Opioids Oxymorphone IR potentiator help

[BloodSpell]

I looked and posted in the potentiator Megathread but I couldn't find much on oxymorphone. Since my interest is both urgent and long term I thought posting a separate thread might get some attention faster, that could then be added to the Megathread.

So, I suspect that the newest addition to my laundry list of prescription medications is having an extremely negative impact on the efficacy of my oxymorphone IR. I recently started a 10-day course of Flagyl for a dental/sinus infection added on to my current long term courses of medium-high dose amoxicillin and an average dose of erythromycin. Since then either my pain levels have drastically increased, which is unlikely, or the Flagyl has drastically decreased the effectiveness of my oxymorphone. I normally have to take 10 milligrams every 4 to 5 hours to keep my pain under control, I am currently taking nearly twice that and my pain levels are still above average. This is really eating into my backup supply, which has taken me years to accumulate, and with the current war on chronic pain patients I can't afford to use up too much of that supply. Since it's only a 10-day course I don't see the point in getting into a huge fight with my pain management doctor about temporarily increasing my dosage, so I'm looking for my best option for a potentiator to make up the difference until I finish this course and see if my pain levels return to normal.



Challenges include my inability to consume solid food in any useful amount and my inability to insufflate due to severe sinus issues. Medications readily available to me include:


Cyclobenzaprine
Promethazine (small amount)
Benadryl
Levocetirizine
Zolpidem
Gabapentin
Clonazepam


I also have access to any over-the-counter medications available in the United States. I'm asking here about oxymorphone specifically because I'm not sure which potentiator would be the most effective for increasing pain relief when dosing every 4 to 5 hours. If there's any further info that would help to determine my best option just let me know, I'm happy to provide any information that could possibly help. I'm a little bit desperate here as my pain levels are reaching the eight to nine out of ten range every evening and it's bad enough to prevent me from typing this up even on my touch screen keyboard, so if there are any really weird seeming typos please just chalk those up to my voice-to-text app.


Also, if anyone happens to have experience with flagyl or any combination of the above medications having a negative impact on the efficacy of oxymorphone or any other opiates I would certainly be interested in hearing about it.

 

[Kittycat5]

I think promethazine or diphenhydramine and the gabapentin are your best bets. They will give some added relief and probably the safest. I dont think it will extend how long the analgesia lasts, just increase it. Some may say the cyclobenzaprine could be added as well, but I personally get nothing out of it.

I cant think of how metronidazole would affect oxymorphone though. Oxymorphone isnt metabolized by CYP450 and cannot find anything on Flagyl doing anything to the conjugation enzymes. Maybe its via enhanced excretion but didnt find any info on that either. Are you taking any other drugs not listed?