Need advice on pain meds

[al from Canada]

Hi Cheryl,
I have spent considerable time researching this very issue. When Linda has raging liver mets (80%) the one thing we wouldn't accept was any formulation with tylenol in it. This drug plays havoc on the liver, which was the last thing Linda needed.

We requested a single entity narcotic. Why? Because mg per mg narcotics are the most effective pain medication. We settled on hydromorphone which is approximately 7 - 10 times stronger that morphine and ussually won't turn you into a Zombie. Linda takes 12 mg 3Xday and has the back-up of 4 mg. break-through pills in case the long acting takes too long. This is down from the initial dose of 24 mg 3Xday.

If you are in the US then you have access to a relitively new non-opiate med called Tramadol. This is an exciting analgesic as studies have found that tramadol actually increases NK Cells. There is some research that suggests that opiates may cause the cancer to proliferate. Tramadol is available as a single entity, mixed with tylenol and very recently in a sustained release formulation. Canadians need not apply! This drug as a single entity SR formulation would be my first choice. On the following post are some links for tramodol.

Good Luck,
Al