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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by myco on April 2, 2009, at 23:14:31
Moron gp first rx'd a cough suppressent that contained pseudephedrine for my pneumonia cough without considering my nardil use...pharmacist caught this in advance and had it changed to codeine cough syrup which he insisted to me is safe with nardil....yet why is it I find codeine and nardil have "MAJOR" contraindication issues online in drug interaction databases...including high bp and coma. WTF is wrong with people! lol
Am I in the wrong here....are MAOI's and Codeine a good match (perfectly safe) like this pharmacist said??? or do I go with the online drug databases. Dr is offwork as of now...calling him cant happen until tommorrow...cough is killing me now/tonight.
advice please :o(
Posted by Garnet71 on April 2, 2009, at 23:33:05
In reply to ADVICE right away: given CODEINE with NARDIL !, posted by myco on April 2, 2009, at 23:14:31
(((((myco))))
Sorry I have no advice, I can only give you a virtual tissue and hug. :(
I hope you feel better soon. Please take good care of yourself..plenty of rest.
It's winter in Australia, huh?
Posted by myco on April 2, 2009, at 23:37:07
In reply to Re: ADVICE right away: given CODEINE with NARDIL !, posted by Garnet71 on April 2, 2009, at 23:33:05
oo hugs ((((garnet71))))
I dont know if its winter in australia...im in canada silly but you were close LOL :0P yep it is winter*more hugs...i'm a hug ho'
myco
-------------
> (((((myco))))
>
> Sorry I have no advice, I can only give you a virtual tissue and hug. :(
>
> I hope you feel better soon. Please take good care of yourself..plenty of rest.
>
> It's winter in Australia, huh?
>
Posted by Garnet71 on April 2, 2009, at 23:43:15
In reply to Re: ADVICE right away: given CODEINE with NARDIL ! » Garnet71, posted by myco on April 2, 2009, at 23:37:07
hahaha you sound like an Aussie sometimes lol
Well make sure you do get some Canadian fresh air and sunshine tomorrow~
. ' ,
- O -
. ' '(that's my plain text version of a sun)
Posted by myco on April 2, 2009, at 23:47:48
In reply to Re: ADVICE right away: given CODEINE with NARDIL !, posted by Garnet71 on April 2, 2009, at 23:43:15
auk no wee lassy, no'an aussie at'ol
> hahaha you sound like an Aussie sometimes lol
>
> Well make sure you do get some Canadian fresh air and sunshine tomorrow~
>
> . ' ,
> - O -
> . ' '
>
> (that's my plain text version of a sun)
Posted by Phillipa on April 3, 2009, at 0:23:13
In reply to Re: ADVICE right away: given CODEINE with NARDIL ! » Garnet71, posted by myco on April 2, 2009, at 23:47:48
Myco wow glad I checked before bed. Don't know what to tell you. Only suggestion call the hospital and demand to talk to an anesiologist as would probably know the best or get that sweet butt back to hospital now. Hope your still up. So drug checker said no? Love Jan
Posted by desolationrower on April 3, 2009, at 3:47:15
In reply to Re: ADVICE right away: given CODEINE with NARDIL ! » myco, posted by Phillipa on April 3, 2009, at 0:23:13
Monoamine oxidase inhibitors, opioid analgesics and serotonin toxicity
P. K. Gillman*Pioneer Valley Private Hospital, Mackay, Queensland 4740, Australia
* E-mail: kg{at}matilda.net.au
Abstract
Top
Abstract
Introduction
Definition and description
Implicated drugs
Treatment
Conclusion
References
Toxicity resulting from excessive intra-synaptic serotonin, historically referred to as serotonin syndrome, is now understood to be an intra-synaptic serotonin concentration-related phenomenon. Recent research more clearly delineates serotonin toxicity as a discreet toxidrome characterized by clonus, hyper-reflexia, hyperthermia and agitation. Serotonergic side-effects occur with serotonergic drugs, and overdoses of serotonin re-uptake inhibitors (SRIs) frequently produce marked serotonergic side-effects, and in 15% of cases, moderate serotonergic toxicity, but not to a severe degree, which produces hyperthermia and risk of death. It is only combinations of serotonergic drugs acting by different mechanisms that are capable of raising intra-synaptic serotonin to a level that is life threatening. The combination that most commonly does this is a monoamine oxidase inhibitor (MAOI) drug combined with any SRI. There are a number of lesser-known drugs that are MAOIs, such as linezolid and moclobemide; and some opioid analgesics have serotonergic activity. These properties when combined can precipitate life threatening serotonin toxicity. Possibly preventable deaths are still occurring. Knowledge of the properties of these drugs will therefore help to ensure that problems can be avoided in most clinical situations, and treated appropriately (with 5-HT2A antagonists for severe cases) if they occur. The phenylpiperidine series opioids, pethidine (meperidine), tramadol, methadone and dextromethorphan and propoxyphene, appear to be weak serotonin re-uptake inhibitors and have all been involved in serotonin toxicity reactions with MAOIs (including some fatalities). Morphine, codeine, oxycodone and buprenorphine are known not to be SRIs, and do not precipitate serotonin toxicity with MAOIs.
http://bja.oxfordjournals.org/cgi/content/full/95/4/434free fulltext is there
and always useful -> http://kidb.cwru.edu/pdsp.php
34466 5-HT Transporter CODEINE SULFATE 29485-83-4 > 100,000.000000 PubChem-Compound PubChem-Substance 3H-5HT RAT CEREBRAL CORTEX Codd EE et al, 1995
Posted by Zana on April 3, 2009, at 11:50:03
In reply to Yes: CODEINE with NARDIL = ok, posted by desolationrower on April 3, 2009, at 3:47:15
What a terrible, scarey place to be. I think Phillipa has a good idea about calling the hospital. You shouldn't have to figure this out by yourself!
Zana
Posted by jerrypharmstudent on April 4, 2009, at 17:58:59
In reply to ADVICE right away: given CODEINE with NARDIL !, posted by myco on April 2, 2009, at 23:14:31
I had surgery while on Nardil and was given heavy doses of opiates afterwards for the pain namely Dilauded and hydrocodone. Dr. and anesthesiologist both said there'd be no interactions.
My story anyway
Jerry
Posted by yxibow on April 5, 2009, at 5:10:31
In reply to ADVICE right away: given CODEINE with NARDIL !, posted by myco on April 2, 2009, at 23:14:31
> Moron gp first rx'd a cough suppressent that contained pseudephedrine for my pneumonia cough without considering my nardil use...
That's rather odd to say the least..
pharmacist caught this in advance and had it changed to codeine cough syrup which he insisted to me is safe with nardil....
good for that
yet why is it I find codeine and nardil have "MAJOR" contraindication issues online in drug interaction databases...including high bp and coma. WTF is wrong with people! lol
>
> Am I in the wrong here....are MAOI's and Codeine a good match (perfectly safe) like this pharmacist said??? or do I go with the online drug databases. Dr is offwork as of now...calling him cant happen until tommorrow...cough is killing me now/tonight.
>
> advice please :o(
>The advice here is that small amounts of codeine are probably allright.
The official comments in drug interactions with opiates, especially those used in heavy pain management or anaesthesia, is that observation in front of a doctor with access to reverse agents, just like observing a drug (say a notorious antibiotic) is warranted.
-- Jay
Posted by jedi on April 7, 2009, at 1:49:39
In reply to ADVICE right away: given CODEINE with NARDIL !, posted by myco on April 2, 2009, at 23:14:31
> Moron gp first rx'd a cough suppressent that contained pseudephedrine for my pneumonia cough without considering my nardil use...pharmacist caught this in advance and had it changed to codeine cough syrup which he insisted to me is safe with nardil....yet why is it I find codeine and nardil have "MAJOR" contraindication issues online in drug interaction databases...including high bp and coma. WTF is wrong with people! lol
>
> Am I in the wrong here....are MAOI's and Codeine a good match (perfectly safe) like this pharmacist said??? or do I go with the online drug databases. Dr is offwork as of now...calling him cant happen until tommorrow...cough is killing me now/tonight.
>
> advice please :o(I have taken codeine often with Nardil with no problem. What you really have to be careful of, like in your experience, is when they add other ingredients to the codeine.
I live in Washington State and travel often to British Columbia. In Canada you can buy codeine over the counter. Once I bought some cough syrup there, and didn't have my reading glasses to read the fine print. The pharmacist swore to me that the medication was fine with Nardil. Well it wasn't, because it contained pseudoephedrine. Another nasty headache. I now only trust myself when dealing with MAOIs and other medications. Too many MDs and other professionals know nothing about MAOIs.
I also recommend a medic alert bracelet that says "Taking MAOI, No meperidine(Demerol). If you are in an accident and in shock, the last thing you need is some EMT killing you with a shot of pain killer.
Be careful out there,
Jedi
Posted by myco on April 7, 2009, at 2:29:33
In reply to Re: ADVICE right away: given CODEINE with NARDIL ! » myco, posted by jedi on April 7, 2009, at 1:49:39
Thanks for the advice...do you know where to buy a medic alert bracelet?
> I also recommend a medic alert bracelet that says "Taking MAOI, No meperidine(Demerol). If you are in an accident and in shock, the last thing you need is some EMT killing you with a shot of pain killer.
> Be careful out there,
> Jedi
>
>
>
Posted by jedi on April 7, 2009, at 11:29:58
In reply to Re: ADVICE right away: given CODEINE with NARDIL ! » jedi, posted by myco on April 7, 2009, at 2:29:33
Here are a few online places. I haven't shopped price.
Jedihttp://www.bizrate.com/bracelets/products__keyword--medic+alert+bracelets.html
http://www.medicalert.org/home/Homegradient.aspx
http://www.americanmedical-id.com/
http://www.giftshoppingzone.com/dukaan/product_info.php/products_id/16557
> Thanks for the advice...do you know where to buy a medic alert bracelet?
>> >
>
>
This is the end of the thread.
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