· NSAIDs, including CELEBREX, cause an increased risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious gastrointestinal events.

Also, you are taking the combination of celebrex, cymbalta and ambien. The following is information regarding drug interactions between these meds and while there is not a great concern I would watch for the indications.

Ambien (zolpidem) and Cymbalta (duloxetine) (moderate interaction)
Description:

MONITOR:
Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

MANAGEMENT:
During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be made aware of the possibility of additive CNS effects (e.g., drowsiness, dizziness, lightheadedness, confusion) and counseled to avoid activities requiring mental alertness until they know how these agents affect them. Patients should also be advised to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

Celebrex (celecoxib) and Cymbalta (duloxetine) (moderate interaction)
Description:

MONITOR:
Coadministration with drugs that are inhibitors of CYP450 2D6 may increase the plasma concentrations of duloxetine, which is partially metabolized by the isoenzyme. The interaction is expected to occur in patients who are CYP450 2D6 extensive metabolizers (approximately 93% of Caucasians and greater than 98% of Asians and individuals of African descent).

MANAGEMENT:
The possibility of prolonged and/or increased pharmacologic effects of duloxetine should be considered during concomitant therapy with CYP450 2D6 inhibitors, particularly potent inhibitors such as quinidine, paroxetine, and fluoxetine.


It is also possible that any of these drugs or the combination of them could be causing your headaches.

Carol