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drug dosage

I would like to know if the combination of paracetamol (2x500), codeine phosphate (4x15) and tramadol (1x50) taken 1-3 times daily is acceptable? I have chronic cardiovascular pain in my legs and diabetic neuropathy afflicting my feet - I am enduring the unendurable every single minute of every single bloody day. I just need to know when it's appropriate to revisit my doctor and start exploring new pain relief, or if I should stick with this for now as it's not quite exhausted yet .... the above combination kind of works but takes away my life because it demands so much regular sleep.
1 Responses
547368 tn?1440541785
Hi Harry,

Please excuse my tardy response to your question. I've had some issues adjusting to our new format. Your post is important to us. I am sorry to hear about your poorly controlled chronic pain. We get it!!

Drug names can vary by country - in some instances even my region. So lets begin by what the drugs you listed are called in the USA. Paracetamol is known by it's generic name, Acetaminophen in the USA. Codeine Phosphate is more commonly shortened to just Codeine. Tramadol is Tramadol in the USA.

I'm confused as to why your medical provider is prescribing two different short acting opiates, Tramadol and Codeine. Neither opiates are high in the scale of potency. It's understandable that you are sleepy. Unfortunately that tends to be a side-effect of most opiates. It's true that some opiates produce that effect more than others - and just because your current combination produces that side-effect doesn't mean that another act the same. Finally Acetaminophen is beginning to be questioned for it's role in  in pain management. It's therapeutic benefits are thought to be minimal.

In my opinion you may obtain better pain control from one short acting opiate and one long acting opiate.

I am also wondering why you are not on a medication that specifically treats neuropathy, two such medications come to mind. The older med and less costly one is Gabapentin. A newer, though similar med is Lyrica.  Lyrica is more costly in the US - but that may not be true in UK. It has also been found to be more effective in many instances than Gabepentin. Obviously we're all different. Which med your body best metabolizes (uses) will determine which one will be most effective for you. There's much more to be said about the two - but that will suffice for now. If you have more questions on these meds, please feel free to ask.

If your pain is poorly managed - which it sounds like that is the case - than it's time to take a different approach to better manage your pain. I would certainly discuss this with your medical provider. You may even find that an addition of Gabepentin or Lyrica you provide better pain control with less of your current medications.  

No offense, I find the combination of meds being prescribed for you rather unusual - but maybe that's customary in the UK. Be assertive and ask for help from your medical provider. No one should have to suffer with poorly managed chronic pain. My heart goes out to you!

Again please excuse my tardy response. I do hope something I've offered has been helpful.  I'll look forward to hearing more from you, soon. Also if you have additional questions or need clarification of something I said, please feel free to ask.  Looking forward to your participation in our community, my friend in pain. .

Best of Luck,
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