how big a load am I taking?

[kupple]

I've been on hydromorphone 4mg BID for a couple years for DDD, hip, and arthritis type pain.  Some days I may only take one 4mg tab - others I might take 3 tabs over the course of the day - it all depends on my pain level.  The only side effect is some memory problems but that might be age related???  I also take 800 mg Advil BID and Prednisone PRN.
My question is - if I stop taking the hydromorphone, will I suffer a withdrawal?  As doses go, is 4mg a large dose?

Kupple

[geminigirl1963]

I do hope that you didn't take my comments/suggestions as that I was a physician or medical professional of any type.  I was simply relaying my ideas and personal experience.  Any and all changes to medication/treatments should definitely be discussed with and approved by your physician/s.

I apologize if I gave the impression that I was anything more than a fellow chronic pain sufferer.

[Tuckamore]

Hello Kupple,

Welcome to the Pain Mangement Forum I am glad that you found us.

Never change your dosage or cut a pill in half without first checking with your physician. It is difficult to say how much withdrawal you will experience when you cease taking the hydromorphone under your physician guidance and monitoring.

As Geminigirl said, You are on a relatively low dose but your system is use to have some level of narcotics. Your withdrawal may be tolerable. Again that is something I would not do until you discuss it with your physician.

Prednisone PRN if taken only a few times a month should not be causing memory issues. The ibuprofen should not have an effect on it either. According to my information ibuprofen cannot cause an elevation in your B/P unless you are taking other medications that you have not mention. It can however interfere with some hypertensive agents (B/P lowering) medications.

Celebrex though similar is different from ibuprofen in that cardiovascular side effects including increased blood pressure have been reported in 3.9% to 13.4% of patients.

These are all things that if you are concerned with or are causing you issues should be addressed with your physician. None of us on this forum are physicians or experts.

I wish you the very best and hope that you will keep in touch with us. I will look forward to your updates.

Take Care,
Tuck

[geminigirl1963]

Your dose of the hydromorphone is relatively low - especially since you say some days you only need to take one tablet.  At one point (after shoulder replacement surgery) I was on 8mg every 4 hours!  There's still a chance of w/d symptoms since you've been on the medication for a couple of years, even at a low dose - every person is different as to how their body reacts when a medication is stopped.  What you may want to try (double check with your doctor or pharmacist before doing this though) is to cut the tablets in half (definitely make sure they are NOT time-release ones) and instead of taking 4mg at a time, take 2mg and then see if you can not only do that, but also lengthen the time in between your doses.

As far as the memory problems, I actually would relate them more to the prednisone and the advil than the hydromorphone.  I know when I've been on prednisone, my memory gets to be absolutely HORRIBLE.  If this is a recent change in your memory and/or sudden change, I would definitely check in with your doctor - advil is an anti-inflammatory and can, in some instance, cause bleeding problems - mostly in the GI tract, but there's also a chance of bleeding elsewhere, such as the brain.  Another thing to consider with the advil is that if you have high blood pressure, any type of anti inflammatory can increase your blood pressure (I have to be very careful with them - was on Celebrex for a short time until it elevated my BP to 185/105 - went back to normal as soon as I stopped the meds) - Untreated HBP can also cause memory problems sometimes (by the way, long term prednisone use can also raise your BP)

Best of luck!