change of painkillers

knackeredknees2

This is my first post on here!!!

I have osteo-arthritis in my left knee. I can't take nsaid's so my only option seems to be paracetamol/codeine mix. I was on 500mg paracetamol with 8mg of codeine but 9 times out of ten this did not help. i would have been better off eating smarties!!!
After a discussion with the DR the codeine was increased to 12.8mg. This was amazing, it worked so well and continues to do so. Then without telling me my repeat prescription was chnged back to the 500/8mg combination. another trip to the DR and it was amended back to 12.8mg codeine with a note put on my records stating that the lower dose did not work.
This morning i got a letter from the GP stating that it was getting changed again to 500/8mg. Something about "our prescrbing advisors recommend this is a more cost effective way to prescribe co-codamol and is equally effective"
I am know left wondering what bit of "the lower does doesn't work" they don't understand!!
Does anyone know of clinical guidelines for this? or am i just going to have to take eating smarties? I am obviously going to be on the phone on Monday morning to point out the error of their ways..
I would appreciate any advice.

Harlansmummy

I recommend asking for the codeine and paracetamol separately. I have the standard 500mg paracetamol, and the 15mg codeine tablets. That means I can dose the codeine according to need, so anything between 15-60mg.

Obviously with co-codamol you can't do that as you would be taking too much paracetamol.

ETA would you be able to take NSAIDs if you took something like omeprazole with it? And also, perhaps you need to change doctors :roll:

knackeredknees2

thanks for the reply. I have reacted to nsaids in the past. Not thought about the possibility of taking omeprazole (actually its never been offered). I'm lucky in that i don't have to take the painkillers everyday but when my knee hurts I need something that works quickily!!
I'll post on Monday to update the situation....

freesia

I found out I could'nt take 'nsaids' after a swift 999 visit to hospital after taking one tablet and then had anaphalactic shock.... Not something I would ever like to experience again...

I would ask (as previously mentioned) your doctor for 500mg paracetamol and 15mg of codeine as a separate medication....

It is all down to cost & prescribing budgets i'm afraid, and it is SO much cheaper for your dr to prescribe this way... It also gives you the oportunity to trial what works best for you...

I have 500mg paracetamol and codeine in both 15mg & 30mg strenghs I can then take what I feel I need according to the pain at that time..

Good Luck

hileena111

Hi
As far as nsaid's are concerned.....I wasnt offered omneprozol either.....I had to ask for it when I heard about it on this forum.
The other suggestion.......what about an NSAID patch......I dont know.... but if they affected your stomach that might be easier on you
Anything is worth asking about

Love
Hileena

Heather65

Hi and welcome,
im on coco 30/500mg for my neck pain but i had to push my doc for theses i was on a lower dose for ages without them making any difference ,i was also given naproxn as a anti flam i find the combination works quite well for me ,the problem i find is i need them quite often and i only get about 50 at a time so it means a weekly visit to the docs,
You have to find what works well for you and try different combos ,i am finding that the effect is starting to wear of sooner which is not good so might have to ask the doc about what else i can try ,you will get lots of tips on here and its good to talk to people who have gone through all sorts of problems ,take care,
Heather

sbolam

hi, i was on 8/500 co-cods to start with and each time i went back it was a fight and half to get them changed..in the end I changed doctor to one who actually listens and and feel now and again my knees. i now have pain killers that work to some degree now taking 30/500 cocods tramadol and diclofenic as well as ompirazole (sorry cant spell it) and now ampitripyline and most of the time i can get around okish and i know get a full nights sleep.


:P :P

stephen.

knackeredknees2

A wee update for everyone. I had a lovely conversation with my GP about the chagne in painkillers. she said that they are eventually going to be stopped from prescribing the 12.8mg/500mg combination. Clnical studies have apparently shown that either the 8mg or 15mg works jsut as well and there is little difference in using the 12.8 dose.
Anyway the outcome is that I have been given 30mg/500mg combination but only to take one at a time. This is slighitly more than what I've had before so it should work.
Took one last night and thought my legs had stopped working they felt as if they had turned to jelly but i didn't casre cause my knee wasn't working!!!

dreamdaisy

I hope they prove to be effective for you knackeredknees, my knees are knackered too and I've been on the 30/500 for years. I usually manage on four a day, two at lunch and two at beddy-byes - my fingers are crossed that they help you. Let us know how you get on, yes? DD

knackeredknees2

A wee update for everyopne. I've been on the 30/500 since June now and they seem to be working fine for me. Curiously in the summer I had to buy painkillers at the airport as I had left mine at home and what did I get.... 12.8/500mg over the counter too!!
So why can't the Dr prescribe them. :? Anyway for the time being I will stick to the stronger ones. Its hurting a bit today though and the painkiller hasn't really worked

Numptydumpty

Hi Knackeredknees, I'm pleased the co co's are working for you most of the time. I've taken 30/500 for a few years now, they do dull the edges, but don't take the pain away completely. I suppose that would be too much to ask :roll:
As for trying to fathom the workings of prescriptions, I gave up years ago
I hope your pain subsides very soon.
Numpty

Soretoe2

Hi Knackeredknees, my sincere sympathy to you. I take 30mg codeine on it's own and add paracetamol sometimes when I feel I need a bit of oomph. This controls the amount of paracetamol in my system, as I have a bit of a dodgy liver.
I've never had any problems with my gp about any dose of anything, so I must be one of the lucky ones.
I also have Mst (12 hour slow release morphine). After a lot of trial and error with just about every painduller out there I have settled on the Mst at night and the codeine in the day.
It's a right old minefield balancing the pain control with the wooziness of some meds on offer.
Hope the knees are not playing up too much today. Joy