Suggest Remedy For Acute Peripheral Neuropathic Pain

Posted on Mon, 16 Mar 2015

Question: My husband is taking Targinact 10mg/5mg for acute peripheral neuropathy pain and we are managing the condition at home. Now he has toothache - will paracetamol help the pain or interact with the Targinact badly? Thanks

Answered by Dr. Anshul Varshney (26 minutes later)

Brief Answer:
You can give Paracetamol.

Detailed Answer:
Welcome To HCM. I am Dr Anshul Varshney.
I understand your concern..
You can give Paracetamol with Targinact. Targinact contains Oxycodone so it can be used with Paracetamol without any significant interactions. However Targinact itself will be helpful in tooth pain.
Share my opinion with your doctor.
I hope it helps.
Stay Healthy.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anshul Varshney (23 minutes later)

Hi - thanks for this. have treated the toothache with oil of cloves and oregano and it is relieved: will keep the paracetamol for when/if it returns. Would you say Targinact was the best medication for peripheral neuropathy? It does not always seem to control the pain and certainly didn't hit the toothache this morning. Cyprus doctors are not always up to speed with medication and have this 'I am the doctor - obey me' attitude when it comes to prescriptions. The disease - and resultant bed-bound, wasting condition - is not easy to manage at home.

Answered by Dr. Anshul Varshney (1 hour later)

Brief Answer:
See a dentist.

Detailed Answer:
Dear Friend.
I suppose you should see a dentist to evaluate for the cause of toothache.
As far as Peripheral neuropathy is concerned, Oxycodone helps in relieving the pain. But I won't say it is the best medicine.
I treat my patients of neuropathy with SSRI like Duloxetine and a combination of Pregabalin and Methylcobalamine.
These medicines show a gradual effect but I found them very effective for neuropathy.
If you have any further query, please ask me.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anshul Varshney (3 hours later)

Thank you for your input on this. I have researched pregabalin/methylcobalamine since receiving your e-mail and it looks the way to go. My husband was on VitB12 injections at the beginning and then it was taken off the market here; he did not think it made any difference though. The first medication prescribed was Cymbalta (Duloxetine) and, whilst it made him better tempered (!), it didn't seem to do anything for the pain over 3 months. It was prescribed, they said, to make it easier to wean him off alcohol - apparently the cause of the neuropathy - but it was not successful and he just carried on as before altho' not spirits. Now he just has a glass of wine at lunchtime with food (Targinact at 6am and 6pm) and feels it is his only hope of a normal life.
If he changes to the pregabalin/methylcobalamine, how long does he have to be clear of Targinact? I gather he has to come off it slowly, although he has only been on the x2 per day for 2 months; before was one a day. Thank you for your help - you have been the only ray of sunshine in my day today. getting to the dentist will be another challenge tomorrow ...
Final thing - he takes Zolaram 0.25 (Alprazolam) at bedtime (8.30 and then midnight). I suspect he is addicted to this now, but is it a problem with Prega/Methyl - I can't see anything on the website. HELP! Thanks

Answered by Dr. Anshul Varshney (20 minutes later)

Brief Answer:
He can be stated on Pregabalin.

Detailed Answer:
In such scenario he can be started on Pregabalin. The only side effect he might get on taking these medicines along with other is sedation.
A person once started on it states getting relief in 4-6 weeks.
So you can discuss with your doctor.
Stay Healthy.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Anshul Varshney (45 hours later)

Thanks Dr XXXXXXX - dentist achieved today; paracetamol seems OK with everything else & extraction had three big roots - 90 minutes in the chair. We are all exhausted! Can you tell me whether there are any implications of taking small daily dose (as above) of Zolaram when we add in Pregabalin? How does Pregabalin work if it takes weeks to kick into effect? Thanks

Answered by Dr. Anshul Varshney (6 hours later)

Brief Answer:
Detail follows

Detailed Answer:
Dear Friend.
I don't prescribe such regimen.
As far as Pregabalin is concerned it definitely helps in reducing the neuropathic pain. It usually takes a few days to show it effects.
You should always discuss with your doctor before you start taking any such medicine.
I hope it helps

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar