Opioids Which Opioid Causes the Least Sweating?

[Eva 33]

I am on opiates for pain management. I currently take Avinza (oral morphine) 270 mgs. a day. The Avinza works pretty well for the pain, but it has a dreadful side effect: profuse sweating, mainly on my face and scalp. The sweating is very annoying and embarrassing. Everytime I go into a store, I sweat and it doesn't stop. After I take a shower, I sweat for about an hour. The slightest bit of physical activity brings the sweating on.

The sweating also messes up my hair and make-up, which is beyond annoying. Even though I'm ill, I still want to look good.

I've read that the sweating is a very common side effect of opiates.

I wondered if anyone can recommend an opiate that is known to NOT cause sweating? I think my pain doctor will try just about anything.

Also, are there any remedies to combat the sweating? My pain doc mentioned the high blood pressure med "Hytrin" to combat the sweating. Has anyone tried this and how did it make you feel? Did it work? I don't have high blood pressure, so I'm kind of scared of the side effects I might have. I really am taking enough meds to try to get my excruciating pain under control.

A few people (including my pain doc) have suggested that another long-acting opiate may NOT cause the sweating. I really haven't had the chance to try anything but Avinza at a therapapuetic dose.

I always handled the short-acting opiates fine---NO sweating at all from those. It wasn't until I went on long-acting opiates that the sweating began. It is NOT hormonal nor is it withdrawal. It's a side effect of the medication.

I just wondered if anyone could recommend a long-acting opiate that doesn't cause sweating? Maybe Oxycontin or Opana? I did try the Fentanyl patch and that caused extreme dry mouth. I don't know if my pain doc prescribes methadone, but does that cause sweating? My insurance recently denied payment for Exalgo, the new long-acting form of Dilaudid. But my insurance covers many meds, and it seems that there are several long-acting opiates to choose from.

If anyone else here is in chronic physical pain, I'd be interested in hearing how well the different opiates helped your pain, as well as whether or not they made you sweat.

Thanks for any stories, experiences, or advice!

Eva

 

[macd610]

Hi Eva!
I'm sorry that I can't answer your question but I want you to know you're not alone. I suffer from this condition too, And for the same reasons.
I feel that I can help you in 1 way and that is by telling you of 1 drug that does the exact same thing to me that you're going through now....Fentanyl Transdermal System. Since your pm doctor is looking at long acting meds, there's a possibility he or she may suggest this ( although many doctors with good reason shy away from this drug).
Of course, keep in mind that people react differently to different drugs.
If you look in other drugs and see the pain management megathread you may be able to get some good answers there... maybe it's even already been talked about and a search would get you the answers you seek.
Either way, it is a good place for you to check out since you are a CPP
Good luck!
Cat

 

[BiggDirty01]

Mild sweating is a side effect of all opiates.

My first reaction to reading your post was that your description seemed very similar to Graves disease, a hyper-thyroid issue I was diagnosed with 7 years ago. I would walk from class to class at my university that is literally a half mile from the ocean, where it was never hot.

I would suggest looking into having your thyroid levels checked (t3,t4 and TSH) via a simple blood draw. The medication to correct the imbalance stopped my symptoms completely within 2 weeks. But now I have to see an Endocrinologist once a month, which is a quick visit...but sometimes a small annoyance.

The only other thing I can think to mention if the thyroid is stable is to alter your attire before you consume opioids (like shorts or tee shirts even if the weather is cool) so you therefore are prepared for the side effect of sweating.

 

[blight12]

I never sweat on opiates and Im new and still determining if i am taking really low doses.

Is it safe to say that high but safe doses of opiates usually causes sweating?

 

[Captain.Heroin]

Hyperhydrosis seems to be a side effect of most opiates, but definitely buprenorphine - so I wouldn't try it out unless you are hoping it has a different effect on you.

 

[morphonorconic]

That's unfortunate that the ER hydromorphone isn't an option, as that's what I was going to suggest. IME, hydromorphone causes fewer adverse side effects than any other opioid. Oxymorphone might be similar in that respect, but I don't really know. Methadone could be another option, as it's synthetic, and tends to cause fewer side effects than many natural or semi-synthetic opioids.

Natural opiates have the greatest side effect profiles. Morphine, a natural opiate, probably has the most [negative] side effects of any opioid, so you might consider switching to anything else, like oxymorphone or oxycodone. In my opinion, (assuming you're taking IR breakthrough meds) an ER drug like Oxycontin, Opana, or methadone combined with Dilaudid (IR hydromorphone) for BTP would cause fewer side effects including (but not limited to) hyperhydrosis, than an equipotent dose of morphine. Perhaps another option could be a small daily dose of ER morphine and several substantial doses of Dilaudid throughout the day. Just keep in mind that hydromorphone not absorbed well when taken orally, and consequently it has a very low bioavailability, so the dose required for adequate pain relief may need to be relatively high. I'm saying this because I do think it would be the best fit for your particular circumstances.

I get hot too when I take opiates, and sweat easily to begin with, so I know where you're coming from. But I can tell you that morphine makes me hotter, redder(flushed) and itchier than any other opioid. Hydromorphone is the exact opposite, and is the cleanest feeling opiate IMO.

 

[walterdini]

As you can see from the posts OP, its actually the longer lasting opiods that cause the most sweating.

Methadone being the worst to my knowledge. And the above comlaints about Bupe and transdermal fentanyl make sense in that paradigm. Fent may be short acting, but not when delivered transdermally, in this case you are essentially getting a 72 hour controlled release med.

Drugs like oxycodone, hydrocodone and heroin NEVER caused severe sweating IME even if high 24/7. But Bupe and especially methadone make me sweat (and on my face is the worst too) like nothing you could believe.

Opana or dilaudid might be you best options if your insurance covers them and strong pain meds are needed. Otherwise I've heard botox injections can work for armpit sweating, so maybe they work for the face too

 

[macd610]

I don't know what ACTUALLY causes profuse sweating. I mean, it does seem like more people experience this with extended release drugs vs immediate release.
I'm interested if anyone knows what difference there is between the 2 types of drugs that would cause this? I feel like I'm not working my question very well.
For example, methadone is not technically an extended release drug, right? I have heard it lasts much longer than most immediate release drugs... so is it possible that whatever it is that causes sweating with extended release drugs may not be present with methadone?

 

[Jabberwocky]

i think that as you're getting a constant dose that is maintained equally (or roughly) your body's thermoregulatory system adopts to the drug being constantly pushed into your system thus increasing your core temperature for the entire period of time until the XR system has finally finished and the drug is moving out of your system. with an instant release dose the thermoregulation will be more temporary as its quickly released and processed by the body.

methadone would cause more sweating IMO as it has a long-half life, it's not something that is present in XR capsules or tablets, its the opiate in itself. i know personally that on a high dose of oxy (but really high - 200mg) or codeine (about 500-600mg) i've sweated my ass off. on 1mg of bupe i sweated my ass off even harder. it was unbearable, and it lasted a hell of a long time.

the opiate which caused the least amount of sweating for me (when not used recreationally) was oxycontin. i know that MS contin caused me to sweat profusely, and i had other problems with it so was switched over to oxy.

i've heard that naloxone can inhibit the thermoregulatory effects of opiates to a certain degree.