Help! Had teeth pulled and took hydrocodone on top of Bupe

[Painful One]

Hey Friends,
Can you guys tell me what to do about this acute pain problem.
I just had two teeth removed and I’m in a lot of pain.
The doctor gave me some hydrocodone and some ibuprofen 800 mg.
I’m hurting so I took one of each on top of my usual 2 a day buprenorphine strips.
I should be fine if I just wait until tomorrow to redose the buprenorphine correct?
I don’t want to run into any precipitated withdrawal here.
Can someone advise?
Thank you friends.
P.O

 

[Painful One]

Not one of you could answer this for me huh?

 

[Painful One]

Feeling adequate pain relief now.
Hopefully can sleep for awhile.
The ibuprofen and hydrocodone on top of buprenorphine has worked well.
Hopefully I won’t find out what precipitated withdrawal is.

 

[Keif' Richards]

Hey @Painful One

Fret not. You should not have any issues with Precipitated Withdrawal. You are correct that a person dependent upon full-agonist Opioids will often experience this phenomenon if they take Buprenorphine. The key here is that you really need to develop a dependence to these full-agonists for this to take place. I´m spitballing here, but a more likely scenario would have you quitting Buprenorphine for 3 days while you binged on Hydrocodone (Vicodin) then tried to return to Buprenorphine.

In short, it would take more time and a greater intake to trigger precipitated withdrawal. The only phenomenon you will encounter is that of your Hydrocodone being blocked by your Buprenorphine depdendence.

I´m not sure if your doc is aware that you´re a Buprenorhpine patient or not. It would be verging on pointless to take the risk of prescribing Opioids to someone for whom we know they will be useless.

I have a lot of experience with oral pain. I recommend cycling between ice and warmth. You can take different OTC analgesics simultaneously. This knowledge seems to be relatively unknown. You can take Acetaminophen/APAP (Tylenol), Ibuprofen (Advil) and Naproxen (Aleve) simultaenously and the different mechanisms behind each will work separately to relieve more pain. This is still a lot of medication though, so it´s not a practice that should be undertaken flippantly or for long periods of time outside of medical supervision.

I hope this helps.

 

[4DQSAR]

Buprenorphine has a much higher affinity than hydrocodone so it should simply do nothing.

 

[streaM Freak]

Not one of you could answer this for me huh?

I don't know about those drugs. Though i had chronic tooth pain as a kid, from elementary school until high school, and OTC pain killers worked for me, just like you're already doing.

Was just giving emotional support though the heart emoji. I know it's not a lot.

 

[4DQSAR]

BTW I don't know where the OP is based but in the UK we still occassionaly use Nefopam which is reckoned to be about as effective as morphine (20mg nefopam ≈ 7.5-10mg morphine sulfate). It's also supposed to be particularly valuable in cases of dental pain.

I note suzetrigine (Journavx) was licenced in the US last year which was explicitly supposed to be an alternative to hydrocodone. I don't know much about it but I note it has FOUR chiral carbons and yet only one of the sixteen possible stereoisomers is used medicially. This is slightly worrying as evergreening is now an industry standard practice so foregoing that MAY suggest issues with toxicity.