Prescription Pain Medication Issue

I'd ask your doctor or pharmacist...

_incogNEATo_ wrote: »

JessicaJS23 wrote: »

I'd ask your doctor or pharmacist...

Oh yea right. Let's ask the doctors who are controlled by Big Pharma why our scripts aren't giving us long enough relief... #illuminati #conspiracy

Right ... Or she could trust us to dose her up good

Ibuprofen and Advil have the same active ingredient. Perhaps the one was an immediate release medication and the other was an extended-release medication, or there was some other difference between the two? The pharmacist could help you to understand what the differences are and why one works better for you than the other. Or, if it turns out your prescription Ibuprofen is supposed to be exactly the same as the over-the-counter Advil and you noticed that the over-the-counter Advil worked and the prescription Ibuprofen did not, you should definitely report that to the Pharmacist at the pharmacy where you filled the prescription.

_incogNEATo_ wrote: »

JessicaJS23 wrote: »

I'd ask your doctor or pharmacist...

Oh yea right. Let's ask the doctors who are controlled by Big Pharma why our scripts aren't giving us long enough relief... #illuminati #conspiracy

First of all, I hope you're joking otherwise I'd have to seriously push back against this.. "controlled by big pharma".? shows right there you have zero clue what you're talking about.

FridayApril01st2016 wrote: »

I wonder if anyone else notices, the problem with prescription medication; that I've been noticing. In March 2013 I was prescribed Vicodin for an arm injury, in November 2015 I was prescribed Naproxen for an abscessed tooth & yesterday Ibuprofen for the same tooth abscessed again (I've been trying to get dental insurance, so that I'd have a root canal & crown; instead of just getting it pulled because then the gap'd cause issues itself but that's another story), anyway with all 3 of those medications, they've only worked for 2 hours; whereas over the counter Advil works for a minimum of 6 hours & with less dosage.

PM me the exact strengths of what you're taking, how often, the history of your current tooth pain, frequency of use of the narcotic, and any other info you feel is relevant. We can continue a discussion that way. I won't ask you do disclose PHI on a public forum.

NorthCascades wrote: »

I had an abscessed tooth once. For comparison's sake, I was hit by a car going 35 to 40 mph while I was riding my bike, the tooth was much more painful. The dentist sent me to a specialist who gave me very strong drugs, but they didn't work. Novocaine was the only thing that gave me any relief until the root canal. If anybody ever tells you a root canal is bad, it's nothing compared to needing one.

Yep, there's a big difference between an injury where nerves transmit to your brain signals that let you know there's tissue damage (ie pain), vs irritation/injury to the nerve itself as in the case of a bad abscess.. OP hope you can find some relieve soon with a dental procedure.

_incogNEATo_ wrote: »

joelo_83 wrote: »

_incogNEATo_ wrote: »

JessicaJS23 wrote: »

I'd ask your doctor or pharmacist...

Oh yea right. Let's ask the doctors who are controlled by Big Pharma why our scripts aren't giving us long enough relief... #illuminati #conspiracy

First of all, I hope you're joking otherwise I'd have to seriously push back against this.. "controlled by big pharma".? shows right there you have zero clue what you're talking about.

Pump your brakes there, Julio. If I was unsure if somebody was joking, I'd try and find out first before insulting them.

Do they have prescriptions for a flaccid sense of humor?

Not the first time I've read such comments on these boards, so yea, very disconcerting the fact people may actually think that , and only aimed to prevent further propagation of such ideas. My bad for prematurely jumping on the comment, since apparently it was a joke.

I mean, if big pharma really had us all in their pocket, they could at least help us pay back sallie mae for the cool $200k+ many of us owe for our education.

FridayApril01st2016 wrote: »

@joelo_83 the PMs aren't working (Application Error) but that's alright, since I am not a private person; I don't mind discussing it on the forum.

Before receiving prescription medications each time, I was only taking 2 Advil 200 mg tablets & then waited at least 8 hours between doses, since the directions indicate; not to take more than 6 tablets in 24 hours.

Currently I took 1 Ibuprofen 600 mg tablet, which I am allowed to take every 6 hours; as needed & is 200 mg more, than the 2 Advil's. I took it approximately 12 hours ago & it also makes me drowsy. The pain hasn't been as awful for about 4 hours, so I just took my last 2 Advil instead & plan to go to my local deli, to get a couple more packets of it; until I am able to go grocery shopping tomorrow. Then I'll just get a significant box of it.

In November I was prescribed Naproxen Sodium 550 mg tablets, which I was allowed to take twice a day; as needed & is 150 mg more, than the 2 Advil's. After a day, I only took the Naproxen; when I ran out of Advil. I still have 5 of the 12, that I was prescribed & never sought any refills.

I no longer have the Vicodin information but as I stated with all 3 of the prescriptions, the pain relief only lasted 2 hours but the over the counter Advil would last least 6 hours, when the pain was at it's worst (a 10, on a pain intensity level scale) & longer when it was just intense (an 8).

Each time I've been also taking Amoxicillin 500 mg capsules. In November I was prescribed to take it, 4 times daily; for 5 days. Currently it's 3 times daily, for 10 days.

@FridayApril01st2016

Oh I think I understand your question now. You're trying to figure out why OTC Advil is working better than the higher dosed ibuprofen you're getting from the RX, and comparing it to a previous Vicodin 5 and Naproxen DS 550..

NSAIDs , specifically ibuprofen, work best in acute irritation such as what you're experiencing with the abscess, and ibuprofen specifically is commonly dosed at 2400mg/day for dental work (800mg 3x/day). I really don't have an explanation as to why OTC ibuprofen would be better than RX ibuprofen except to speculate on pharmacokinetic variations, meaning: One 600mg or 800mg will take longer to dissolve and be absorbed than 2 or 3 smaller 200mg tabs or capsules, leading to a quicker onset of action, and perhaps longer duration (since it's suppressing creation of inflammatory molecules longer). So in theory, even though you are getting exposed to the same total of 600 mg over X amount of time, the absorbtion, distribution, metabolism and elimination values might vary from the two dosage forms. Total speculation tho without an appropriate kinetic study (moot point honestly, if it works for you keep doing what works). If you'd rather take 2-3 OTC Advil instead of your Rx 600mg ibuprofen, by all means do so, keep doing what it is you're doing that's getting you relief.

Comparing between 2 NSAIDs like you are in the case of Advil 200mg OTC, and Naproxen DS 550mg (ie OTC Aleve) is apples to oranges, as they are not equivalent milligram to milligram. They have totally different kinetic profiles, and is why ibuprofen is dosed 3-4 times per day where as naproxen is usually 1-2 times per day. Same with Vicodin. It's in a totally different class of medicine, being a combination of analgesics (hydrocodone and acetaminophen) with little to no anti-inflammatory activity. So don't rack your brain too hard trying to compare..

So my final recommendation.. The 600mg ibuprofen you have can be taken safely about 4x/day, and its always better, especially in a case like this, to take it on schedule, not as needed. For the next few days, just take it 3-4x/day and help really get that swelling down. Additionally, it would not hurt to take a dose of OTC 325mg or 500mg Tylenol separated by a few hours of the ibuprofen 2-3x/day to help with pain alone. Combine that with the Amoxicillin to start getting the infection down and you should have some relief. Don't be too concerned with the varying amoxicillin dosages (3x/day vs 4x/day), it gets plenty of tissue penetration and great coverage for the likely suspects causing infection in and around the teeth and gums. Amoxil 500mg 3x/day is a perfectly reasonable regimen to be on. After the initial bulk of the pain goes away and you start to get some relieve in a day or two, bring the ibuprofen down to "as needed" or maybe just 2-3/x a day. **Finish all of the antibiotic** .. If you've been through this before you know the antibiotic is just a temporary fix, but hopefully it'll buy you some time while you figure things out with your dentist.

Last but not least, I'm obligated to drop a huge disclaimer that, without reviewing your current med list, allergies, PMH and all other variables considered in the prescribing of the meds above, the information I posted is for entertainment/educational purposes only.