I Am Allergic to Codeine. Any Suggestions for Pain Control After Mommy Makeover?
Doctor Answers (47)
Alternatives to codeine for pain relief
Many times when patients tell me they are allergic to codeine it is not a true allergy, but rather a sensitivity, meaning they get nauseated or have some other side effect, rather than a rash, hives or other true allergic reaction. It is best to define this first, and then look at some of the alternatives, both narcotic and non-narcotic.
Although we have relied on the use of narcotic pain relievers for pain since the Civil War, they have some negatives and some patients just don't tolerate them. Or, in the case of recovering addicts, they never want to touch them again. Does this prevent us from being able to do surgery because of inability to deal with the pain? Not at all.
There are non-narcotic alternatives available which may be sufficient with proper mental preparation and good planning.
Discuss this with your doctor at length and I am sure a good program me can be planned to give you peace of mind going into surgery
Non-Narcotic Medication following Mommy Makeover
Consider using a pain pump for post operative pain control
Alternatives to codeine include oral Demerol and synthetic forms of morphine. I usually place a pain pump and this greatly decreases post operative pain and discomfort.
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Ultram & Double Strength Tylenol are Great Options
Pain control is extremely important following cosmetic surgery. Patients frequently report allergies to various pain medications and as a result, pain management may require adjustment in the postoperative period.
Most patients who say they are allergic to codeine don’t have a true allergy. They usually have severe nausea, which codeine is notorious for causing.
We typically use a synthetic codeine derivative called Hydrocodone, which has a decreased incidence of nausea compared to codeine.
Examples of prescription Hydrocodone commonly used include Vicodan and Lortab. When these don’t work or patients are allergic to them as well, we use Ultram. We replace narcotic pain relievers with double strength Tylenol as soon as possible following surgery to avoid the potential for drug problems.
Pain tolerance varies from patient to patient and with appropriate care can usually be managed without difficulty. When allergies to pain medications occur, multiple alternatives exist to deal with this problem.
Allergic to Codeine Pain Medications
The allergy to codeine in pain medicines is so common that I rarely use these pain medications in my practice. Artificial codeine, hydrocodone, is more commonly prescribed and used in products like Vicodin and Lortab and these medications are surprisingly effective on many individuals who cannot tolerate codeine but can tolerate hydrocodone.
Even when I have prescribed the hydrocodone medications, I encourage my patients to as quickly as possible to convert to anti-inflammatory medications like Advil, Nuprin and Motrin which are Ibuprofen products and Alleve which is a different anti-inflammatory product. These medications actually effect the pain problem itself instead of hiding the symptoms in one's brain and have less side effects.
Never forget the use of ice and cold packs to reduce the amount of pain on almost all areas of the body following surgery.
Pain control after mommy makeover
Alternatives to Codeine and Narcotics
Exparel will be available for those concerned about minimizing discomfort after surgeries such as tummy tuck and breast augmentation.
Exparel costs the same as a pain pump and produces the same result but with less hassle and works great.
Narcotics are used only as needed (as cause nausea, vomiting and constipation as frequent sided effects).
Pain Control After Mommy Makeover
If you have a sensitivity to Codeine (nausea, light-headedness, constipation), you may be fine with other narcotic pain relievers (Vicodin, Percocet, Demerol), especially if you have had no problems with them in the past.
If you have a true allergy (rash, hives, swelling, shortness of breath), you may also be allergic to other narcotic pain relievers. In this case, Tramadol may be a safe option.
No matter what you take for pain relief, I recommend a muscle relaxer as well. I also recommend placing a pain pump to supplement your medications. This is similar to an epidural in that catheters are placed in the surgical area. These catheters are attached to a reservoir which continually pumps local anesthetic into the surgical area for pain relief without narcotics and can be refilled. Another option is Exparel, which is a long-acting local anesthetic that is injected during surgery.
As you can see, there are a few good options for pain control. It's best to talk with your surgeon about your allergies and devise a plan that suits your needs.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.