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I Am Allergic to Codeine. Any Suggestions for Pain Control After Mommy Makeover?

Doctor Answers (41)

Alternatives to codeine for pain relief

+2
All narcotic pain relievers have some resemblance in their chemical structure, and an allergy to one can mean being allergic to others.

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


Vancouver Plastic Surgeon
5.0 out of 5 stars 8 reviews

Consider using a pain pump for post operative pain control

+2

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.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 9 reviews

Ultram & Double Strength Tylenol are Great Options

+2

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.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 76 reviews

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Allergic to Codeine Pain Medications

+2

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.

John K. Long, MD
Houston Plastic Surgeon
5.0 out of 5 stars 4 reviews

A long acting local anesthetic will reduce your need for codeine

+1
Most oral pain medicines used after this surgery are cousins of codeine. If there is one in particular that works for you, then you can us it. There are also a few modern pain medications which have much less of the side effects of narcotics like codeine; these will be more expensive. I inject Exparel into the abdomenal wall and incision as well as the breast incisions at the time of a Mommy Makeover. Exparel is a long acting local anesthetic which keeps these areas numb for three days after surgery .Patients take less than half of the usual number of pain pills after this surgery if Exparel is injected. Without the side effects of codeine, like nausea, vomiting, sweats, dizziness, and constipation ,patients feel much better after surgery. When the patients have good pain control and minimal side effects, they are up and walking around earlier. This ensures that patients don't get blood clots and helps with deep breathing. Being able to walk and move around comfortably early after Mommy Makeover really speeds the entire recovery!

Stephan Finical, MD
Charlotte Plastic Surgeon
5.0 out of 5 stars 3 reviews

Pain control after surgery

+1
There are many pain medications that can be used after surgery. Vicodin is the most common but there are people that can not tolerate vicodin or codeine. Ask your surgeon for a different form of pain medication. I also use a muscle relaxant in combination with pain meds that reduce the need for narcotics and helps reduce recovery time.

Shahriar Mabourakh, MD, FACS
Sacramento Plastic Surgeon
5.0 out of 5 stars 74 reviews

Pain relief after surgery

+1
The abdominoplasty pain of the MM can be greatly decreased by using Exparel. It's FDA approved and limit the use of codeine or Percocet. I recommend it to my patients. 

Frank J. Ferraro, MD
Paramus Plastic Surgeon
5.0 out of 5 stars 9 reviews

Mommy makeover and pain control. Allergic to codeine

+1
Hi,
  This is a very doctor specific question but it is important for you to know that there are other ways of controling pain.  It might be with the use of intraop injection of nerve specific areas with a long acting anesthetic, marcaine, or with the use of lidocaine given with a pain pump.  Pain control can be with other medications that can be listed by your doctor but there will be one that you will be able to use that will control your pain. 
  Good luck with your procedure. 

Steven M. Lynch, MD
Albany Plastic Surgeon
4.5 out of 5 stars 16 reviews

Exparel for post operative pain control in mommy makeover

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If you have a true allergy to codeine or cannot take any other narcotic pain medication such as hydrocodone or oxycodone, I would use Exparel at the time of surgery.  This is a long acting local pain medication which when used properly can make post operative pain very tolerable. I have had patients that have had tummy tuck and never used a narcotic pain medication following the surgery when using Exparel.

Good Luck,

Trey Aquadro, M.D.
Auburn, AL

Ralph Trey Aquadro, MD
Auburn Plastic Surgeon
5.0 out of 5 stars 7 reviews

Allergic to codeine, any alternatives for pain control

+1
I would make sure you have a true allergy to Codeine. If you have a history of an anaphylactic reaction or severe rash with Codeine, I would try using Tramadol or Toradol for your pain control.

Robert Najera, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 5 reviews

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