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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Rick Alan on April 4, 2016, at 5:01:21
There are warnings about codeine and parnate on most drug interaction sites, but I recall having taken a low dose of Vicodin for two years while on Parnate several years ago with no problem. Now for back pain I would like to start a low dose of codeine 15-30 mg per day, and would like to know if this is safe in spite of some of the warnigns
Posted by J Kelly on April 4, 2016, at 7:00:17
In reply to codeine and parnate?, posted by Rick Alan on April 4, 2016, at 5:01:21
> There are warnings about codeine and parnate on most drug interaction sites, but I recall having taken a low dose of Vicodin for two years while on Parnate several years ago with no problem. Now for back pain I would like to start a low dose of codeine 15-30 mg per day, and would like to know if this is safe in spite of some of the warnigns
>I had a hypertensive crisis while taking Parnate. My GP prescribed a narcotic pain med and neither of us knew the danger of combining it with an MAOI. I spent the day in the e/r. I cant be sure it was codeine, however I would be very careful if you decide to take it and ask your pdoc for Nifedipine just in case.
Jade
Posted by SLS on April 4, 2016, at 7:30:03
In reply to Re: codeine and parnate? » Rick Alan, posted by J Kelly on April 4, 2016, at 7:00:17
http://bja.oxfordjournals.org/content/95/4/434.full
It is a difficult decision to make.
- Scott
Posted by Lamdage22 on April 4, 2016, at 8:14:05
In reply to Re: codeine and parnate?, posted by SLS on April 4, 2016, at 7:30:03
Try medical marihuana for pain instead. Preferably a strain with equal amounts of THC and CBD.
Posted by Rick Alan on April 4, 2016, at 11:54:26
In reply to Re: codeine and parnate? » Rick Alan, posted by J Kelly on April 4, 2016, at 7:00:17
SLS (Scott?) according to the article you sent
"The limited available clinical and experimental data agree that morphine analogues are not SRIs, nor do any of them precipitate serotonin toxicity with MAOIs (morphine, codeine, oxycodone, buprenorphine). There are no reports of serotonin toxicity with those drugs" but this is a very complex article, perhaps you could interpret this paragraph.
Posted by Christ_empowered on April 4, 2016, at 12:13:45
In reply to codeine and parnate?, posted by Rick Alan on April 4, 2016, at 5:01:21
are there alternatives? I don't know much about pain killers...do they still make Darvon?
Posted by baseball55 on April 4, 2016, at 19:37:03
In reply to Re: codeine and parnate?, posted by Christ_empowered on April 4, 2016, at 12:13:45
I've had surgery on parnate and was on oxycodone for two weeks. Nobody, including the pharmacist, raised any flags. I do know that tramadol and demerol are dangerous with parnate, but nothing I've heard or read or been told indicates that codeine, hydrocodone, oxycodone or morphine are problems. Before the surgery, I met with the anesthesiologist about parnate and what might be contra-indicated. They had me on morphine for the first night, so she must have concluded there was no problem.
Posted by Rick Alan on April 4, 2016, at 20:33:56
In reply to Re: codeine and parnate?, posted by baseball55 on April 4, 2016, at 19:37:03
Thanks for this. My Parnate was not interrupted for bypass surgery, and of course i receive strong codeine based pain meds for about two weeks afterward. I had forgotten about this.
Posted by Robert_Burton on April 5, 2016, at 7:29:52
In reply to Re: codeine and parnate?, posted by SLS on April 4, 2016, at 7:30:03
> http://bja.oxfordjournals.org/content/95/4/434.full
>
> It is a difficult decision to make.
>
>
> - ScottExcellent citation. Note that the relevant finding is: "The phenylpiperidine series opioids, pethidine (meperidine), tramadol, methadone and dextromethorphan and propoxyphene, appear to be weak serotonin re-uptake inhibitors and have all been involved in serotonin toxicity reactions with MAOIs (including some fatalities). Morphine, codeine, oxycodone and buprenorphine are known not to be SRIs, and do not precipitate serotonin toxicity with MAOIs."
There is, hence, no possibility of of SS arising from codeine co-administration with an MAOI.
Posted by SLS on April 5, 2016, at 11:48:26
In reply to Re: codeine and parnate?, posted by Robert_Burton on April 5, 2016, at 7:29:52
Nice to see you!
I am interested in knowing whether or not fentanyl is safe when taken with a MAOI. There is some debate about this. Do you happen to know anything about it?
- Scott
This is the end of the thread.
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