Possible deleterious effect of hydrocodone/ibuprofen (vicoprofen) on SVR

[kittyface]

Does anyone have any thoughts/comments/info about this?  Is everybody taking just tylenol/ibuprofen for sx misery?  Perhaps prescribed opiates would help make the journey more tolerable?  I understand the potential for addiction but would it be worth it?  

What say you?

Kittyface

[mremeet]

I don't think you could or should take an opiate based pain reliever unless you're experiencing severe pain. Even then I believe it's usually used only for a relatively short period of time due to its addictive properties (unless the patient is terminal). I'm in my 24th week of treatment and have had all sorts of side effects. The only time I really needed pain meds was for the first shot (which was a doozy) and once in a while afterwards here and there (usually just before my shot). I also took a couple of valium when I went to the ER for some relief from a really bad rash I had. Otherwise I get by without them ok. Also, I would think it's unlikely your doctor will prescribe them to you on an ongoing basis.

From my experience, most hepatologists simply assume (or suspect) their patients are in all likelihood former or currently active IV drug users (due to the large percentage of patients who contracted HCV that way). So a patient's possible addiction/desire for opiates (and other drugs) are always in the back of their minds, especially if the patient is asking for what may appear to be excessive pain relief. My doctor or nurse have never accused me of such a thing, but I've picked up on subtle cues during the screening process and also with how "stingy" and reluctant they were to provide me with meaningful pain relief prior to having my biopsy. I think they did that because they assumed I was likely to have been an IV drug user.

Anyway, that's my experience, yours will probably be similar. Lastly, I was in a bad accident many years ago where I was laid up in the hospital for quite a while with very painful injuries. They gave me morphine for several days, which definitely makes you feel better. But even after just a few days I did not want to come off of it. Plus it constipated the he11 out of me. If you're in desperate pain, especially if you're terminally ill, then opiates certainly have their place. Otherwise, they're the scourge of humanity. I'd avoid them at all costs.

[scubadiver30]

I was thinking the same thing last nite. Ibuprofen nor Paracetamol aren't cuttin it anymore and I was on my way to the pharmacy to ask for stronger stuff (I've read somewhere here that Steve Tyler managed sx with Percocet or Vicodin???)..So I was gonna ask for the Spanish Version of Percocet (Is this opioum based???)...
And now that you said it, I don't know if my doc thinks I'm an IV user (he always told me not to worry about transmission vectors, I could have gotten it in the dentist or in a surgical procedure, he said) but maybe you're right. Maybe they stigmatize us all unconsciuoslly..
You'd think if I take a stronger med for 10 weeks I got left I'd get hooked? Shoot.. maybe I could deal with that later and just finish TX with the proper duration.
Now, at week 12. I'm about to drop out..
It is really killing me :-(

[Xenigma]

Lyrica for pain.  not an opiate.
Ask your doc about it.  Everyone says it is wonderful.
(You can gain weight from it though)
enigma

[ladybug52]

I have taken an old prescription of vicodin on shot night and it's amazing how much tolerable symptoms are. I held off till week 8 and took my shot that day then the vicodin 1/2 then 1/2 4 hours later. I am very stingy with them since I don't have a lot, I doubt if I could get hooked. Besides, it's the pain relief I'm after, not a high.

[painterlady13]

Because of a previous back surgery and the length of time I must stand at my job, I must take vicodin 2 or 3 times a week.
Since I found that I had HCV I lowered the dose from a 7.5/500 to a 5/500 and now only take one if I need it, I used to have to take at least one a day and cut back.  My doc said this was ok as long as I didn't over-do the acetominiphen(sp) no more than 2000 mg a day and I add the content of the vicodin in to that count.  

[nygirl7]

Where did you hear Steven Tyler took Percocet for sides? I would have bet 100000 dollars that wasn't true - he's sober and has been a LONG time so I'm shocked.

I wouldn't take ANY medication on a regular basis - whether it be tylenol or vicodin but remember...vicodin HAS tyelnol in it. So you can't take two every four hours or something like that because...that is an awful lot of pounding on your liver.

I got a bottle of 60 percs about six months ago and still have some left. All of this hell has been to improve my liver histology - so I have no intention of doing something that might hurt it one bit.

[scubadiver30]

Hi New York Girl
How are u doing these days? I guess you're feeling better yes?
Sorry about Tyler, I just read it someplace. I didn't know you were an Aerosmith fan...
I was just looking for options cause I'm feeling pretty bad these days (and I'm takin Ibuprofen everyday..):-(
I guess the pounding on the liver during TX is a must if we wanna finish the course
saludos
scuba

[nygirl7]

I would just be surprised because he didn't take them with his surgeries - maybe he has more confidence now that he won't use again but knowing him I just am very surprised by it. I really am. Guess it hit him harder than most of us (although he looks like **** still and that sort of scares me).

I want to get ahold of him and have a post treatment picture taken - we used to be pretty once upon a time :)

God I hate this disease.

I think its fine to take an occasional perc or something just not on a daily basis if possible. Anything that your liver has to filter isn't good for it (says me who smokes....so what does THAT tell you? Oh yeah nygirl < Worlds Biggest hypocrite).

[GrandOak]

IMHO, nothing is worth the toll addictions (physical, emotional, or social) demand upon your body, mind, and spirit.

FWIW, while on tx, for me Tylenol was recommend (PM variety to help sleep at night):

1) To offset any flu-like sx's
2) Because of low platelets and hence low clotting factor, ibuprofen was discouraged.

[Forseegood]

Hi, just wanted to thank you for the tip, never heard of this stuff "Lyrica"? but I'll google it, I'm allergic to opiates, so this news comes in handy...hope everyone is feeling better who is reading this...

Copyman: speaking of opitates, I was busy and wasn't able to write you on this awhile back, but you mentioned that you had chronic constipation and some kind of rumbling in the stomach...how long have you had this? what are your stats again please? if you dont mind me asking...thanks in advance...

[ladybug52]

Well there you have everyone's opinions. I would have never said that I was taking an old vicoden script if you hadn't brought it up. I think Mrmeet is right, most dr's think we are all drug addicts. I couldn't even get mine to prescribe something for nausea last week. FWIW, I know better than to take tylenol and vicodin. Mine are 500mg and if I half it I still don't take additional Tylenol. I'm weeker than a lot of folks I guess, I hate pain, fever and body aches. I couldn't do this 72 weeks!!!!!!!!
Scuba: Hang in there! I had a horrible couple of days last week and now feel great. I'm just hoping some of those good days will come your way soon. Do what it takes to get thru this, just finish the tx. And I'm not to stingy to send you vicoden! It doesn't have to be refrigerated!
Bug

[mremeet]

Why would a "normal" HCV patient undergoing IFN/riba treatment ordinarily need an opiate based pain reliever? In the absence of a physically debilitating pre-existing condition like severe arthritis or a serious back injury (which Kitty did not mention having), why would opiates be appropriate? I think they should be an absolute last resort, opiates should only be used under sufficiently serious situations warranting their use. And IFN/riba treatment rarely rises to that level for the vast majority of patients who undergo combo therapy. I've had just about every side effect in the book and then some, and I haven't needed any opiate based pain killers. Ibuprofen, acetaminophen, naproxen, anti-histamines, moisturizing lotions, sleep aids (lunesta), anti-depressants and prednisone? Saure. But opiates? Nah.

Treatment usually causes fatigue, exhaustion, irritability, insomnia, mental confusion, depression, hair loss, itching, skin rash, dandruff, psoriasis, anemia, neutropenia etc etc. This can make you one miserable SOB (as it certainly has in my case), but I wouldn't characterize this type of suffering with acute physical pain that would warrant an opiate based pain killer. Even in my very worst moments of writhing in misery from a horrible rash I had (drug allergy), I can't say I couldn't get by without opiates.

A broken arm? A slipped disc? An abscessed tooth? Kidney stones? Sure, but not for ordinary IFN/riba treatment.

[mremeet]

A "real live educated doctor" told you the only nsaid you could take was Ibuprofen because the others "eat your liver like pac man?" And they also "kill your heart"? And therefore only opiate laced Tylenol is what's required for long term pain relief associated with IFN/riba side effects??

Tell me sambone, was this doctor from Earth or was he a specialist in Martian physiology? That matters, you know?

[ladybug52]

I have a very physical job lifting patients and excercising them and walking them all day. I am very sore and can usually put up with aches and pains, but add fever with a pulled back from lifting a 200 lb patient off the floor and, yes I feel justified taking 1/2 a vicoden. Everyone is quick to tell others what they should or shouldn't do. It's a personal matter and I knew I would regret saying anything, but I'm not going to hide it either.

[giddyup]

If you need to stop pain a drug like norco or vicodin will work great. I received them from my hepatologist throughout tx. They really helped.I've been told some people can't control there urge for more, but I've never met someone like that. Docs regulate their dispension quite heavily so even if you did become "addicted" you would have a hard time getting them. Just because you take some doesn't mean you're getting on a toboggan to hell. If you can't take the pain then take the med. giddy

[ladybug52]

First I commend you on your strength. I wish I could handle pain better. It's not like I sit around and enjoy the pain meds. I work full time go to my son's high school soccer games twice a week and my bowling league on Thurs. I know I am being overly sensitive about this but I just wanted you to know not everyone is "normal" I thought I was, but if taking an occasional 1/2 of vicoden makes me not normal, then I'm a wimp.

[mremeet]

Ladybug I wasn't trying to be dismissive of someone like yourself who might be taking an opiate based pain killer for a legitimate reason. If you read my posts carefully above I did qualify my statement repeatedly that I don't think opiates were ok *unless* you experienced severe/debilitating physical pain due to an injury etc. And if you truly are experiencing a situation like that, and your doctor has no problem prescribing them to you on an ongoing basis, than I'm certainly no one to argue with that. Besides, you're a nice person, so I don't want to argue with you anyway ;-)

Sambone, this whole thread was initiated by kittyface's simple and direct query. And kittyface didn't say she was experiencing any kind of chronic physical pain associated possibly with a pre-existing condition (not yet anyway). She simply asked about the general viability of taking an opiate based pain reliever as an ongoing way to manage normal side effects of Tx. And so my answer to her (not you) was based within that context. And I maintain it's perfectly reasonable and definitely desirable to avoid opiates for a "normal" patient during a "normal" course of tx. And I explained my side effect laden situation with treatment as an example. And let me tell you something, I'm probably one of the biggest sissies out there when it comes to pain threshold/tolerance. My dentist always marvels at how much novocaine it takes to numb my teeth before he starts drilling/grinding. Even then, half the time I need nitrous. I used to pop percocets like candy when I had a broken pelvis (after I came off the morphine), and they just did NOT seem to cut it. My biopsies were hellish nightmares of excruciating pain, even preceded with with big needles of lidocaine and two ativans. And yet I see woman after woman here saying they "couldn't feel a thing" during their biopsies. I'm the kinda guy if I were captured in a war, and they brought me to the interrogation room and some big 'em effer came walking out with a pair of pliers in his hand? I'M TALKIN' - and I'm talkin' right now. Troop movements, positions, equipment, secret rocket plans, where my porno stash is - WHATEVER - I'm spillin' the beans. So my point here is, if a big whimp like me can handle what is a probably worse (or at least average) tx experience than most experience, and do so completely without opiates - than I think most other people can too. And you know what? Most people do!

If you have a special pain situation that warrants the ongoing and long term use of opiates, fine. But the fact remains: a long term relationship with any opiate is risky, even if it's occasional or intermittent or it's a relatively weak opiate. Especially if you just happen to have a previous history with opiate abuse, as many HCV+ people do. And for those that insist, "Oh I'm not one of those people who get addicted". Ok, maybe you're not, but we are talking about the active ingredient in HEROIN here. I have a good friend who has a crushed verterbrae that was fused and he's had all kinds of surgeries since first injuring his back nearly 40 years ago (he fell off of a hay wagon). He HAS to take oxycontin, which is basically a synthetic form of heroin. And since his pain gets so bad at times, he just HAS to take them. He's addicted to them now and has been for a long time. It's a very unfortunate paradox, he knew the risks ahead of time going into it, but his pain was so severe he decided he had to do it. Now he has what is in all likelihood a lifetime relationship with oxycontin (or equivalent). And I'm not trying to compare oxycontin to Vicodin or what you're taking, but the point remains: be deadly careful with ongoing flirtations with opiates. Make sure they're a last resort, not a first resort.

[ladybug52]

You are so funny!:) I didn't even get to read the whole thing because I have to run (not literally) but I'm sorry I'm so sensitive. You're great. It's one of those things whee initially I was agreeing with you and then I started getting paranoid, and then I started taking it personal and really! You're exactly right. Don't take anything we don't need to take, we're fighting for our livers here!
Bug

[jmjm530]

I agree with much of what you say, but Mre does make some good points, and if we're going to dump on everyone here who has some attitude, well there goes half the posters here including you and I :) I have no doubt that narcotics have their place, but I also noticed over the past two years somewhat of a cavalier attitude (not from you) among certain members regarding their use. Cautions regarding narcotic use are always good in any thread that brings them up.

Be well,

-- Jim

[ithurtss]

Everyone is different, treatment did not work for me and my viral load has shot thru the roof...I take a vicoproen at night to sleep.  I suck it up during the day most of the time.  Doctors have told me that this will not hurt as long as I do not take them all day.  Every now and then I take a Percocet, got 30 of them in Sep 05 and have 6 left, if the pain gets real bad.  I have constent ear infections that contribute to the pain.  I am going to Mayo next week on my own dime to see if they can help with the pain and my energy so i can continue to work.  I do not want to become an addict as I never have beem but if that is what it takes not to hurt and try and have a good life...why not.  Yes people think that we are all junkies but has anyone notices that we have a lot of vets in this hood?  take care