Help! Nausea before taking my Hydrocodon

[klynnk1]

Every morning for about 3 weeks I have had severe nausea.  It will last until I take my first dose of Hydrocodon which used to be around 11am but that means nausea every day til nearly noon.  Now I am taking it earlier to stop the nausea but that gives me an extra dose which I don't need for the pain - just to make the nausea stop.  Are those withdrawal symptoms I'm having in the morning? Any suggestions?  I really need some help on this Please ...

[Tuckamore]

Thanks for the update. So often we never hear the from a poster after their initial question - so again, thank you.

I have a concern. Do you DX you have a DX of low thyroid production - or have yourself due to the relief with a nature-thyroid supplement? If you have a true thyroid disorder you require medical treatment. This condition can have some serious side effects - nausea is minor compared to other possibilities. Please consult your PCP.

I am glad that you no longer experience nausea. It may have just taken time for the medication to clear your system. It's also possible that you have some GI distress that requires a diagnostic look.

Please consult your PCP and get to the bottom of your SX. You must be tired of hearing me repeat that - but our health is so important. Conditions caught early have a much better chance of responding positively to treatment and even resolving. On the other hand the longer you wait the more problems that may develop. I know how much I dislike consulting a physician - but it just good sense to do so.

Good Luck My Friend,
~Tuck

[klynnk1]

The nausea never resolved completely after stopping hydrocodon but it did resolve within 2 days of starting nature-throid for hypothyroidism.  Within 2 weeks after that my appetite was back to normal.   I think it was a combo of the low thyroid and the 7 months of pain killer use that screwed up my gut.  Never knew low thyroid could mess up your digestive system.

[Tuckamore]

I am so happy to hear you are doing better klynnk. I'm more than delighted your system worked. Wonderful.

We'd love to hear from you again soon - and please feel free to be active in our community. You are always welcome here.

Warm Wishes,
~Tuck

[klynnk1]

My doctor is booked 3 weeks out so in the meantime I have continued tapering the hydrocodon and the nausea is tapering with it.  I am down to a quarter of a pill so less than a dose of a 2.  Tomorrow I will start the liquid form and do a 1.5 dose.  It may not be the cause but it is working on the symptom. I only have maybe 1 hour of nausea and the intensity is at least half of what it was. Huge improvement and my appetite is finally kicking in again so I think I'm out of the woods at this point.

[Tuckamore]

Sorry I am so late to your post. Welcome to our Pain Management Community. I've not been as active here the last several days due to some pain issues myself - I'm glad you found us and took the time to post.

I agree that your nausea is not likely related to the weaning you are attempting of the opiate. As Phil said you are on extremely small doses of Hydrocodone. He has covered opiate withdrawal expertly. I'd like to address the nausea a bit more.

I really think there is probably another causation of your nausea. It just so happens that a dose of hydrocodone eases it. Why, I'm not certain as chemistry is not my forte. However it's my guess that you may find another med would do just as in controlling the nausea.

There are many antiemetics available (most through prescription) that may control your nausea. An antiemetic is a drug used to prevent and control severe nausea and vomiting.

Some examples of antiemetics are Zofran, Granisol, Aloxi and Anzemet - but these are some of the Big Dogs and you may find relief from an over the counter antiemetic. Pepto-Bismol, Dramamine and Meclizine be be helpful but never take a medication based on a suggestion from an on-line person like myself. Check with your pharmacist. They are the experts in medications and their help is free.

I hope you'll schedule an appointment with your medical provider. He/she can best determine the cause of your symptoms. Nausea is a horrid feeling and my heart goes out to you.

Please keep in touch and let us know how you are doing. I'll look forward to your updates. I also hope you'll be active in our community. We welcome new members as we all learn from one another.

Best of Luck,
~Tuck

[klynnk1]

Thank you for your response.  It was very helpful.

[philnoir]

You are on very small doses of hydrocodone. 5-10mg / day for only 4 months -- Feb - May.

People who take opioids for pain for an extended period of time do not experience opioid withdrawal while they are taking those medications. It is only after the medication is removed that withdrawal symptoms can occur.

However, with your small dose and limited time using hydrocodone, the chances of you experiencing opioid withdrawal are low. Regardless, when you do discontinue opioid therapy, weaning slowly is advisable, however, with a dose of 5-10mg / day, there's not much room for weaning.

People in pain who use opioid analgesics for longer periods of time experience opioid tolerance -- a phenomenon where a dose of opioid analgesic no longer produces the same pain relieving effect.

Opioid tolerance is marked by an increase in pain and does not produce withdrawal symptoms.

People in pain do not normally have "cravings" when they experience opioid tolerance, but they feel pain even after taking their medication -- it stops being effective as a pain reliever.

If the medication is still effective in reducing your pain to acceptable levels, then you are not experiencing opioid tolerance.

I could suggest moving the times of your dosing around closer to bedtime as an experiment, but I don't wish to contradict your doctor's orders.

So, my recommendation is that you ask your doctor to review all your medications. Perhaps this might provide a clue to your morning nausea.

If not, your doctor may want to examine your abdomen, and make some tests to check your overall condition.

Again, even though the hydrocodone seems to relieve the symptoms, I do not think this is a "withdrawal" symptom and I have my doubts that your nausea is related to your hydrocodone prescription.

Please talk with your doctor about this morning nausea. Another good source of information regarding drug interactions that may be causing nausea is your pharmacist.

Best wishes.

[klynnk1]

In January 2015 I had hives and swelling on my fingers from a reaction to medication. I started Hydrocodone dose of 2.5 at the beginning of February  3-4 times a day. By the end of March I was taking 1-2 doses of 3.5 a day.  At that point I started using my hands and pain increased so I was taking a dose of 4 twice a day. April and May were good at that dose. Then the nausea started in June - I haven't started tapering yet but I think my body is wanting more and thus the a.m. nausea.  I have both pills and liquid Hydrocodon so I would be able to adjust my dose slowly for tapering unless that just prolongs it. I just want to cry - this whole thing has been such an ordeal.

[philnoir]

How long have you been using hydrocodone?

What level are you tapering from and how quickly are you tapering?

Withdrawal intensity is a function of length of use, and dosage.

[klynnk1]

I figure I have another month to go before I am off the hydrocodon and I will try and taper off toward the end.  I just need to stop the nausea without making the situation worse.  Nausea is such an annoying component to this whole ordeal.  As I taper do you think it will make the nausea worse or easier to handle?

[philnoir]

Nausea is one symptom of opioid withdrawal. There are many more.

Common symptoms of opioid withdrawal:

Anxiety, "jumpiness", mood swing, restlessness.
Fatigue
Nausea/Vomiting/Diarrhea
Achy Flu-like Feeling, Dysphoria
Rhinitis -- runny nose
Hyperalgesia
Chills, Sweats -- temperature sensitivity