Concerning pain medications...

[RobM105]

Does anybody have any thoughts on pain medications? I'm just curious as to which ones work best. My 300mg x 3 a day of gabapentin used to work, but the pain's getting a lot worse, and it's taking more and more, and now I'm up to 600 mg x 3 a day, and the pain still leaks through sometimes.

Is there anything anybody could suggest? A friend I met awhile back in one of the groups I joined for sufferers of MS suggested Oxycontin, but that seems excessive as well, and I heard narcotics don't really work too well on nerve pain. Anybody here have any experience with it?

[Cammie]

I take Oxycodone and it does help. I am on a low dose and the doctor is reluctant to prescribe any higher, due to the picky laws and all the media attention focused on drug addiction and Oxycodone abuse. I take Gabapentin and Oxycodone is a good back-up to Gabapentin. It's not a cure-all, however. I'm hoping to be able to try some form of cannabis soon, but doctors around here don't want to prescribe it. Yet!

[RobM105]

I'm on roughly 2400 mg of Gabapentin, 240 mg of Codeine, 2400 mg of acetaminophen and 2400mg of ibuprofen, daily right now. It seems to work, but it leaves me so strung out, and any less means I'm still in quite a bit of pain. Does Oxycontin do the same?

[Cammie]

It sounds likes you are in worse pain than I am! Everybody experiences MS differently, and everybody also responds to pain meds differently. I have read in different MS forums where some people take two or three times as much Oxycodone as I do, and for some, it doesn't work. I definitely recommend giving it a try. There are many good doctors who understand that some people have to have this pain relief, and some people need more than others to get relief.

[jimmylegs]

robm105, are you still working on this issue?

[RobM105]

Well, they increased my dosages of Gaba to 1200 every 8 hours. 3600 mg a day. Slightly high, but there's no real side effects to it, are there?
Why do you ask, anyhow?

[coach]

was taking gaba and still am. Vicodin helps but am worried about it being a narcotic. thought that wasn't supposed to help with neuropathic pain but does. quicker than gaba. wonder if I can get neuro to prescribe. mainly calf muscle pain and pain in bottom of feet and recently pain (numbness) in pelvis (front area). also csf fluid out of nose. lack of appetite. from what i've read on this site the meds have their problems. also hoarness in voice. no allergy or cold. vocal cords ok per ent dr. upper body wants to tip backwards. legs useless. strength doesn't seem to be an issue. getting pressure from family members to try drugs. would probably be recommended to try novantrone. don't know where to turn. not convinced
AI drugs are the way to go.

[NHE]

getting pressure from family members to try drugs. would probably be recommended to try novantrone. don't know where to turn. not convinced AI drugs are the way to go.

Novantrone (also known as mitoxantrone) is cardiotoxic. The number of treatments you can receive is limited. Congestive heart failure can occur during treatment or even years afterwards. It's not a long term solution as an MS treatment. Leukemia is also a risk factor of novantrone.

Congestive heart failure (CHF), potentially fatal, may occur either during therapy with NOVANTRONE® or months to years after termination of therapy. Cardiotoxicity risk increases with cumulative NOVANTRONE dose and may occur whether or not cardiac risk factors are present. Presence or history of cardiovascular disease, radiotherapy to the mediastinal/pericardial area, previous therapy with other anthracyclines or anthracenediones, or use of other cardiotoxic drugs may increase this risk. In cancer patients, the risk of symptomatic CHF was estimated to be 2.6% for patients receiving up to a cumulative dose of 140 mg/m². To mitigate the cardiotoxicity risk with NOVANTRONE, prescribers should consider the following:

All Patients

• All patients should be assessed for cardiac signs and symptoms by history, physical examination, and ECG prior to start of NOVANTRONE® therapy.
• All patients should have baseline quantitative evaluation of left ventricular ejection fraction (LVEF) using appropriate methodology (ex. Echocardiogram, multi-gated radionuclide angiography (MUGA), MRI, etc.).

Multiple Sclerosis Patients

• MS patients with a baseline LVEF below the lower limit of normal should not be treated with NOVANTRONE®.
• MS patients should be assessed for cardiac signs and symptoms by history, physical examination and ECG prior to each dose.
• MS patients should undergo quantitative reevaluation of LVEF prior to each dose using the same methodology that was used to assess baseline LVEF. Additional doses of NOVANTRONE® should not be administered to multiple sclerosis patients who have experienced either a drop in LVEF to below the lower limit of normal or a clinically significant reduction in LVEF during NOVANTRONE® therapy.
• MS patients should not receive a cumulative NOVANTRONE dose greater than 140 mg/m².
• MS patients should undergo yearly quantitative LVEF evaluation after stopping NOVANTRONE to monitor for late occurring cardiotoxicity.

Secondary Leukemia

NOVANTRONE® therapy in patients with MS and in patients with cancer increases the risk of developing secondary acute myeloid leukemia.

NHE

[NHE]

I'm on roughly 2400 mg of Gabapentin, 240 mg of Codeine, 2400 mg of acetaminophen and 2400mg of ibuprofen, daily right now. It seems to work, but it leaves me so strung out, and any less means I'm still in quite a bit of pain. Does Oxycontin do the same?

That sounds like a lot for your liver to detox. You want to look into taking some n-acetyl cysteine to help it out. It's used to make glutathione which is the principle detox agent of the liver. Loss of glutathione is why an acetaminophen overdose is toxic. It uses up all of the glutathione and then the liver can no longer deal with the acetaminophen metabolites.


NHE

[msmything]

I'm in a significant amount of pain, have been for 10 years? I was actually diagnosed after receiving a Cat scan due to a severe headache, turned out the MS was so active it was visible on CAT scan, though they did a follow up MRI with gad. I could deal with the pain in my head with advil/tylenol max dosage perday, along with getting chiro adjustments. After a few years, I started on Gabapentin 600/3xdaily and baclofen 20 mg/4xdaily. The BEST was the start of Cymbalta 60mg 1 sometimes 2 x daily.
A number of years ago I started to go to a pain management specialist, he started me on Norco 6x daily. I've since moved to Oxycodone 90mg a day along with a Fentanyl patch 150 mcg every 3 days. I LOVE the patches, the 1st time I awoke with no pain, I thought my life was my own again

Yes, it sounds like I should be walking in to walls all of the time, but you adjust as it comes along. My liver enzymes are fine, I've taken a Milk Thistle Blend for many years. I feel the DMDs we take are stronger than anyone is supposed do to themselves...

[BethT]

I am on gabapentin (2400mg/day), baclofen (50mg/day), oxycodone (20mg every 8 hrs) and morphine (60mg every 8 hrs). Plus Aleve and Tylenol. Even that doesn't always take care of the pain these days... but am on track to be getting a pain pump implanted over the summer. Am pinning my hopes on that!

[vender]

Nubain / Nalbuphine. It is an agonist antagonist. It will not get you high. It is not addictive. It is not a scheduled painkiller. It will however block your opiate receptors. It has worked amazingly well for my pain. I have found a side affect that completely gets rid of my leg spasticity. Not many people take this drug and very very few doctors even know what it is. It is only prescribe to 2500 people in the United States. It is a shot. 3 to 5 times a day But I would not be walking without it. If others are taking this drug please respond.
It is given to women before childbirth. It works better and women than men. I am a man and it works great. I no longer take opiates and have my life back. For me this drug is a lifesaver.