Chronic Pain Today

Vicodin, or generically known as acetaminophen with hydrocodone, is a schedule III drug.Vicodin is given for pain management and relief to those where the benefits of the drug should outweigh any potential side effects. Hydrocodone is an opiate like narcotic and acetaminophen is an over the counter (Tylenol) pain reliever. The combination of the two show to have more benefits than each alone.

Side Effects

Nausea, vomiting, constipation, lightheadedness, dizziness, drowsiness, flushing, vision changes, or mental/mood changes

Serious Side Effects

Changes in urine production, slow or irregular heartbeat, slow or irregular breathing, impaired or restricted hearing

Cymbalta, or the drug duloxetine hydrochloride, has been cleared by the FDA as only the second drug for fibromyalgia. However, not everyone can take it. There are some side effects of Cymbalta and there are various dosages for different conditions.



Nursing mothers should not take Cymbalta because the effect on the infant is yet to be known. This also goes for pregnant women during the 3rd trimester. There is potential risks to the fetus can include extended hospital stays, tube feeding, and some respiratory distress.



Those with renal failure or impairment should not take Cymbalta.


The elderly should not take Cymbalta as there is no dose adjustment for it. If it is prescribed, special care should be taken and the patient needs additional onitoring.


Those with Hepatic insufficiency should not take Cymbalta.


Cymbalta is designed for those with fibromyalgia, diabetic neuropathy, Generalized anxiety disorder, and and major depressive disorder. The dosing ranges from 20mg to 60mg once or twice a day. For more info on dosing Cymbalta see the various dosages for different conditions.

Acetaminophen is more commonly know by its brand name Tylenol. It is one of the drugs with the fewest side effects and the most tolerance by those taking it. It is typically mixed with stronger drugs for pain management in chronic illnesses.

Acetaminophen with codeine (Tylenol with Codeine)

This has side effects of nausea and vomiting, constipation, and disorientation. Generally codeine has to be broken down in the body by an enzyme for it to be turned into morphine. Some people cannot do this and therefore this drug is not effective in those people.

Acetaminophen with hydrocodone (Vicodin, Lortab, Zydone)

Relatively safe and useful medication but its usage can be habit forming and there is a chance of becoming dependent. Time spent on Vicodin should be less than a week. There are very few side effects to Vicodin, mainly constipation.

Acetaminophen with oxycodone (Percocet , Tylox)

Again, like Vicodin, the main side effect is constipation. This drug is relatively safe and is a wee bit stronger in most people than Vicodin. It is still a short term solution to pain and shouldn’t be taken in long term situations.

Cymbalta, brand name of the drug duloxetine hydrochloride, has now been accepted as the second drug available to help in the treatment of fibromyalgia. This medicine is available in three strengths: 20mg, 30mg, and 60mg. Depending on what the Cymbalta is treating there are different starting doses.

Fibro

Starting dosage of Cymbalta for fibromyalgia is 30mg once a day for one week, and then a maintainence dose of 60mg once a day.

Diabetic Peripheral Neuropathic Pain

Cymbalta for Diabetic peripheral neuropathic pain has a dosage of 60mg a day, with a slower starting dosage for those that are already in renal failure.Studies haven’t shown how effective this drug is in this condition past the three month mark.

Major Depressive Disorder

Typical doses for major depressive disorder is 40mg administered in 20mg twice a day. Treatments of up to 60mg a day can be seen, usually either once a day or in 30mg twice a day.It may require several months of treatment on this drug.

Generalized Anxiety Disorder

Cymbalta is typically started at 60mg once a day although some patients will see 30mg doses for a week before going on to 60mg a day.Control of GAD after the 10 week mark on this drug has not been established.

See the Side effects of Cymbalta

Side effects of Cymbalta:

• Nausea

• Dry mouth
• Constipation
• Loss of appetite
• Tiredness, Drowsiness, Yawning
• Dizziness
• Increased sweating
• Blurred vision

Patient exclusion criteria:

(Things that will keep a person off of being prescribed Cymbalta usually)

• Epileptic Seizure

• Closed Angle Glaucoma
• High Blood Pressure
• A Drop in Blood Pressure Upon Standing
• Hardening of the Liver caused by Alcohol
• Chronic Liver Inflammation
• Hardening of the Liver
• Liver Problems
• Serious Kidney Problems
• Manic-Depression
• Suicidal Thoughts
• Alcoholism