Has anyone been prescribed Demerol in Tablet form for pain??
I've heard of dentists sometimes prescribing this medication, but not much for CP patients.. I'm guessing it's like taking Hydromorphone in a tablet also.. It probably works best as an IV med.
Thank You

I've had it in the ER for my Migraines and Cluster Headaches( in a shot form) .. Just curious, because it works great on Migraine and C. Head Pain..
Thanks again..

Well I'll tell you about this and it was the really best thing concerning Demerol.

I had a HA specialist that said you needed at least 150 mg of Demerol for a migraine headache, otherwise it wouldn't work well for the majority of people.

He had a compounding pharmacy make up 200 mg demerol suppositories for his patients on demerol.

That was a very effective dose and you didn't throw up if you were sick already.

Now they do make a demerol/phenergan combo that works pretty well, 50 mg demerol/25 mg phenergan. You can actually end up taking 3-4 of those (not at a time, but over the course of an hour, hour and a half) but most docs won't tell you that.

They will give the same amounts of demerol and phenergan in the ER.

There is also a plain demerol pill, no phenergan with it. Even if a person isn't sick a lot of times they take phenergan with demerol cause the demerol can make you sick.

Have they tried you taking a valium and breathing oxygen for your cluster headaches?

I know that has been a very, very effective treatment for a lot of men with cluster headaches. I don't know how demerol will work on cluster headaches, I've never had those.

It can work well on migraines, and yes IV form works better, but the entire trick is that generally 50 mgs of demerol is not going to be enough for a migraine, probably you need 100 mgs at minimum.

I had pethidine (aka Demerol) tablets for a couple of weeks for post-operative pain relief following my laminectomy/discectomy. They helped a bit, but didn't last very long - 2-3 hours, at most. I was on diamorphine before that (for 2 days only, epidural) and switched to codeine (with paracetamol) after the pethidine, then dihydrocodeine, then Tramadol, and finally buprenorphine, which is what I take now.

Unfortunately, many people seem to find that facial and headache pain doesn't respond very well to opioids. I don't get migraines often these days, and when I do I find that the only thing I can do is hide in the dark and wait for them to pass. Nothing I take seems to help much. I really feel for people who get this kind of pain regularly.

Sorry to reply to my own post, but I somehow forgot to address one of the points in the original post, about pethidine/meperidine for chronic pain. The main reason it's not suitable for pain relief over an extended period is that with continued use the metabolite norpethidine (normeperidine, if you're in the States) can accumulate to dangerous levels, possibly resulting in significant toxicity. It's also not recommended that pethidine be taken concurrently with drugs like Tramadol and certain antidepressants, due to the possibility of seizures and, potentially, Serotonin Syndrome. I've mentioned this before (I think), but when I left hospital after my operation I was prescribed pethidine, Tramadol and fluoxetine - a serotonergic witch's brew if ever there was one!

wait, you went from diamorphine (heroin) straight to codeine? thats a giant step downwards.

Post-op that's the point in scaling back opioid treatment.
As the poster said, diamorphine to Demerol to codeine to DHC to Tramadol to (I believe) low dose buprenorphine.
In foreign countries where the use of hydrocodone or oxycodone is not prevalent, this is not at all an unusual post-operative schedule of pain treatment.
From personal observation, it actually could be considered quite liberal.

oh, I didn't catch that he went from diamorphine to demerol, the way he had it typed threw me off. yeah, that is a better declining scale.

I was on 100mg IM pethidine pre- and post-op every 4 hours for a week; in fact it was almost forced on me. That was in the days when it was considered a first-line analgesic and the nurses liked the chance to give you an injection because it meant that they could steal one or two as well.

Then the consultant came back from his golfing holiday and threw me out with paracetamol - no reduction or anything. By God I felt awful the following few days.

Sorry if my post above was a bit cluttered and confusing - I find the more pain I have the more garbled my messages become.

I had the laminectomy in 1995 in Oxford, England, and in those days oxycodone had yet to be introduced to the UK (hydrocodone remains unavailable). For the first couple of days immediately following my surgery I had a catheter inserted in my spine to deliver a constant stream of diamorphine, and I was given boluses as needed (very good pain relief). After that I was given oral pethidine for the next few days in hospital and then was given another two weeks of pethidine when I left hospital. Next I was switched to Tramadol for a few weeks, then codeine with paracetamol (I think I got it the wrong way round above, sorry).

My leg pain was greatly relieved by the surgery, but my back pain remained and gradually worsened. I'd had multiple injuries for three years before I finally had surgery, and the doctors suspected this had resulted in some nerve damage. For the increasing pain I was codeine again, and then dihydrocodeine, but neither were enough. My doc was very up-front with me about being reluctant to start me on morphine, but she felt confident that buprenorphine would help, and it did. As martind suggested above, I'm on fairly low-dose buprenorphine, at least compared to the amounts in Suboxone. After gradually titrating the 'right' dose for me, we settled on 0.4 - 1mg three times a day (depending on pain severity), which sounds like a medium-highish dose of buprenorphine (by analgesic standards) but is actually quite common, as my doctors explained to me. Like many other opioids, in chronic pain buprenorphine's dose range is quite flexible and is often prescribed in greater doses than those described as 'standard' or average in the BNF (British National Formulary) or its equivalent in other countries. At the moment I'm prescribed twelve 0.2mg tablets a day, and I usually take 0.8 - 1mg in the mornings and then 0.4 - 0.6mg during the day, depending on how bad I am (sometimes I only need 0.2 - 0.4mg). There is no concept of extended/immediate opioid pain management over here, as is commonly practised in the States and elsewhere (i.e. OxyContin for long-lasting background relief with oxycodone IR for breakthrough), but buprenorphine is naturally quite long-lasting (6-8 hours) and it seems to work for me.

Chances are, if I'd had my operation a year or two later I'd have been on oxycodone instead, as it was introduced (I believe) in the UK in the late nineties. I'm quite happy with the Temgesic (sublingual buprenorphine) at the moment, as it doesn't seem to have quite as pronounced side effects as the other strong opioids, and also the dose I'm on has not changed in over ten years, meaning that my tolerance is pretty much the same as it was after my first few months on it. When my pain is more severe (usually in the mornings, due to severe arthritic pain and stenosis) I find that I need 1mg (I'm always surprised by how much of a difference an extra 0.2mg can make when I increase the dose from 0.8mg to 1mg). I also take Tramadol (100-200mg a day) and diazepam (usually 2-5mg) as needed, but not necessarily every day, for muscle spasm. It's a pretty good combination for me: not perfect, but it reduces the pain quite a bit on good days.

Apologies if I am rambling or my posts seem a bit messy these days. On top of the usual back stuff I have a nasty case of cellulitis, and am feeling a bit loopy...

That extra 0.2mg makes such a big difference because that's how this drug seems to work; a sharp climb in effectiveness at low (Temgesic) doses followed by quite a flattening of the curve as doses in the 4-16mg are used, and beyond that, it's probably at a ceiling where there is no point in taking any more.

I've heard that less is more with buprenorphine. I've only had one encounter with it at 8mg. and it worked good for any pain I had at the time (this was summer '08)