Does anyone know what the maximum daily dose of flexeril is? my docs don't want to change my meds at all (tramadol 400mg/day, gabapentin 2400mg/day, flexeril 30mg/day), but I've been having quite a few episodes where I'll have really REALLY bad muscle spasms and was wondering if I could jump from 30mg-60mg as per rx'ing info goes...
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OD Moderators: Keif’ Richards | negrogesic
The Pain Management Mega Thread v2.0
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NeighborhoodThreat
Bluelight Crew
I don't think there is a technical maximum daily dose, its just a matter of dealing with side effects (remember that Flexeril/cyclobenzaprine is similar to the tricyclic antidepressants and the same dangerous exist in overdose).
I wouldn't jump right from 30mg to 60mg a day. I know people who are scripted 30-40mg a day for muscle pain but I've never seen it higher.
I wouldn't jump right from 30mg to 60mg a day. I know people who are scripted 30-40mg a day for muscle pain but I've never seen it higher.
Doomed2pain
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I am in same boat, could you not ring a drug helpline and ask for interactions and risks?
Sending gentle hugs, I haven't slept properly in nearly 10 days now. Crisis team have been.
My experience with tramadol was awful, I was on 400mg day, gabapentin 3200mg and 40mg Prozac and after 6 weeks ended up in hosp and was switched to dhc and citalopram. I was in a real state.
Please be careful.
TheTwighlight
Bluelighter
Very well, depending on the dose, but not quite as well as Lyrica at the equivalent dose.
Hooddood78
Greenlighter
I think too that it might help you a lot with fibromyalgia but lyrica would definitely be better and more effective. I have had both for years and have quite a lot experience on both. I still would add some old-school antidep to it, maybe amitriptylin or nortriptylin. That would do wonders on a small dosage. Perhaps.. You never can say these for shure.
I have now only 25mg+75mg of lyrica per day. It was in the maximum 600mg/day dosage for couple years but since I got this neurostimulator I have cut a lot of medicines. Also regular opiates but now I have made myself addicted to opiates in a bad way... Not good. I eat opiates for over 10 years without problems of overuse but now I just made that one error and shoot up a dose of if I remember correct oxycodone and the rush was something.. Now I´m strugling to get rid of this use and leave these just for recretional purposes.
-Hooddood78
I have now only 25mg+75mg of lyrica per day. It was in the maximum 600mg/day dosage for couple years but since I got this neurostimulator I have cut a lot of medicines. Also regular opiates but now I have made myself addicted to opiates in a bad way... Not good. I eat opiates for over 10 years without problems of overuse but now I just made that one error and shoot up a dose of if I remember correct oxycodone and the rush was something.. Now I´m strugling to get rid of this use and leave these just for recretional purposes.
-Hooddood78
Doomed2pain
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lyrica and gabapentin, and tricyclics like amitrip are meant to be good for fibro yes, that is if you can stomach the sideeffects i was on them all at one point or another for a long time but it just made me more unweel. I was really hoping they would have worked too.
just had olanzapine added to my med regime and it is helping a little which is good.
just had olanzapine added to my med regime and it is helping a little which is good.
doppelganga196
Bluelighter
Nobody with experience with dihydrocodeine???
Doomed2pain
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Hooddood78
Greenlighter
Yeah, yuo´re right about that. They all have side-effects. With amitrip my wife was very much unhappy with my quite low sexdrive and mouth was dry all the time. Those were the two worse side-effects for me. Lyrica really didn´t cause anything for me, I think.
Now I really try to survive without taking anything IV. Just save that for some special occasions with some special goods on hand. Now the bube won´t feel nothing..
Olanzapine is quite interesting medicine for pain management..!? Though I have heard someone also using it here in my country too.. I mean for pain.
-Hooddood78
Doomed2pain
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they have put me on it for the mental disorders and for my over pruction of adrenaline. he just upped it today and put me on diazepam too so as long as i take them at the same times as the oramorph, comprazing, piriton and the zomorph it helps me with the seizures, pain and emotional instability i am feeling.
will be getting better pain meds in a few months so this is just to hold me til then but i feel it helping the panic attacks and whatnot so i hope they keep me on it longterm, i don't care about the dependence now, i just need a better quality of life
***** anyone ever used serrapeptase as an anti inflammatory?
will be getting better pain meds in a few months so this is just to hold me til then but i feel it helping the panic attacks and whatnot so i hope they keep me on it longterm, i don't care about the dependence now, i just need a better quality of life
***** anyone ever used serrapeptase as an anti inflammatory?
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doppelganga196
Bluelighter
Hey doomed2pain. Yeah, i was curious about others feelings about dihydrocodeine as i dont think i've seen it mentioned on here. I take a dose of codeine early in the day which i admit i enjoy for about half anhour, then get pain relief for approx 3 hours. This is where the DHC comes in. Normally i'll dose 180mg which is very effective i find. Also i dont "enjoy" the effects from DHC, just enjoy the fact that i can actually ignore the pain.
The best thing about DHC is that you can redose within an hour or whatever if it hasnt done the trick. Also it lasts long, like 8 hours.
I suppose i just would like to know what other people thought about it as i've read mixed reviews.
The best thing about DHC is that you can redose within an hour or whatever if it hasnt done the trick. Also it lasts long, like 8 hours.
I suppose i just would like to know what other people thought about it as i've read mixed reviews.
Doomed2pain
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when i first took df 118 at 17 it got me really high and gouchy lol.
for pain relief i found it shit but i have stupid amounts of pain so was moved from dhc straight to fentanyl. i'm not really of much help am i. i have never had adequate pain relief from codeine and i have never found it a high inducing drug even when i first was prescribed it years ago after an op. mind you i have always taken meds for pain so maybe that is why.
are you doing cwe or getting prescribed dhc with no paracetamol in?
for pain relief i found it shit but i have stupid amounts of pain so was moved from dhc straight to fentanyl. i'm not really of much help am i. i have never had adequate pain relief from codeine and i have never found it a high inducing drug even when i first was prescribed it years ago after an op. mind you i have always taken meds for pain so maybe that is why.
are you doing cwe or getting prescribed dhc with no paracetamol in?
doppelganga196
Bluelighter
^ In 2009 i was on DHC continus 60mg, also cocodamol & gabapentin. Now almost three years later after a several month titration off diazepam it's been hard to get anything more than the occasional box of 30 cocodamol as my Doc really doesn't want me hooked on anything else & says i'm better off using otc analgesics.
However! Last week i told my Doc i was done with the diazepam & asked to discontinue the 4mg diazepam per day & if i could get some oxazepam to take as needed only. So he gave me 14 oxazepam 10mg & when i asked about getting some releif for the pain he suprised me with a script for 100 30/500 cocodamol.
Such a releif not having to visit 2 pharmacies a day anymore. Come to think of it here in the UK a fair amount of chemists are often not stocking dihydrocodeine with apap at the moment & i wonder if it's being phased out?
However! Last week i told my Doc i was done with the diazepam & asked to discontinue the 4mg diazepam per day & if i could get some oxazepam to take as needed only. So he gave me 14 oxazepam 10mg & when i asked about getting some releif for the pain he suprised me with a script for 100 30/500 cocodamol.
Such a releif not having to visit 2 pharmacies a day anymore. Come to think of it here in the UK a fair amount of chemists are often not stocking dihydrocodeine with apap at the moment & i wonder if it's being phased out?
Doomed2pain
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Nah I can still get paramol over the counter, mum bought some for my fella other day as his knee is playing up from having to lift me anywhere. I was on the 90mg continus dhc after I was hospitalised due to my pm dr giving me serotonin syndrome from gabapentin, trams and Prozac.
Are you under a chronic pain management clinic? Also i pm'd you, did you get it?
Are you under a chronic pain management clinic? Also i pm'd you, did you get it?
greywoodfoxhall
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Hello.
I am a 25 year old male. I developed TMJ out of nowhere about a year ago. My jaw literally began completely locking up, and I had to manually rip it open. The noise it made almost made grown men vomit. I already suffered from left arm pain from breaking my left humerus at 17. It was a compound fracture, so bad the docs said only way it could have been worse was if it had broken the skin. Due to the proximity of the radial nerve and the risk of hitting it, I had to be put into a huge 20 pound cast when surgery was really warranted. A tendon or something healed on the wrong side of my elbow during my time in the cast, I literally cannot bench press, can't curl as much with the left arm, and push-ups/dips make it audibly pop. If I use it too much, I am punished the next two days with a dull pain in my joint/arm. At 14 I shattered my maxillary ridge running into a kid's forehead in gym. My teeth were intact, just sticking straight back. Everything was fine, until two and a half years ago when I began getting 'flashback pain' in the teeth that were at the center of the impact. I had a root canal as all the nerve tissue was dead, yet I still get "phantom tooth" pain now. I have lower back pain that began after twisting my back two years ago weed-eating on a hill. I went to a chiropractor, and the severe pain was managed... but as I sleep on a couch, and spend time on a computer, I get lower back pain that then causes muscle tension spreading up my whole back. I get migraines, possibly a symptom of the TMJ as well as stiff shoulders and neck. I also have horrible restless leg syndrome. I also have fibro. And, I am constantly nauseous and get stomach cramps as well.
I had been self-medicating for years, and had my medical card in CA. But, now I am in TN and on probation, so smoking is out of the question. I was on Subutex for about 2 years, but was shooting it (unfiltered) and wasn't even getting pain relief, it just made me feel not dope-sick. My Subutex doctor tricked me into a costly injection, and stopped seeing me when I refused to pay. My late girlfriend's addictionologist wrote her Subutex, but would only write me Suboxone. It made me feel very sick, and gave me headaches. They gave me sumatriptan in response, a bullshit migraine med. I finally got into a pain clinic, and the doctor gave me Tramadol. Seeing as I had been using heroin to self-medicate, this did nothing for me. I went to the psych ward because my depression and anxiety were killing me. There, the psychiatrist gave me 6 10mg Percocets a day. This somewhat helped. I also got on Lyrica, and Remeron (amazing drug, helps me eat as I am in recovery from being a purging anorexic, helps me sleep, helps my RLS, and helps my depression... without the side-effects of most psych meds. SSRI's will literally kill me, distonic reaction, I get the "Lamictal rash," and Abilify makes me feel like I'm shaking constantly). I also got back on Klonopin. When I returned to the pain doctor (actually a nurse practitioner), she was none too happy with me being on 60mg of oxycodone after she had only given me Tramadol. I got dropped back down to 3 7.5mg Percocets a day, and started self-medicating with Opana ER and Heroin. The next visit, I told her that with my fast metabolism, I was constantly watching the clock, as a Percocet only made me feel a little better for like an hour. I asked what long-acting meds there were. I get a localized, very nasty rash/hives from IV morphine, so we decided that was out. She offered Opana ER. I jumped on it. I have been on 2 10mg Opana ER's for about 5 months now. I was getting 2 Tylox 5's until last week, when she gave me 2 7.5mg Percocets in their place for breakthrough pain (they aren't worth shit). I also get 20 25mg Promethazine or Phenegran suppositories a month. The Opana ER isn't working as well now... and my insurance rolls over come January 1st, and I will have to pay $260 a month for my Opana. I am on Vyvanse, and my blood pressure/pulse is always up when I come in. It is obvious I am not at risk of being too medicated when it comes to CNS depression. Actavis makes 15mg Opana ER generics. My doctor wants a MRI on my jaw, even though she cringes when she feels the way it pops (constantly). I want an MRI on my back, and my arm... as well as my intestines checked for Chron's (even on all the opiates, I have at least 3 or more bowel movements a day, coupled with the nausea that was there before the opiates. It is common for people with eating disorders to develop Chron's). I cannot afford my Opana ER's, and they have made my life liveable again. But, the only way I can keep getting them is getting a 10mg a day dose increase. How should I approach this?
Thank you for the input.
peace
~f.xy
I am a 25 year old male. I developed TMJ out of nowhere about a year ago. My jaw literally began completely locking up, and I had to manually rip it open. The noise it made almost made grown men vomit. I already suffered from left arm pain from breaking my left humerus at 17. It was a compound fracture, so bad the docs said only way it could have been worse was if it had broken the skin. Due to the proximity of the radial nerve and the risk of hitting it, I had to be put into a huge 20 pound cast when surgery was really warranted. A tendon or something healed on the wrong side of my elbow during my time in the cast, I literally cannot bench press, can't curl as much with the left arm, and push-ups/dips make it audibly pop. If I use it too much, I am punished the next two days with a dull pain in my joint/arm. At 14 I shattered my maxillary ridge running into a kid's forehead in gym. My teeth were intact, just sticking straight back. Everything was fine, until two and a half years ago when I began getting 'flashback pain' in the teeth that were at the center of the impact. I had a root canal as all the nerve tissue was dead, yet I still get "phantom tooth" pain now. I have lower back pain that began after twisting my back two years ago weed-eating on a hill. I went to a chiropractor, and the severe pain was managed... but as I sleep on a couch, and spend time on a computer, I get lower back pain that then causes muscle tension spreading up my whole back. I get migraines, possibly a symptom of the TMJ as well as stiff shoulders and neck. I also have horrible restless leg syndrome. I also have fibro. And, I am constantly nauseous and get stomach cramps as well.
I had been self-medicating for years, and had my medical card in CA. But, now I am in TN and on probation, so smoking is out of the question. I was on Subutex for about 2 years, but was shooting it (unfiltered) and wasn't even getting pain relief, it just made me feel not dope-sick. My Subutex doctor tricked me into a costly injection, and stopped seeing me when I refused to pay. My late girlfriend's addictionologist wrote her Subutex, but would only write me Suboxone. It made me feel very sick, and gave me headaches. They gave me sumatriptan in response, a bullshit migraine med. I finally got into a pain clinic, and the doctor gave me Tramadol. Seeing as I had been using heroin to self-medicate, this did nothing for me. I went to the psych ward because my depression and anxiety were killing me. There, the psychiatrist gave me 6 10mg Percocets a day. This somewhat helped. I also got on Lyrica, and Remeron (amazing drug, helps me eat as I am in recovery from being a purging anorexic, helps me sleep, helps my RLS, and helps my depression... without the side-effects of most psych meds. SSRI's will literally kill me, distonic reaction, I get the "Lamictal rash," and Abilify makes me feel like I'm shaking constantly). I also got back on Klonopin. When I returned to the pain doctor (actually a nurse practitioner), she was none too happy with me being on 60mg of oxycodone after she had only given me Tramadol. I got dropped back down to 3 7.5mg Percocets a day, and started self-medicating with Opana ER and Heroin. The next visit, I told her that with my fast metabolism, I was constantly watching the clock, as a Percocet only made me feel a little better for like an hour. I asked what long-acting meds there were. I get a localized, very nasty rash/hives from IV morphine, so we decided that was out. She offered Opana ER. I jumped on it. I have been on 2 10mg Opana ER's for about 5 months now. I was getting 2 Tylox 5's until last week, when she gave me 2 7.5mg Percocets in their place for breakthrough pain (they aren't worth shit). I also get 20 25mg Promethazine or Phenegran suppositories a month. The Opana ER isn't working as well now... and my insurance rolls over come January 1st, and I will have to pay $260 a month for my Opana. I am on Vyvanse, and my blood pressure/pulse is always up when I come in. It is obvious I am not at risk of being too medicated when it comes to CNS depression. Actavis makes 15mg Opana ER generics. My doctor wants a MRI on my jaw, even though she cringes when she feels the way it pops (constantly). I want an MRI on my back, and my arm... as well as my intestines checked for Chron's (even on all the opiates, I have at least 3 or more bowel movements a day, coupled with the nausea that was there before the opiates. It is common for people with eating disorders to develop Chron's). I cannot afford my Opana ER's, and they have made my life liveable again. But, the only way I can keep getting them is getting a 10mg a day dose increase. How should I approach this?
Thank you for the input.
peace
~f.xy
dhopeless
Bluelighter
Hey, I have been taking subutex for a few years now, first to combat an opiate addiction and now for chronic back pain. January of '09 I was in a horrible car accident in which I smashed my little coupe head on with a huge conversion van. I broke 7 vertebrae in my upper back, I broke my right humerus and a few ribs resulting in a punctured lung. I was on subutex at the time so they had to put me on a very high dose of morphine to compensate for my tolerance. I ended up taking ms contin 100mg twice daily for a couple months after which I got back on my Subutex. Prior to then, I was taking 2 tablets a day. After being on morphine for 2 months I needed more, so my doctor raised my dose to 3 8mg tablets a day. I have been on that dose happily ever since, until recently my doctor said that he had to lower my dose down to 2 tablets a day because he said that 'they're (who?) saying that your receptors are full after 2 tablets'. Well that's bs if I've ever heard it, because everyone's tolerance is different. Well now he has me down to 2.5 tabs a day, which still takes care of the pain, but it seems if I go any lower than that than I start having trouble. I have been at the same dose, 24mg/day for about 3 years now and I really want to keep it that way. I would settle for 2.5 but 2 tabs a day simply doesn't cut it. I'm going to tell all this to my doctor but he has been under a lot of scrutiny lately from the DEA and RB to switch over all his patients to the suboxone film strips...a couple months ago when I went in he told me he was going to have switch me to the suboxone and I freaked out at him and reminded him that I can't take that because it makes me sick, which is true. So he said he'd feel better about giving me the tex as long as I cut down...a fair compromise, but if my pain isn't being treated properely, then what good is it?
I was wondering if over time my tolerance would decrease to the point where 2 tablets would do the trick, but I would much rather just stay at 3. What should I do? How should I approach this situation?
I was wondering if over time my tolerance would decrease to the point where 2 tablets would do the trick, but I would much rather just stay at 3. What should I do? How should I approach this situation?
ErgicMergic
Bluelighter
Greywoodfoxhall, since your TMJ disorder pain is mostly neuropathic in nature, you should try an opioid which has serotonin (5-HT)/norepinephrine (NE) action. Some good ones are: Kratom (not as addictive as regular opiates, totally legal, works with NE, mu- and delta- opioid agonist); Tramadol (works with 5-HT, NE, mu-opioid agonist and might be your best choice because of this, it's just addictive after daily use); also Tapentadol, even though its CII placement reduces availability.
For neuro pain, try supplementing 1000mg Chelated Magnesium daily in split doses, along with 15-30mg DXM daily, as NMDA antagonism helps.
I see you use/abuse Opana/Heroin, so Kratom/Tram won't do diddly squat alone. Try supplementing your opiates with these two drugs.
For neuro pain, try supplementing 1000mg Chelated Magnesium daily in split doses, along with 15-30mg DXM daily, as NMDA antagonism helps.
I see you use/abuse Opana/Heroin, so Kratom/Tram won't do diddly squat alone. Try supplementing your opiates with these two drugs.
dhopeless
Bluelighter
Hey, I have been taking subutex for a few years now, first to combat an opiate addiction and now for chronic back pain. January of '09 I was in a horrible car accident in which I smashed my little coupe head on with a huge conversion van. I broke 7 vertebrae in my upper back, I broke my right humerus and a few ribs resulting in a punctured lung. I was on subutex at the time so they had to put me on a very high dose of morphine to compensate for my tolerance. I ended up taking ms contin 100mg twice daily for a couple months after which I got back on my Subutex. Prior to then, I was taking 2 tablets a day. After being on morphine for 2 months I needed more, so my doctor raised my dose to 3 8mg tablets a day. I have been on that dose happily ever since, until recently my doctor said that he had to lower my dose down to 2 tablets a day because he said that 'they're (who?) saying that your receptors are full after 2 tablets'. Well that's bs if I've ever heard it, because everyone's tolerance is different. Well now he has me down to 2.5 tabs a day, which still takes care of the pain, but it seems if I go any lower than that than I start having trouble. I have been at the same dose, 24mg/day for about 3 years now and I really want to keep it that way. I would settle for 2.5 but 2 tabs a day simply doesn't cut it. I'm going to tell all this to my doctor but he has been under a lot of scrutiny lately from the DEA and RB to switch over all his patients to the suboxone film strips...a couple months ago when I went in he told me he was going to have switch me to the suboxone and I freaked out at him and reminded him that I can't take that because it makes me sick, which is true. So he said he'd feel better about giving me the tex as long as I cut down...a fair compromise, but if my pain isn't being treated properely, then what good is it?
I was wondering if over time my tolerance would decrease to the point where 2 tablets would do the trick, but I would much rather just stay at 3. What should I do? How should I approach this situation?
I was wondering if over time my tolerance would decrease to the point where 2 tablets would do the trick, but I would much rather just stay at 3. What should I do? How should I approach this situation?
muvolution
Bluelight Crew
greywood- I cannot emphasize enough that if you have actual pain, you should not be abusing your meds. Read many of my responses on the last few pages regarding this topic. If you ever want to get relief from your medication or to get your pain under any kind of control, it is really important that you not abuse your medication, or any opiates.
At this point, you just need to begin reducing your opiate dose while workng with a pain management doctor to get a medication which is effective. Many people have good luck with methadone for tmj, but remember that opiates provide, at most, 20% pain relief, so you are going to have to do more than just take opiates.
dhoples - I know it isn't what you want to hear, but many studies have shown that bupe has a ceiling does of 16mg in most people - the 24mg ceiling really only affects a few people. You should read this thread and you will see people with huge habits only taking 2-4mg a day. I know that you are on this for pain, but I would suggest trying low-dose bupe as it will work even better for pain than the high-dose. It has to do with the fact that bupe has a high-binding affinity, but it is only a partial agonist. It will produce analgesia at moderate doses, but at higher doses, it antagonizes itself and actually becomes less potent as a pain killer.
thread here: http://www.bluelight.ru/vb/threads/...hine-Mega-Thread-and-FAQ-v13.0?highlight=bupe
At this point, you just need to begin reducing your opiate dose while workng with a pain management doctor to get a medication which is effective. Many people have good luck with methadone for tmj, but remember that opiates provide, at most, 20% pain relief, so you are going to have to do more than just take opiates.
dhoples - I know it isn't what you want to hear, but many studies have shown that bupe has a ceiling does of 16mg in most people - the 24mg ceiling really only affects a few people. You should read this thread and you will see people with huge habits only taking 2-4mg a day. I know that you are on this for pain, but I would suggest trying low-dose bupe as it will work even better for pain than the high-dose. It has to do with the fact that bupe has a high-binding affinity, but it is only a partial agonist. It will produce analgesia at moderate doses, but at higher doses, it antagonizes itself and actually becomes less potent as a pain killer.
thread here: http://www.bluelight.ru/vb/threads/...hine-Mega-Thread-and-FAQ-v13.0?highlight=bupe
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