This is a pretty old post, but there are quite a lot of responses explaining why Demerol isn't used much anymore, especially for long-term use. You may want to post a new question so you'll get better responses.
It could be you've grown tolerant to the Endocet. Talk with your doctor and they may up the dosage or change you to another medication.
I have been wondering about asking my pain management physician about Demerol for "break-through" pain days.
I wear a Fentynal patch that I change every 48 hours and that keeps the pain manageable for the most part. But for bad "break-through" days I've been using Endocet (and have been for several years). It doesn't seem to be making a difference anymore...even when I take two at the same time. I'm thinking of asking my doctor about Demerol for the bad days. Any thoughts?
I also use zofran, SO much better than phenegran. And my copay is $10. Works great!
I wish you the best Mellie! I hope that you get that surgery soon if you need it. Please let us know how it goes!
Wow, what a great amount of information. Well, I guess I know why my NP has never mentioned Demerol for BT pain.
I have tried both compazine and Zofran for post surgical nausea and vomiting. I have a strange time with it. I don't get sick the first day,but subsequent days I do and it gets worse by the day until about Day 6 or 7 post-op. Even with the Zofran I wind up vomiting repeatedly. Last time they said they would probably admit me for a few days. Normally that would ve a problem but since the kids are in Maine for the week, it may work out, IF i have the surgery on Tuesday.
I see the surgeon tomorrow at 11; so hopefully I'll get some answers.
WOW! Thanks for checking on all that Sandee. I'll check out what my insurance plan covers and my pharmacy as well. That is such good news for me!
This is the price comparison I found. It is quite a bit of difference here. When I had mine filled I paid about eighty dollars for 12 tablets but it was the Zofran and I got it at a discounted price.
ONDANSETRON HCL 4 MG TABLET 30 tablets $18.83
ZOFRAN 4 MG TABLET 30 tablets $720.26
Zofran IS available in a generic form. Ondansetron is the generic name.
The patent for Zofran recently expired, which is why it can now be purchased and manufactured in a generic form. There are several strengths of generic Zofran available for sale, including Ondansetron 4 mg to 8 mg tablets. It also comes in several forms.
I don't know the cost differance between generic and brand name but there should be a difference. With all newly patent expired meds the cost will eventually come down.
Phenergan is actually an antihistamine and makes sense that it would not work as well as a drug made just to treat nausea and vomiting such as Zofran. Zofran works by blocking the action of serotonin, a natural substance that they believe may cause nausea and vomiting.
I'm always told that they don't use it as often anymore....I am severely allergic and have to always make sure they know that, and they always say that it's not used as often. I discovered I was allergic right after the birth of my first baby, when I swelled up in my neck, throat, face, vomiting, and they are asking me "Are you allergic to demerol???" hahaha what do you think???? What was awful was that they had to give me medicine to counter the effects and get it out of my system when they had to rush me to surgery because I was hemorrhaging...and I was screaming in pain as they forced blood transfusions into me and did a D&C to stop the bleeding....traumatic for sure!!
I am also told that most people have nausea and vomiting from it, that's why I have to specify that I have swelling.
Didn't mean to go off and tell a story...just the word "demerol" makes me nervous!!
I think it's just that the generic Zofran is also very expensive. My doctor prescribed it for morning sickness and only prescribed 5 pills. I found out why when I had it filled, 5 pills cost $89. It's safer and more effective than phenergen, but it's still too bloody expensive.
This is why it is not used for pain management. I read alot of articles about the different pain management drugs and can't find the one I was thinking of but this explains some of the reasons.
Demerol has fallen out of favor in pain management due to the breakdown of demerol in the body produces nor-meperidine. With prolonged use as in chronic pain management this build up can cause dangerous and uncomfortable S/Es. As nor-meperidine builds up in the body it can cause confusion, combative behavior and can lower the seizure threshold. Demerol more specifically nor-meperidine is metabolised in the kidney thus anyone with kidney disease of dysfunction should not receive it. Elderly people who are more prone to confusion (sun downers) etc should not receive it. Demerol is fine for short lived acute pain in young healthy people although most Dr.s don't prescribe it correctly since in young healthy individuals with good kidney function will clear the drug quicker than the usual q 4 hrs it is prescribed Q2 to Q3 is more in line with the drugs bioavailability. Demerol works well in post op especially for the patient who is having post operative shakes. Long term pain management is not the correct clinical application of demerol. While I am on it Phenergan doesn't potentiate anything except sedation. Phenergan has been shown to actually increase pain perception in patients.
Jaybay,
The Zofran worked great when I could not keep my meds down. It really works well. Thanks for the info about it:)
Hi Jaybay,
From what I've sen on here I don't believe that there is a Generic Form of Zofran as yet. I'm assuming this as EVERYONE is talking about how very expensive Zofran is. I think it's still too new. Sorry!! :(
If anyone that is using it will answer then we'd know for sure. I called CVS and asked about a Generic for Zofran and they told me that there is that there IS a GENERIC out. They said it's been out for about a year now. So I don't know, maybe the Generic is INCREDIBLY expensive also. But at least you can check the price where you live!!
Please let us know what you find out........Sherry :)
Just an FYI for anyone who experiences nausea and vomiting with general anesthia - ask the anesthesiologist to include zofran with the mix. That stuff is a wonder drug for nausea and vomiting. It's my understanding that it was developed for chemo patients. Whatever the reason, since it came into more widespread use I have never once had a problem with anesthesia-related nausea. I had one oral prescription for it a few years ago, but because there was no generic at the time and I need an anti-emetic daily, I had to stick with phenergan. Does anyone know if zofran has a generic equivalent now?
The information I have regarding Demerol in Pain Management is not encouraging. In my state it is not used for that purpose accept in short term, extreme cases. But every state has their physicians have different approaches to pain management.
Demerol acts differently than morphine and the family of morphine derivatives and synthetics. They targeting nerve endings from transmitting messages of pain where Demerol does not..
This is my understanding of the opiate from a trusted source.
"Demerol acts on the central nervous system, essentially tricking the brain by replacing the feeling of pain with a “high.” Patients who are given Demerol for pain are basically feeling euphoric effects of the medication rather than their pain."
When I have been given Demerol it didn't necessarily ease my pain but I sure didn't care if I had it. Demerol use to be the drug of choice post surgical. Now it is used less and less often.
If your physician is open to prescribing it to you it may be worth a try, especially short term. Just be sure you gather lots of information, educate yourself on it and weight the pros and cons.
We are are different. Dilaudid was very effective in relieving my pain but I am allergic to it so it is never a choice. Oh the decisions we are faced with as chronic pain sufferers! It often seems like a crap shoot. My heart goes out to you.
~Tuck
My experiences with Demerol are many. That is MY preferred drug for use when I have my MAJOR surgeries. Sine I throw up VIOLENTLY with Morphine the Doctors have found that Demerol has always been the best to use for putting me to sleep for the procedures. It does cause some hallucinations (not bad) when it is continued AFTER my surgeries for a couple of days. However, if it is stopped within 2 days afterward I'm just fine and it gets me through the WORST part of the pain.
I'm hoping that it will be used for this Hip Surgery that I have coming up on September 8th as that is what they used last time. My GREATEST fear is that I would awaken DURING this EXTREMELY Major Surgery!! I know that the Demerol will not allow that. But I'm NOT sure that it will be an option this time as I'm on VERY strong medications (Fentanyl Patches 62 mcg and Percocets 10/325 every 8 hours) and I don't know if Demerol will be compatible with these Medications. I will be meeting with the Anesthesiologist in the coming weeks BEFORE the surgery and he WILL be in CLOSE contact with MY PM Doctor throughout EVERY step of my operation. I'm VERY grateful that I have such a Professional and Knowledgeable Surgical Team taking care of my EVERY need!!!
I've NEVER heard of Demerol EVER being used for ANYTHING except for Surgical procedures. So I'm assuming that it isn't ans has NEVER been an option for a BT medication. That's just my own PERSONAL obervation on Demerol!!
Good question Mellie!! :)......Mama Sherry
Doctors have seriously backed away from using demerol for even short-term or post-op pain management in recent years. Seniors in particular seem to react very badly to demerol with hallucinations. I don't remember the study well enough to say if that reaction is due to slow metabolism or medication interactions. Apparently there are a lot of side effects and drug interactions with demerol and there are better medications available now.
Many years ago I was given oral demerol for post-op pain management following shoulder surgery. I had a Mumford procedure which involves cutting off the last inch or so of the collar bone where it inserts into the shoulder joint. The demerol didn't work well at all and I achieved more pain relief with vicodin and Aleve (naproxen). But then, bone pain generally doesn't respond all that well to narcotics anyway.
I remember just reading something about how Demerol isn't used in pain management because it has such a short half life and just does not provide relief long enough.
I will see if I can find the article I was reading on this.
I have heard about demerol being used as an oral medication for a pregnant woman (if I remember correctly). Only in one instance. I may be wrong, though. I, too, have only been given demerol in the hospital for serious arm, neck, and shoulder pain. When I was in labor they gave me Staidol. (A derivative of demerol, I believe)
I'm sure our resident pharmacist could tell us more about this as it is most widely used in the hospital, I believe.
If it has worked for you, though, in the past, I don't see why you shouldn't ask the doctor about it when you have your surgery.