Tuesday, 18 January 2005

Morphine or codeine allergy?

Are you "allergic" to morphine or its derivatives (like codeine)? (Note added 23 July 2006: I mean "allergic" in a lay person's sense, as in "very bad reaction to" - I'm not a medical expert and I don't claim to be one so don't hold me to the standards of a medico! I'm editing this post to make it quite clear what I mean.)

Believe me, the best time to find that out is as soon as you can, before you might need it - not when you've had to be administered a dose of morphine or codeine as a painkiller after an operation or serious injury. Constant throwing up night and day due to a bad reaction to morphine really isn't conducive to a speedy recovery. Or indeed to killing pain.

"Allergies" to drugs are not nice at all. What's an easy (and legal, of course!) way to find out if you have a morphine or codeine "allergy"?

First, ask your parents/grandparents if they're "allergic" i.e. have had a bad reaction to morphine or codeine or other morphine derivatives. This kind of bad reaction is often hereditary. If your mother says she gets nauseous even at the thought of morphine, that's a bit of a clue that you might not do too well on it yourself.

Second, if you've ever taken anything with codeine in it, listen to what your body says about it. Solpadeine is a drug you can buy over the counter without a doctor's prescription, in England at least. I've found that, for me anyway, Solpadeine is extremely effective for headaches and period pains (aside to any squeamish lads or indeed ladettes reading this - yes, I said "period pains". Too bad, menstruation is perfectly natural and not something to be discussed only in hushed tones, just think of this as my own small contribution towards the much needed desensitisation of society [/aside]).

Anyway. Solpadeine. I take it when I need it from time to time, but I can't manage more than one capsule (which is enough to sort out the pain for me), and I can't take the dissolving (and therefore more quickly absorbed) variety either - it makes me feel sick. I really, really should have learned something from that. If Solpadeine makes you feel ill, especially when you take the soluble type or take more than one capsule, you may be "allergic" to codeine or morphine and you should consult a medical professional to check!

My excuse is that I didn't know codeine was a morphine derivative when I was prescribed a heavy duty codeine preparation for a serious condition recently (plus when you're in a bad way the last thing you may think of is to check whether the particular painkiller on offer is going to make you vomit - you just want any painkiller, NOW!!!).

[Added 28 December 2005:] I never dreamt anyone would be stupid enough to read the previous few paragraphs as meaning that I was actually advising people to try taking Solpadeine or some other codeine derivative in order to test whether they're "allergic" to codeine, fer goodness' sake. I never suggested anything of the kind, and I certainly don't suggest it. I just meant that IF you had ever taken it in the past and didn't react well to it, then you should definitely go to a medical professional and get it checked out. I did NOT mean that you should check it out by experimenting on yourself, no one could possibly mean that, as anyone with more than a couple of brain cells to rub together would know! But given the recent comment, I felt I had to add this paragraph. I hope all is crystal clear now. Honestly, some people...

Alternative painkillers

[Added 18 June, as I notice quite a few hits for this post]:There are other painkiller medications available, especially combined with tablets that reduce the acidity in your stomach so you're less likely to throw up after taking them. Not so effective at dealing with the pain caused by certain conditions, perhaps, but better than exacerbating your condition through constant spewing (the interruption to sleep from frequent desperate grabs for the sickbucket won't exactly help speed up recovery either).

Obviously you should consult your medical adviser, but mine gave me a painkiller called Motifene or diclofenac sodium, plus a "stomach liner" (lots of names, I've seen Zoton and Lansoprazole) which I took first thing in the morning before taking the painkiller - and they worked great for me.

So: have you got a codeine/morphine "allergy"? - check it out when you can, and find out what alternative analgesics are available for you, or you may be sorry when you need a serious painkiller.


Anonymous said...

Thanks for your observations. I have the same reactions to codeine. It would be useful if someone compiled all the codeine (morphine) derivates like percocette and others. They provoke the same severe nausea reaction. Also, most commonly, the post operative self-administered analgesic contains some kind of morphine. One needs to be alert. Thanks. A

Anonymous said...

My aunt seems to be allergic to morphine patchs and pills but while in the hospital they gave it to her intraveinously and she was fine. Nothing else seems to work for her post herpatic neuralgia. Any suggestions?

Improbulus said...

Thanks for the comments. If people are willing to post info about morphine/codeine derivatives they know about, I am happy to list them here.

Sorry, no thoughts about your aunt's position - is there anyone in the medical profession around who has any ideas?

Anonymous said...

If an allergic response follows oral medication but not IV, it may be the binder or other "inert" ingredients in the pill that the patient is reacting to.
"Allergy" is often over used term. Many people have unpleasant side effects to various medications. This does not mean they are allergic to them. Erythomycin makes me sick to my stomach. That's not an allergy. That's just erythomycin being its chaming self. Tylenol turns me pink and itchy all over. That's an allergy.

Improbulus said...

Point taken Anon, but I'm no medic so I used the term "allergic" very loosely - for "bad reaction to". Hopefully non-medicos will get the drift.

Anonymous said...

please, please do NOT follow the advice here. Codeine can kill you if your allergy to it is severe enough. Do not take a chance by taking it just to discover if you have this allergy. That is down right foolish.

Improbulus said...

I hope people who read my blog will read it more carefully than "anonymous" did (the last comment above).

The thrust of my post was that it would be wise to find out sooner rather than later whether you have a codeine allergy. IF you have ever taken something like Solpadeine and it made you feel ill, then that might be a clue that you might be allergic, and you should definitely get your position checked out by a medical professional. I never said you should take codeine just to find out!

I never thought anyone looking at my blog would be daft enough to take codeine just to see if they're allergic to it, but as someone has clearly been stupid enough to misread my post as suggesting that very thing, I will edit it now to make it absolutely clear that I've never suggested that, don't suggest it, and wouldn't suggest it! Clear enough??

One New Teacher said...

I had a bad experience finding out I was allergic. I got extremely cold..then burning hot where I stripped off my clothes. Then I got naseous, but because the pain in my chest was overbearing, I couldn't vomit. Then my mother was over me asking if I was ok (I passed out). Yeah...I would put that experience in my top 3 worst feelings category.

Improbulus said...

Yeah completely agree, the constant throwing up is not nice at all. I almost feel I should wear a tag saying "Do not administer morphine". I mean I don't seem to be fatally allergic to it, luckily, but still I'd really rather not have it if there are other painkillers available.

Anonymous said...

If I am allergic to codeine would I also be allergic to morphine?

Improbulus said...

Well I'm no medical expert but that may well be, as they're related drugs - I just Googled them, see e.g. this page which says (as I'd heard) that most medical codeine is a morphine derivative. Best check with a doctor/chemist/pharmacist to be sure.

kikinurse said...

I can relate to the codeine problem!!!! Here is my story...I was in a car accident and hit my head on the windshield, was taken to the ER with a hematoma ( bruise w/ bump) on my forehead. nothing serious! I was given codeine to take for pain when released. I took the codeine the next morning and immediately started getting VERY sick!!!! I head felt like it was going to expload, I couldn't even walk it was so tremendous, I was shaking and crying. I called my parents to come and get me!!! I was crying in agony and felt like death!!! Mean while, not having a clue that It could be a drug reaction at all! But I was fine, just bruised, and didn't have any problems until I took the codiene. I lasted about 2 hours until I started literally "projectile vomiting". At the time I was a nursing student and learned that this vomiting happen from increase intracranial pressure (in brain). I had to be rushed to the ER again!!!! The light in the ER almost killed me!!! I was in a fetal position and near the end of my tolerance. I was given something intraveneously, but I am not sure what it was! I thought I had died and gone to heaven as soon as the drug was pushed!!! I had total relief of all pain without any drugged feeling. WOW Thank god for that nurse!!! So, I was brought in for a CAT scan and nothing was wrong. So, a year later I had a toothache so the dentist gave me a lortab. I took it and got near the same reaction that I had when I took morphine. It was so bad I forgot all about my toothache!!!! I was violently shaking, I knocked everything off the walls in my house, I vomited violently!!!! I was alone, and thought I would never get through it! I got in the shower and stayed there for hours until finally It calmed down. I can only assume that codiene, oxycodone, and hydracode are all equally toxic to me. I am not sure about morphine! I am working on determining what was given to my in the ER to stop the pain. When I do I will list and would like to get to the bottom of this mystery with my body and pain medicine. OH, very important, I can take darvocet, which is perpoxyphine!!!!! Its a lifesaver, since I suffer migraines. I only take it in emergency migraines. Thanks, please post if you have any comments. I am interested in your opions. mrs. RN....

TrixDemon said...

My mom is allergic to morphine. She kept telling the docs that when she was is hospital, she thinks it caused her first heart problem. However they gave it to her again, and 2 hours later her heart stopped and she had to be resusitated. All she was in for was to have her gaul bladder removed. Allergies to medication is a dangerous thing.

Improbulus said...

Thanks for your comments kikinurse and Disturbed Muse.

Looks like Oxycodone and hydracode might be things to avoid, from your experience Kikinurse (maybe the "cod" means they've got codeine in them? Don't know, haven't had a chance to check them out yet). Like I said I'm no medico so I don't know about them, or darvocet/perpoxyphine. Useful to hear that info though.

Disturbed Muse, sorry to hear about your mom. I wonder if we should wear a "Don't give me codeine/morphine" bracelet, sometimes! It's odd that she told the docs and they still gave her morphine. Yes, being allergic to the very stuff that should help you is not a good thing!

Anonymous said...

I'm glad to find this blog. I have had several severe reactions to opiates and opiate derivatives, (and one very sever one to IV Valium) and had a very hard time trying to tell medical professionals "please do not give me that stuff, I have very bad reactions to it." The doctors and nurses most common response is "well, opiates cause the side effects you are explaining." They simply don't get the message that a pulse rate of 20 from taking 1 Percocet, isn't simply a "side effect", and if it is, then they need to take the stuff off the market completely. Anymore I just listen to my body and my own intuition. I'm convinced that most of the medical profession will kill you if you allow them to take full responsibility for your health. Today I try my best to stay well informed and make my own decisions about how I care for my health. I told doctors for 30 years that opiates made me sick and the reactions got worse and worse each time they insisted I take it, and I've only had it maybe 10 times in all my 50 years.

Thanks for speaking out about this.

Improbulus said...

Thanks for your comment. I'm surprised the medical professionals you've encountered don't take your bad reaction to opiates seriously - or maybe I shouldn't be...

Anonymous said...

I was given codeine for a wrist injury at A&E and had a very bad reaction to it. It's very frightening when you tell the doctors you feel faint, they tell you to breathe slowly and you won't!! But I did, twice, aswell as vomiting constantly. It took a kind nurse to recognise the signs, as she had had the same experience, to tell me I would feel better in 24 hrs.

Improbulus said...

It certainly sounds as if the medical profession as a whole ought to be better educated as to the possibility of people have a bad reaction to morphine or codeine. I wonder if anyone researched into what percentage of the population suffers like this? Is it only very few of us, or is it quite common?

Narcanian Woman said...

In response to Kikinurse's experience in ER with allergic reaction to morphine ... I had a life threatening reaction to Codeine which nearly caused a heart attack and did cause hyperventilation. I was given an injection of the drug NARCAN which stopped the bad reaction to Codeine. I also had constant vomiting from IV Morphine on another occasion. Even after my stomach was empty I continued to heave and that was after having had a 6 inch incision sewn up on my belly. My sister whose a RN was with me at the time and got a doctor out in the hallway to change my IV pain pump medication to Demerol. Within 20 minutes the vomiting and nausea stopped. What bugs me is that the doctor who gave me the IV Morphine pump knew that Codeine was life threatening for me since I told him that myself minutes before going under anesthesia. I didn't know that Morphine was a derivative of codeine at the time. My preferred pain killers are Toradol (very strong Ibuprofen which might NOT be given more than about 5 consecutive days and might sometimes cause bleeding) and the other is Demerol for no more than one day for me. Unfortunately, these drugs may not be strong enough to kill the pain of a large incision which cuts thru 3 layers of muscle tissue not to mention the cutting and stitching of internal organs. The idea of asking a doctor to let one try other pain drugs for no more than 5 days (5 tablets so they might not think one is over doing it and are not some kind of drug addict)prior to an impending surgey/procedure is one I am currently persuing at the behest of my sister. Trying a pain killer for the first time during or after a serious medical procedure or upon injury clearly is not the best time and you would think that doctors would know that and recommend drug trials for each individual under a controlled setting with a seringe of Narcan at the ready. I think someone might consider having rooms in hospitals or clinics specifically for those drug trials for patients anticipating the need for a pain killer. They would make a fortune not to mention safe thousands of lives and prevent massive suffering. They of course would probably require patients to sign waivers of liability prior to such drug trials. Unfortunately, the only time such progressive changes in medical practices occur is when more patients start suing their hospitals for not having better drug protocols. Hospitals, not to mention medical insurance and pharmacuetical companies clearly sometimes act in my opinion as though they care more about money than they do about preventing pharmacuetical errors and deaths. I think many of the doctors are victims of the institutionilize systems they practice under themselves. I wish they would put up a bigger stink as an organized group about the failings of the way medicine is practiced in hospitals and clinics. Many of them are also brainwashed by the drug companies. I remember telling one of my doctors about the heart palpitations that the drug Seldane was causing me, and his response was that he was taking it daily himself and didn't have any problem with it trying to convince me that it was harmless. Needless to say, I stopped taking it. I was taking Seldane for sinus problems caused not by seasonal allergies, but by the high blood pressure medication I was given. And don't you know that Seldane was later taken off the market I think for causing heart problems. I think doctors might not make hey because they themselves are afraid of being sued and having their license put in jeopardy. They might need to fight for their own rights to be immune from liability by the institutions they work under and by the drug companies to some limited degree so long as they administer and prescribe the drug within the realm of written recommendations. I do not think they should be immune from liability by their patience. How does the American form of capitalism make for such a complex world? And does anyone know of other pain killers that are not derivatives of morphine, codeine or aspirin?

Anonymous said...

Please try and differentiate an immunologic response (i.e. an allergic reaction or allergy) from a drug side effect (nausea, vomiting etc). The former usually warrants complete avoidance of the offending substance due to the potential for serious harm or death and the latter is possibly treatable via additional medications or use of alternative means i.e. minimizing use when needed.

Improbulus said...

Narcanian Woman thanks for sharing your experience. I've mentioned towards the end of my post alternative painkillers which worked for me (diclofenac sodium with Zoton) but you need to check with your own doctor of course.

Anon, fer goodness' sake, my point isn't to get into semantic arguments about what an "allergy" means in a medical sense. I've no idea about the right technical terminology. My point was to warn people that it may be worth finding out in advance, as in before they need it, whether they might have a bad reaction to morphine derivatives as pain killers. That was all. I've edited my post to put "allergy" in quotes to make that clear.

kikinurse said...

Thanks so much for the reply, especially narcanian woman! I did some research and discovered that I was given Toradol ( the strong and only injectable nonsteriodal anti-inflammitory) when I was treated that evening at the ER... Thank GOD I wasn't given any codeine derivatives!!! I really don't think I would have come out alive if that would have happened. I have spoken to several medical professionals, including pharms, and I was told that It was a "normal" to have these side effects! NO WAY!!! That is upsurd!!!! Codeine and/or codeine derivatives should not cause SEVERE pain!!!! I have administered plenty of narcotics to patients, and Never have any of them experienced anything near what happens to me! If that was the case, the drug woud have been band long ago! It should at least relieve some pain in my case..I don't even think that I would have minded the vomiting that much, had my head not felt like it was going to exploid! I suffer from migraines, and promise you that the reaction I received from codeine and lortab didn't even come close! It was almost like I was near a convulsive seizure. I couldn't function and therefore, had to go to the emergency for it!!!! I had no other choice. I was so pitiful and had no idea what was causing the pain! Thank god for Toradol and Darvacet!!! I know that the reaction I experienced was more than just a "common" adverse reaction. I would insist that I am ALLERGIC" to these substances, and would rather suffer with anything else than be submitted to that ever again!!!!!! I have also had a bad (not quite like the codeine) reaction to the antibiotic family "tetracyline", which increases pressure in the brain! Apparently, my body doesn't tolerate this at all! While taking this antibiotic, I had headach and nausea daily for 2 weeks, then discovered it was the drug causing it... I know it all seems strange, but I'm so grateful to share this information with you all and learn of others experiences. I guess we are all the opposite of drug addicts!!!!LOL

Anonymous said...

I had a bad experience three days ago. My mom and grandmother both had bad, bad reactions to morphine and codeine, and told me I probably did as well, but when I had wisdom teeth removed in my 20's, I thought, well I don't know for sure so allowed the oral surgeon to administer morphine. Bad do not want to be thowing up for hours non stop right after tooth extraction.

A week ago, I started having abdominal pain for four days, worse at night, so went to a walk in clinic as we are away from home. Dr. there did tests and x-ray and determined it was not serious and sent me home with Tramadol. I had told him carefully and explicitly that I could NOT take codeine or morphine, or any synthetic versions (Vicodin) or any derivitives. I had been given Vicodin after a bad back injury and it made me very ill. After taking two Tramadol pills as instructed Thurs night, I woke up Friday with overwhelming nausea... horrible, then the vomiting started.... when I was empty, the dry heaves and retching went on and on and on.... I was shaking, trembling, sweating, unreal... I am 68 and have never had anything like it. I ended up in the ER having IV fluids and anti nausea drug phenegran IV as well (thank goodness for that drug) After two hours to deliver the Iv and doing tests, , nothing else was discovered and I was sent home. The next day when I felt better, I researched Ultran and generic version Tramadol, and saw the word CODEINE.. I agree with the others on this site who say the drs do not listen.. they either do not believe the severity of the vomiting or something.. I do not understand it... I cannot imagine having this reaction after a large surgical incision! And the pain was not relived by much. I think I will stick to aspirin, advil and tylenol. One study said that tylenol was superior to Tramadol for post op pain! without codeine!
Thanks for all the other posts.

Improbulus said...

Thanks for sharing your story Susie. I now know to avoid Vicodin too!

It's horrendous that doctors should still give you morphine/codeine derivatives when you've specifically told them you react badly to them, and other alternatives are available (though they may carry with them their own, separate, risks, e.g. I've since read that diclofenac sodium, which I now have on prescription as an alternative heavy duty painkiller when needed, might not be good for the heart).

I've been lucky in that doctors I've seen have listened and prescribed me alternatives. Maybe the moral is always to ask them exactly what they are prescribing, and also ask "That doesn't contain morphine or codeine or a derivative does it?"

Anonymous said...

Hey all,

FYI - allergic response to an opiate (ie. morphine, codeine) is severe in around 0.2% of people. 0.02% of people are sensitive enough for death to result.

While alot of you have criticised the medicos for giving you these pain meds despite your bad reactions (and rightly so), be aware that the reactions you've been describing (vomiting, fainting, etc) are on the 'mild' end of the spectrum and, as some have suggested, can possibly be considered 'side effects' and not true allergic responses.

Even though you feel like death, they're not likely to be life-threatening. Unfortunately, the doc's seemed to have recognised this, without recognising the distress it is likely to cause you.

Best to steer clear and be firm with doc's - they can't administer something against your will in the majority of circumstances, if you just make that perfectly clear.

Good luck all,

(med student)

Special note to disturbed muse, sorry to hear of your experience - the opiates can cause a decrease in blood pressure but are unlikely to cause cardiac arrest directly as such: hopefully (and i say that in the most caring way), your mum's reaction was due to an underlying cardiac condition that has since been sorted out. Nevertheless, be firm with doc's!!

Improbulus said...

Winkel, thanks for your very helpful comment.

You are right that in most cases the bad reaction is a side effect rather than a true life-threatening allergic response. If there is absolutely no choice, if no other option is possible and you have to be administered morphine/codeine or die, then of course it's better to suffer a bad side effect.

Nevertheless, as you say the distress it causes ought to be recognised. If there are alternative painkillers which could be used doctors should use them, particularly as, in most situations when morphine/codeine is likely to be needed, the extra distress can only exacerbate the situation (e.g. post-surgery, it won't help the recovery).

Mike Murrow said...

this is all interesting. i am allergic to morphine. a true allergic reaction to morphine results in anaphilactic shock. most people experience what you describe because they were given an over dose.

i know this because i stopped breathing when i was given morphine in a drip. at first it was thought that i was over dosed. however, it turns out, that as rare as true morphine allergies are i actually am allergic.

the thing is i can have other opiates like codine. i have been through several clinics and tests to learn all of this.

just wanted to add my two cents.

Improbulus said...

Mike, thanks for sharing your own experiences. It's interesting, your point about overdoses. They ought to tailor the size of the dose to the patient (e.g. I shouldn't be given the same amount as a 6' tall man for the same effect!) but sometimes I wonder if they do.

I'm glad at least you can have codeine even if morphine is dangerous to you. Do you wear a bracelet or the like to indicate that you can't be given morphine in case of accidents?

Anonymous said...

Where can you find alternative painkillers to those containing morphine or codeine?

Improbulus said...

Anon, in my post I've mentioned a couple which worked for me, though you should always consult a medical professional on what's suitable for you personally. And my first port of call for alternative painkillers would definitely be a doctor.

Anonymous said...

All very enlightening... just to clarify from a pharmacist's point of view:

codeine is not so much a derivative of morphine. Codeine, and most opioids in this class, get metabolised TO morphine, the active metabolite being morphine-3-glucuronide.

The ideal professional for anyone to consult on these matters is a registered practising pharmacist (=chemist). This should be your first port of call, not google.

True morphine allergy occurs in less than 1% of the population.

'Allergies' are very fashionable it seems.

Valium is not an opioid.

An expected reaction to first use of morphine (called a type A adverse drug reaction, AKA side effect) includes nausea, vomiting and sedation. This is NOT allergy, which would only be indicated by anaphylaxis, swelling of the throat etc.

Tolerance to the predicatable unwanted effects of morphine (except constipation) results in 4-7 days normally, which is why an antiemetic is given alongside for this initial period.

It would be a shame to think that patients are not benefiting from morphine and the like because of a perceived allergy. Was the allergy documented at the time? We frequently see 'allergies' to penicillin which, on questioning, turn out to be diarrhoea.

about the overdose point, it is difficult to overdose on morphine when used properly: a low dose (5-10mg every 4h) initiated slowly and titrated upwards in the right percentage. It does not get calculated on body surface area.

Improbulus said...

Thanks for the pharmacist's view, Anon, and the explanation of what the active ingredient is that some of us react to badly - so it's morphine-3-glucuronide and drugs that contain it, is that right?

Yes I've had that nausea etc, but not just on the first use of morphine - every one. Which is why I avoid it. I didn't realise you could get an antiemetic to counteract the morphine. The nurses etc could see me miserably throwing up, and no one EVER offered me an antiemetic.

Instead, when I've subsequently said I morphine makes me throw up, the medicos have simply given me an alternative drug. Not morphine plus antiemetic.

Why is it a shame? Do you think morphine is the best painkiller and therefore it should be used in combination with an antiemetic, instead of switching e.g. to diclofenac sodium (which is what I was given as an alternative)?

Anonymous said...

morphine,codeine..heroin and methadone to be added as well.The 'good side'of this "allergy'to opiates-less addictions.

Anonymous said...

I was enlightened by the blogs on various morphine/codeine allergies. However, I had a very scary incident that I wonder if a professional could enlighten me on. I had an outpt. procedure and was premedicated with vicodin. I had the usual sleepiness initially with the vicodin, but then had cold sweating,hot and cold spells,bradycardia then tachycardia and difficulty controlling my breathing. EMS was called and my heart rate was 150's with a BP of 150/80. (I normally have a HR of 50-60 and a BP of 90/50). I went to the ER and the MD blew me off-gave me fluid and sent me home. THe next day, I woke up and felt like I could not sit still. I had intense itching (no rash though) and felt crazy-I was manic and went back to ER where I paced and paced because I simply could not sit still. I kept itching and feeling as if I was crazy. THe ER doc said this reaction could last for several days but I could find no evidence in the PDR about this type of pschy reaction. I am a normally calm, rationale person, but I must admit this reaction persisted for approx 5 days (ie feeling panicky, manic and itchy). It was quite scary. Does anyone have insight or experience with this tpe of reaction? By the way morphine does not relieve pain and made me have paranoia /hallucinations with 1 dose.

Anonymous said...

the itching is normal in the use of opiates,along with the paranoia and throwing up.Can last for a couple of days maximum.

Improbulus said...

Anon, good to know those of us with a bad reaction to morphine aren't ever likely to take to heroin etc!

Vicodin - sounds like you had a worse than usual experience. Thanks for the enlightenment, Anon.

By the way please can people leave a pseudonym or initials when commenting, you don't have to give your email or website when you do so - makes it easier when replying to comments, there's an awful lot of "anonymous"es on here! Ta.

Improbulus said...

Just choose Other and put in some initials, no webpage necessary, before hitting Publish.

Anonymous said...

According to my allergist, I do have a true codeine allergy-- hives inside my throat and externally on my neck as well as facial and tongue swelling--and I do wear an ID bracelet identifying two medical conditions and two true allergies (penicillin and codeine). My regular doc (a GP), who knew I was allergic to codeine, prescribed tramadol and provided some Ultram samples to me in May for my fibromyalgia pain. Since I am so sensitive to medication, I didn't take the Ultram samples and went to the pharmacy to fill out the tramadol Rx (lower dosage, short-term use whereas Ultram lasts 24 hours). Thank goodness I asked to speak to the pharmacist since it was the first time I was going to take the medication (I can veryyy cautious). It was the pharmacist who said, "I see you have an allergy to codeine. You cannot take this medication or Ultram if you are allergic to codeine because they are derivatives." I never had a chance to tell my original doc because he closed up his practice after 17 years (moved to work in an ER across the state line), but it was news to my new doc (internal med) who didn't know that tramadol/Ultram are derivatives of codeine.

I just think there are so many meds for the docs to remember that you specifically need to ask the docs to look up in the PDR possible reactions and precautions with any drug they are going to presribe to you if you have severe allergies or are very sensitive medication like I am.

I also wanted to mention that like Anon who posted on June 17, I had an absolutely horrible reaction to vicodin over 20 years ago when it was given to me for migraines. It was pretty much the same reaction as Anon had. My mom said I went absolutely bonkers--babbling, crying, pacing and pacing and pacing (I was home visiting for the holidays) for two days. I later told a doc about the reaction and he said that vicodin, can in some rare cases, create a sort of psychotic reaction. After that, Vicodin, along with Soma and Oxycodone (I sob uncontrollably when I take either one) are on my list of "bad reaction" drugs that I carry with me. And, to top it off I had a doc who tried to have a nurse inject Vicodin into me in the ER to relieve the excrutiating pain from a broken heel after I told him that I had a horrible reaction to it! I was told later that I screamed at him and at the nurse saying, "How dare you give me something I just told you I can't have! I'll sue your a** if you, the nurse, or someone else gives it to me!" Apparently the loud screaming stopped him in his tracks (I'm pretty sure the screaming was the result of the excrutiating pain of the broken heel). So, now I carry a bright pink index card with me in my purse listing my alleriges, illnesses and conditions, drugs I have bad reactions to, and drugs and vitamins I take (dosages, number of times per day, and what they are for).

Improbulus said...

Thanks for sharing your experiences Southwesterner.

You're absolutely right about doctors needing to look things up, and the importance of asking them to check whether what they're recommending could be a derivative of what you're allergic to.

It's hard to believe that doctors will insist on giving you stuff you tell them you can't take, but I've heard too many horror stories of the arrogance (or something else!) of some doctors - not all, of course - don't blame you for screaming at him, that probably saved you from getting injected with it.

Hope your card will work, though I would have some concern that someone who is prepared to ignore what you tell them will equally ignore the card too/

Anonymous said...

I had a severe reaction to codeine when given some pills to deal with pain after having a root canal. After mentioning it to my mom, she told me that she too had a horrible reaction. I've made sure that my children know about this.

An acupuncturist friend commented that many people have reactions to opiates, so I know that at least alternative therapists know this. I would assume that doctors would know it as well and mention it to their patients. Why don't they??

Here's another reason to be cautious: some people are ultrafast metabolizers of codeine. This is especially dangerous for mothers who breastfeed their children because it can affect their baby. In the past year a healthy 13-day-old breastfed baby died from an overdose of morphine (which, as someone mentioned previously, is what codeine turns into after it is processed by the body).

Apparently there's a genetic test that can reveal if you are a rapid metabolizer of codeine and other drugs. I hope that more work is done in this area because every BODY is different and drugging us in the same way is probably a fairly crude method of treatment.

According to a Wall Street Journal article, the following populations have the most rapid metabolizers:
people of North African, Ethiopian and Saudi Arabian backgrounds.

"One test that can show how people metabolize several types of drugs, including codeine, is made by Roche Diagnostics. A spokeswoman for the company said labs typically charge between $500 and $1000 for the test."

Improbulus said...

Thanks for the info NEG. Maybe doctors don't mention this because they think opiates are the best painkillers and would rather their patients were constantly throwing up than in pain. Who knows. If there's an alternative painkiller that's as effective, or almost as effective, I'd rather have that - but if there isn't, maybe that's why the medics put us through it?

Interesting to hear about the rapid metabolisation issue. Can't say I'm surprised - everyone is an individual, as you say, I recall reading about how drugs tested only on men can have a radically different effect on women.

But short of drugs personalised to your exact individual genome (and that may come one day), I'm not sure what can be done apart from testing on the major known groups e.g. women vs. men, main ethnic groups etc. And of course all that costs.

Anonymous said...

I had some sort of opiate as pre op medication back in the 70's and had a reaction where my leg where the shot was administered get huge and red. Since then, I have had my med files tagged with the allergic to opiates sticker. Now docs tell me that noone is actually allergic to opiates? They now say that one of the agents in the shot is the culprit. Does this make sense? What can I take instead? I am considering abdominal surgery and am worried about the pre op and post op meds.

Improbulus said...

Carol, well it sounds like at least one commenter above has a true codeine allergy!

You really should discuss this with your medical advisers, they should be taking a full history before your surgery so make sure you tell them about your bad reaction in the 70's and that you're worried about it. Surely if you stress the point they can't ignore it.

Anonymous said...

i had a shot in the m. room and by the time i got home i was buring up and felt like my body was squeezing itself to deatj . this was a horrible night and then the vomiting started . i felt like death would be better . took my nasuea pill and finally went to sleep . still fell like i have been run over . is this a horror stor or what ==she

amatrine said...

What do people do? I am allergic to all the pain killers excpet torodol. Morphine, and any derivitives causes me hives, codine causes cererbral edema,.. I have severe chronic pain with no relief. The only one I am not allergic to is phentenol, for some reason, but you cant take that at home. Darvocet even makes me break out in a chest burning rash. To make it worse, I am allergic to all antibitoics. Allergist cant find one I can take. This is torture. I had a doctor that didnt believe me once, shot me up with morphine, and I broke out in hives and couldnt breath. His comment, I guess you were not exagerating after all" ... ugggg

Anonymous said...

Late post here, but it just happened to me recently. I took Tylenol with codeine as given by the oral surgeons (wisdom tooth extraction) and had severe painful leg cramps. I mean PAINFUL. It was incredible, I'd never felt anything like it (nor do I want to again).

Family doctor said it was a rare occurance that wasn't an allergy but was a nervous system response. He actually mentioned the name of it, I asked him to write it down but he ended up writing something we'd talked about previously, but I've forgotten what it was called, I'll have to ask him for the name of the reaction again.

As for the person who said that codeine turns into morphine when taken by the body, that's not entirely true. A small percentage of codeine is metabolized into morphine but not nearly all of it.


Anonymous said...

When i take anything with codeine in it, my tongue puffs up a little bit and my lips go numb...

Jim Henderson said...

Hi everyone...

I'm going to weigh in on this as a medical student and a spouse of a Anesthetist (the people who really know about this stuff in medicine). I'm relaying what I've been told. This is not medical advice to YOU, should not be taken as such, and YOU SHOULD ALWAYS CONSULT YOUR DOCTOR. I'm a student, not a licensed doctor, so anything that I say is the same as a member of the public talking out of their rear end having read a medical textbook... Don't rely on my word for anything; ask a medical professional.

Firstly, as the Pharmacist wrote above... True allergies to narcotics (including codeine) are rare. VERY RARE. The number of people who think they are allergic exceeds the people who are actually allergic by several thousand percent.

Anaphylaxis is a distinct reaction, which usually involves swelling and major constriction of airways. My brother has an allergy to peanuts... The merest taste of peanut oil will cause his throat to close up, and he'll be dead in 15 minutes without his Epi pen. If you don't get this kind of reaction, it's not an allergy - what you are getting, is a side-effect.

This is an important difference, and you should know this before you tell a doctor that you are allergic to a drug, because there are circumstances where they really, really need to use a narcotic, and if you can't be given it, it puts your health at risk.

It is very important to realise that the normal reactions to narcotics include:
-Shallow breathing
-Decreased heartrate
-Light-headedness, fainting, dizziness, confusion, anxiety
-Very short-term memory problems
-Nausea, vomiting, stomach pain, diarrhea

These are not friendly, nice drugs that you can take in your daily life without issues.

If you take codeine for pain-killing, do it because you need it, and be prepared for the possibility of side-effects. They do happen, and that's the trade-off :-/

Now... Narcotics in the hospital are given for a few reasons. The first of which is pain control. The important thing to realise is that this is not just for your pain as you feel it. Pain is a message to your mind, but to your body, too. When you are unconscious in an Operating Room and the surgeon cuts you open, your body freaks out! Your heart rate rises, and all of those pain responses kick in, whether you know you are feeling it or not. That reduction in heartrate side effect is really important at that moment. An Ibuprofen tablet isn't going to cut it, and if your anesthetist can't give you a narcotic, it makes life harder, for certain cases.

Surgical consequences:
Giving the right amount of narcotic for surgery is hard... Too little, and the benefits are not enough, too much, and the patient suffers side-effects. If too much narcotic is given, we have a great injection called Narcan (which someone above mentioned - P.S. Sorry you got a bit too much narcotic - the exact amount to give someone is tricky to get right), which will counter-act the narcotic, and fix problems with heart rate, breathing, etc.

Either way, after medical narcotics, you'll almost certainly feel sick and want to throw up. Remember that drug addicts get these symptoms too... It's what the drugs do. That's completely normal, and you are given a number of different drugs to counter-act that as well (my local hospital gives 5! Each offers a ~50% reduction in the chance of nausea (this is a bit of a simplification), so 1 drug = 50%, 2 drugs = 25%, etc. - 100% is not possible, however). The corrective drugs (antiametics) don't work on everyone, and certain classes of women are particularly affected - they will throw up, no matter what you give them to mitigate the effects. This is why when doctors face patients who turn up with a laundry list of 'allergies', they are almost always women, and they almost always mistake normal side-effects for allergic reaction.

Also, when it comes to sensitivity to narcotics, it is inversely proportional to alcohol intake. The more you drink, the less sensitive you are, and the more narcotic has to be given for the same effect. Be truthful to your doctors about how much you drink... It makes them much better able to manage your pain. If you drink a lot, you'll very often find that you need more headache pills to get rid of that migraine than your one-pint-a-week friend. If this is the case, and you take a few more before your headache goes away, please, please, please have a word with your doctor. Using more than the recommended dosage of some tablets can have other nasty side effects, particularly on your stomach, and you don't want that.

Final Thoughts

If you think you have an allergy to codeine or a narcotic, please take a good hard look at it and decide whether it is a real allergy, or just a normal response (which can still be unpleasant, I know). Giving your doctor options is really important for your pain and your wellbeing, if you ever get hospitalised. People turn up in hospitals ever day, brandishing long lists of the drugs that 'make me feel sick' and 'give me hives'... Except in extreme situations, doctors are obliged to respect those lists as allergies and not give you the drug, even when they are very often not. Then they get entered into your patient record, and the doctor in 10 years who is trying to save your life with surgery really has their hands tied, because it is still on your record and has to be respected.

To the poster above who mentioned that their mother felt sick just thinking about codeine... That should tell you something. You really can make yourself nauseous without the drug, and sometimes when you take the drug, you feel nauseous because you expect to feel nauseous if you take the drug. The placebo effect works both ways. The outcome is still that you feel nauseous, of course :)

Breast feeding after medical narcotics is fine, as far as we know (this means that there have been no cases of affected babies after their mother has received one-shot narcotic, otherwise someone would have published a paper about it).

The drugs don't hang around in your body forever, and when they stop affecting you, they're often pretty much done. Your body doesn't have a secret cupboard to keep the narcotic in, after it stops affected you, and your breasts were created particularly well to try and protect against such things passing across into milk. You almost certainly won't see your baby to breast feed before the effects wear off, regardless. If you want to be extra-safe, pump a some bottles a few days before your surgery and keep them refrigerated, then have the surgery, pump and dump for a few days, and then go back to normal. It'll also put less strain on you for a few days, post-surgery. Clearly, however, taking narcotics (including morphine) in large quantities, while simultaneously breast-feeding is a really dumb idea, and there is a decent chance of passing some on.

I hope this helps to calm some worries, everyone. I also hope that it gives you a better picture of what an allergy really is, and what a side-effect is, particularly for codeine and other narcotics. If it gets you to decide that your nausea is not an allergy and enables your doctors to better serve you in the future, it's a really good day.

Anonymous said...

I am amazed at the number of people sensitive to these opiates. I have had bad reactions to codeine and cannot tolerate this drug. I get violently ill from codeine and have a hard time breathing and rash all up.
I have had a near death experience with morphine while in the emergency with kidney stones. I asked the doctor for demerol for my pain because I have never had a bad reaction to this medication. He insisted that morphine is from a different family of opiates than codeine. The nurse began injecting the morphine in my arm when it started to burn...the last thing I remember is not being able to breathe and my heart felt like it was going to explode in my chest. I blacked out and woke to a doctor and three nurses working on me. I was given Narcan and an injection of Benedryl to reverse the medication. I had gone into anphylactic shock and my body went into seizures...I had come close to dying. The doctor and nurse both apologized to me and explained that it is very rare to have such a bad allergic reaction to morphine. I was told wear a medical alert bracelet and to write on my health card "extreme allergy to morphine" because if I am ever in an accident or become unconscious this common painkiller injection could be the end of me.

Anonymous said...
I recommend anyone with an allergy to register with MedicAlert, you pay a yearly subscription but you get a wallet card (updated every year) and either a bracelett or neck chain with engraved embelem(you have to pay for bracelett/chain. Then any meical people who need to treat you can see brief medical details and call for full medical breakdown including who you doctor and next of kin are. Very good organaisation imo.

Anonymous said...

It is amazing to see so many others that have terrible reactions to opiates like I do. However, it is VERY frustrating when it is kind of glossed over as being "an unpleasant, but normal" side affect. It is more than just unpleasant for me. I've taken codeine, demerrol, morphine, and Lortab and have had such severe reactions I thought I was going to die. The dizziness was so severe I could not get relief from lying down or sitting up, and walking was impossible without help. The nausea is so severe that dry heaves cause major stomach pain. I had intense burning in my hands and arms as well. Then the scary part begins, you feel as if you are going crazy. I started having panic attacks after my last "try" with an opiate. While it is comforting to know I won't be an addict, I live in fear of needing a serious pain reliever and not being able to take anything. I don't know how it affects others, but I received absolutely no pain relief and then had the reactions on top of the pain. Is there a way to be tested for extreme sensetivity to these drugs without having to find out the hard way?

Anonymous said...

I may have missed it, but did no one else have a totally alien version of their hospital hover around them?
Every member of the staff progressively shift into homicidal criminals, especially at night?
Lay about for 6 hours feigning death, to avoid attention from the planted murderers among the other patients?
Try to escape into the darkness and rip out all the epidural and feed lines in the process?
Come to terms, finally, that letting themselves be killed would protect their visitors from further risk?
Have every sound source from every TV and conversation centered above the bed?
Listen to all the other patients deciding whether I should be allowed to live, now I was a threat to their affairs?

And when all this became more apparent to my family and they acted to stop the Morphine and highlight that on my medical notes,
be given another shot by a careless staff member?

Finally get a "different" drug, Oxycode?, and have the whole nightmare start again?

I quote "If we told you all the possible side effects, nobody would take it!"

Anonymous said...

I hope someone can help me. I went to the ER with Chest pain and they immediately gave me Morphine IV, and within seconds I had extreme pain in my neck which caused me to stiffen my head back and extreme pain in my shoulders and upper chest. It went away in a few minutes but geeeez it was painful. I read where curvature of the spine is something the dr should know before given morphine. Does anyone know what could have caused this pain?

angioplasty said...

I know how important it is to have a powerful painkiller is especially during surgery. I really do feel for those that have an allergy to these painkillers.

sexymama5 said...

thank you for your insight i am an australian mother of 5 who were all caesarian section births but didn't have a problem until my 3rd child when i continually vomitted until no morphine was in my system it only occured when i was raised past a 45 degree angle so was flat on my back for 24 hours until an alternative was found they now have on my records a precise mix for general anethsetic that stops this problem and i was fine with my last 2 births
i don't have problems with coedine and require it daily for pain due to chronic illness but panadeine forte is the strongest i can have without reaction i also had problems with pethadine temazapan and other strong pain relief and sleeping medication does anyone know if these all have a common ingredient that might cause these reactions or maybe my system is just too sensitive
alternative pain relief is available in things such as a TENS machine which sends electrical impulses to block nerves but is only for pain relief after ops i'd welcome any suggestions as am due for an op in next few months

Anonymous said...

I don't get nausea - I just get horrible, horrible pain. I went into the hospital with chest pain (yes, I have heart problems) and I had had problems with codeine before. They wanted to give me morphine. I asked them if I would have a problem with that. They assured me that I would not, that I did not have an allergy, just a sensitivity to codeine. I do not drink at all. I believed the doctor and took the morphine even though my chest pain was not that severe. Soon thereafter I was writhing in pain from the morphine. They administered the Narcan. It didn't work. They administered it a second time. About 2 hours later the pain started to subside. Whether that was from the Narcan or just the Morphine wearing off, I don't know. I live in fear of getting cancer or something like that requires heavy duty pain medication. The odd thing is, I can take Vicodin, which is synthetic codeine. Go figure. But they're taking that off the market.

jessica said...

i was accualyy reasearching this because i had a bad allergic reaction to codeine last night..i took in the form of cough syrup..i had severe chest pain shortness of breath,heart palapations, and sweats..i went to hospital here and they gave me meds to counter act..but i didnt ask if i was probably allergic to morphine or you think i might be allergic to those meds too?

Anonymous said...

I am waiting for hip replacement surgery and am getting anxious about post-operative pain management since codeine (and any of its related counterparts) give me that squeezing chest pain that so many of you have described. I concur with those who "don't care" whether it is a true allergy or a side effect - it is grusome to experience and does nothing to help the pain! Am going now to the pharmacist with my dilema and my list. And hope I don't get my call until I find something that will work!

Sheri said...

I don't see any posts on here mentioning an allergy or reaction to poppy seeds in addition to codeine/morphine etc. Opiates of course, have the poppy as their source.

When I was 12 or 13 I ate poppy seed cakes that were densely packed. This was at a Sunday morning brunch. The next morning when I got up to get ready for school, I noticed that my lips were beginning to swell rather rapidly from that point. Within an hour they were huge and it was like a freak joke, but not so funny as if my airway was cut off, I could die.

I had to stay in emergency after being given a shot I think in my neck. I can't remember as I'm 49 now and that happened when I was 13. I avoided poppy seeds like the plague. But one time at work when I was in my 20s, I had a terrible headache and took a pain reliever from a co-worker. (I know -- shouldn't do it, but she was a grandma type and at that time I hadn't related poppy seeds to codeine or any opiates.)

Anyway, yes it was a 292 pill which had a lot of codeine in it. Both of my eyes started to swell up and then weirdly pulse and twitch.

After that I avoided all opiates as well as poppy seeds. But a few months ago I was eating some bread and my lips began swelling. I freaked at looked at the bread wrapper -- eek! poppy seeds were in the ingredients. The print was tiny and I'd never seen poppy seeds in whole wheat bread before.

My most recent weird experience was at the eye doctor last week. I'd never had eye drops there before, but did that day. Apart from the regular burning, I had a terrible reaction with burning and swelling. I thought: "Could it be?" and lo and behold, after some research on the Internet, I found that yes, some eye drops contain poppy seed oil!

I also read that a poppy seed allergy is rare, but it's even rarer when related to opiate allergy.

Anonymous said...

I just had my tonsils out Two days ago, ouch enough on it's own. I was feeling mostly fine, and was the only one of three people with their tonsils out in my recovery room not given morphine. Last night, however I was a little rough-feeling and just couldn't sleep, so I figured maybe I should take some Tylenol. My first instinct was to avoid the T3 I was prescribed and just stick with regular Tylenol, ground into a fine powder and downed with a glass of water, of course. However upon examining the T3 package I saw that it would lead to some slight drowsiness. What could be better?! Pain-free and sleepy enough to sleep. We ground it up and I swallowed it down. I was fine for about an hour before absolute crushing, severe and unbearable pain occurred.

I have had my gall bladder out as well, after suffering with it for 2 years and the pain (for me) was very similar to a severe anxiety attack, right in the center of your chest. So I am not unfamiliar with this type of pain, and no wuss when it comes to taking it, either.

When after 20 minutes of it, we finally decided to call 911, the lady on the line asked the intensity of the pain on a scale from 1 - 10. If you've been in the hospital recently, as I had been, You know that to them 1 is no worries and 10 is death.

Without hesitation I said it was a 10.

They arrived very quickly, and oh-so mercifully the pain subdued on it's own without the need of other drugs.

However the medic informed me that this was a highly a-typical 'allergic' reaction, But I cannot think of what else it could be related to, except this.
There was no vomiting or nausea associated with this pain.

oh, and I'm 21 so heart problems were unlikely and they did double check to be certain and I was good as gold in that area.

Despite what the medic said, I will be utterly avoiding T3 now if I can help it for the rest of my natural born life.

I was praying for a black-out.

Sheri said...

"A true allergy to opiods causes trouble breathing, low blood pressure or swelling of the lips or tongue."

This is from a government medical site. It backs up what the medical professionals on here are saying.

Most of you on this board do NOT have an allergy to morphine, codeine or opiates at all. The PAIN that you experience is a side effect. It's a rarer side effect but NOT an allergy. If a "medic" told you that, it wasn't accurate.

Please everyone, I hope you will listen because it really is important to differentiate between a true allergy and side effects.

I have a life threatening true allergy to even poppy seeds as well as codeine, morphine etc. -- My lips swell up and my breathing is affected. If I don't get medical treatment, I'll die. It's an anaphylactic allergic reaction.

The problem with lumping in everything as oh I'm allergic to morphine and who cares if it's a true allergy is that so many people do these that when someone (like me) really has a true allergy to it they think I'm crying wolf like you guys. Less than 1% of people are really allergic to morphine and it's derivatives.

I hope this helps you see why it IS important to differentiate between even really bad side effects and a true allergy.

Thank you.

LM EDWARDS said...

Hey I'm a marine and as such have been given almost every major painkiller at one time or another. I can take IV morphine and the Oramorph(R) solution without any reaction other than the normal occaisional itch and slight nausea for the first 20 minutes. I have been issued Co-Coadamol(R) previously with no reaction but yesterday i got issued some 30mg Codine Phosphate tablets and since taking 2 my back, stomach and shoulders have gone bright red and i'm having to apply mousturiser and boby oil every 10 minutes to try and keep from tearing myself to shreds! I'm guessing this means i'm reacting to a 'binder' or other inert compound within the tablet but how would i go about finding out which one and accessing alternative medication??? I can't afford this to happen to me in the field, any ideas???? gratefully recieved!

Mika B, said...

I do have lots of allergies. I have not met a narcotic that I was not allergic too. Most of the pain killers out there I am allergic to. I have to be totally put out to have dental work done or in or out of patient surgeries. I am also allergic to benadryl, a few antidepressants/behavior drugs such as lexapro, amatryptaline, zoloft, celexa, effexor, Trazodone, wellbutrin, remeron, lamictal, trileptal. Food allergies are popcorn and kiwi. I touch kiwi the inside fruit and I get a rash from it. Sometimes i get a rash from oranges too. the juice touches my had and I get a rash from it and it stings. I also am allergic to blue #5 and Yellow #5 and #6.

When I ask family about mom's side blames those genes on my dad's side and my dad's side blames it on mom's side. Dont know why it happens. But in my family I am the only one in my family that has this many allergies. I also have allergies to dust, mold, and I get the spring fever and fall fever. I have chronic sinus problems. Who knows were it came from but I am going to see a Geneticist in October! Im tired of not knowing how to fix what is going on and not knowing what more is to come. I have always wondered if there was some disorder out there that if one has all these allergies then what it is called. Anyone have any ideas i would love to hear it.

Anonymous said...

I took a recreational dose of codeine, between 300-400 mg and id taken it a few times before in much lower doses and felt fine, but this time my body went red all over and started itching violently, my heart was going a mile a minute, I was throwing up constantly and I felt like I was going to die. Can someone tell if i had an allergic reaction or not? any feedback would be appreciated.

SC said...

I was prescribed Panadeine Forte (codeine) for post-dental-work pain. Within minutes of taking it I got intense, painful pressure right in the middle of my chest. It was *slightly* alleviated when I lay down but seriously, even then it felt like my heart was being ripped out. So I note to myself, no more codeine.

A few days ago I developed a nasty cough and bought some medication. Not long after my first dose I developed severe wheezing and shortness of breath. Sure enough, the label (which I stupidly failed to look at before I bought it) proclaimed "Pholcodine 15mg". Pholcodine is a codeine relative. Be warned!



Unknown said...

I just wanted to add my 2 cents. I have a strong "sensitivity" (not a proper alergy) to morphine. Similar symptoms to those described above - vomiting, severe headache, light sensitivity, etc. However, I have no problem with codeine. I've been trying to work through the drugs I *can* take comfortably, and those I can't. Percodan (and similar) are no go. Ocycodone is also no go. And demerol has more side effects than effects. But hydrocodone seems OK. I mean I wouldn't want to take it if I wasn't in pain, but the side effects come down to something I can handle.
Anyone have any ideas about which painkillers are most closely related to morphine? And which are furthest away (like codeine)?
My personal horror story, having a big red "no morphine" tag on my file, and waking up after shoulder surgery, 54 stiches and bone removed, to realise they'd put me on a morphine pump. The next 24 hours were some of the worst I've ever experienced.
Any ideas on what's chemically furthest from morphine (and percodan) would be greatly appreciated.
Dutch Girl

Anonymous said...

H there

My experience with opiates is this... A number of years ago I herniated a disc in my back and was prescribed T3's ( Tylenol with codeine ) I took one, and 20 minutes later was passed out on the floor in a cold sweat, nauseous, and hallucinating wildly. Luckily I came too, and was well enough to return the bottle of pills to the pharmacy. I was terrified that I might accidentally take one at a later date. A few years after that when in the hospital having my twins by C-section I informed the nursing staff about my reaction to the (very small) amount of codeine I had taken, and they put a red wristlet on me warning against it's use. After the C-section they gave me morphine by IV. I instantly crashed. Seriously crashed. They hit that big red button on the wall and all hell broke lose. After many shots of dopamine and epinephrin, oxygen, and numerous bags of saline forced into my veins to flush it out they managed to stabilize me. I was unconscious for 3 days, and in the hospital for 2 weeks... with a nurse in my room round the clock for over a week. I still couldn't stand up for more then a few minutes without passing out, but I demanded they discharge me at that point.

It turns out that I'm "allergic" to the chemical signature of an opiate, and [should] be wearing a medic alert bracelet. Strangely though, I can take MINUSCULE amounts of demerol for extreme pain for a short period of time.... before it starts depressing my breathing.

Anonymous said...


Unknown said...

I also have "side effects" from all narcotics. I HAVE WHAT IS CALLED SPHINCTER OF ODDI ATTACKS OR SPASMS. Whenever given codeine, morphine, ultram etc. This duct from the liver either shuts down or just spasms. The pain is so horrendous that I really cannot wait for the ER people to get their act together therefore the physician at the Medical College of Ohio at Toledo (that diagnosed me) prescribes IM Inapsine that I keep at home. My husband is a physician who then injects me. This is somewhat rare. Only to be diagnosed by a physician probably a gastroenterologist. Just some additional information. This May have no bearing on anyone here and certainly not a diagnosis. Hope this makes sense?????????????

Anonymous said...

The difference between a recession and a depression is that when your neighbor's unemployed, it's a recession but when you're unemployed, it's a depression.

Recently ended up in the ER for a knee injury & the doc lectured about how he was sure we'd agree that a little nausea was no big deal compared to death. Puked for three days because he's too arrogant, ignorant, or lazy to find a different pain med.

Surgery is scheduled this week & the complaint rolls on.

Beware, some doctors just don't care about you.

Peter said...

I need to know if there is a non opium or poppy seed derrivitive pain killer. I cna't tolerate them. We can get a man on the moon but thier is not an alternative pain killer that does not come from the opium plant. Thier must be a chemist who has found an alternative in pill form because i have diease that has chronic pain.

Ray said...

I've recently had an allergic reaction taking tylenol with codeine for pain from a root canal. I had previously had a reaction/side effect from hydrocodone, hives, itching. Nothing too serious that benedryl wouldn't cure. However, this time when the itching started after taking tylenol with codeine, I took some benedryl and fell asleep. I woke up with a swollen tongue, shortness of breath, and swelling on my face. Time for prednisone! Fortunately, I had prednisone handy along with an epi-pen if the prednisone didn't work.
So, now I'm trying to discover what else has codeine in it. As I've read through many of these blogs I see that it is a morphine derivative or at least related to morphine.What other drugs can I take for pain?

Anni said...

I've had a severe reaction on several occasions taking these pain-killers. My reaction is different in that I don't have vomitting,but do have what feels like muscle spasms from my upper to lower abdominal area, that come and go in waves, lasting for several hours, a lot like childbith contractions but without the delight of a new baby at the end. It's incredibly painful and I also experience difficulty breething. I've been taken to A&E 3 times. I was administered with what I was told was a muscle relexant, which very quickly relieved me of the terrible pain.
I went to see a doctor at the hospital some weeks later to try to find out more and to have something put on my records to avoid future agonies. My deepest fear being what a lot of you have expressed, that of being in an accident and in pain, only to then have that pain greatly exacerbated in A&E with these "pain-killers".
The doctor was very strong in his view that no such notice should be added to my records, "in case I ever really needed pain relief"! Where do you go with that one? I was told there was NO alternative to Opiate based pain relief. Not knowing for sure that I was actually reacting to that, I asked if there was a test or way of discovering what ingredient could be causing this problem. I was informed that there was no such test.

To underestimate and undermine the pain and suffering caused by these drugs is very frustrating and frightening, and to a lot of medical professionals who have never experienced for themselves this horror,there seems a great lack of empathy and a will to change the status quo.
Thanks for your website, it's reasuring to know I'm not alone.

Anonymous said...

I have been told by an Allergist M.D. that I am allergic to Morphine, Codeine and Benzocaine, and have been tested for the latter in a clinical setting. My reaction is extremely intense and unbearable itching of internal organs: lungs and eyeballs in particular. I have not yet read of any similar reaction. My skin turns red, my face swells and turns purple in color, blood pressure goes up and my skin itches uncontrollably. Breathing has been difficult only in one case. I do not get any of these drugs for surgical procedures any more, am identified in the hospital as allergic to them, based on these previous reactions in the hospital and referral to an allergist, and there are very few pain killers after surgery that I can be given. Benadryl has eased the symptoms in all cases. Now I am wondering if my 'allergies' are allergies or bad reactions after reading all of this. Either way, I am avoiding them! I had a minor surgical procedure today and was given Propofol in lieu of Fentanyl (spelling?) because they did not consider the latter to be safe for me.

Sheri said...

Re: "Propofol in lieu of Fentanyl" etc.:

You sound like me -- someone who has what is known as a "true allery" to opiods/opiates.

There are 3 different opiod/opiate groups and not all people with true opiod allergies will be allergic to all 3 groups so doctors may prescribe different ones.

I've had at least one opiod in each group and am severely allergic to all 3 PLUS poppy seeds -- which is very, very rare!!

That the doctor doesn't want to chance you on Fentanyl MAY ( and I say may because I'm not a medical professional and don't know your allergy details) think you are allergic to all 3 groups.

Those who are truly allergic will sometime experience hives but signs such as "my face swells and turns purple" and "my blood pressure goes up" are EXTREMELY live threatening. Swelling is an anaphalitic (sp) allergic response that requires IMMEDIATE medical help.

The difference between reactions from side effects and true allergy IS important, contrary to what some posters have said. BECAUSE IT IS LIFE THREATENING where as the reactions are not and are really people reacting to the known side effects of opiods.

In reality, common medicines use the side effects of opiods to treat other conditions.

For instance, does anyone know that the popular, over the counter anti-diarrheal product, Imodium, and it's generic 'cousins' are actually CODEINE!!

I never would have guessed, and as a true opiod allergy case I'm glad no harm was done!

I had the flu and terrible diarrhea and bought the generic equivalent of Imodium at Costco. Thank God I only took one tablet when I got home because it was my first time trying it and I wanted to see if one worked before I took any more.

Well, I swear it was only about 15 minutes after swallowing the generic Imodium tablet that I felt my eyes twitching. I tried to ignore it, but it kept up and then I thought "That is weird. My eyes haven't done that for so long!!! Not since I took that 292 for my headache 20 years ago and had the terrible allergic reaction -- twitching then swollen eyes and face etc!

I thought "No, It couldn't be, could it?" and RAN not walked to Google! Sure enough, I found out Imodium etc. is an opiod!!

Quickly, I made myself throw up the tablet -- still intact. Doing that saved me an emergency room trip!!

So beware everyone with a true allery to codeine!!

(BTW Pepto Bismul is not an opiod, but has minerals. You may be able to take that, although I can't as I have an ulcer and it may worsen ulcers as one of it's side effects.)

Kikinurse said...

I can relate to the codeine problem!!!! Here is my story...I was in a minor car accident and hit my head on the windshield, was taken to the ER with a hematoma ( bruise w/ bump) on my forehead. nothing serious! I was given codeine to take for pain when released. I took the codeine right before bed. I awoke feeling extremely sick!!!! My head felt like it was going to expload, I couldn't even walk it was so tremendous, I was shaking and crying. it was blinding agonizing pain! I was crying( which made my head hurt worse) in agony and felt like death!!! I had not a clue that It could be a drug reaction at all, I was fine and didn't have any problems until I took the codiene. It lasted about 2 hours until I started literally "projectile vomiting". At the time I was a nursing student and learned that this vomiting happen from increase intracranial pressure (in brain). I had to be rushed to the ER!!!! The light in the ER almost killed me!!! I was in a fetal position and near the end of my tolerance! I was given 10 mg Toradol (only injectable NSAIDS- non opiate) intraveneously and IV saline! I thought I had died and gone to heaven as soon as the drug was pushed!!! I had total relief of all pain without any drugged feeling. WOW Thank god for that nurse!!! I can only imagine if I was giving morphine... I seriously bet I would have died!

So, I was brought in for a CAT scan and no sign of bleeding from the wreck... All was ok..

A year later I had a toothache so the dentist gave me a lortab. I took it and got the exact same reaction that I had when I took codeine. It was so bad I forgot all about my toothache!!!! I was violently shaking near a seizure, I knocked everything off the walls in my house, I vomited violently!!!! The vomiting caused the pain in my head to escalated to a pain level unfit for humans! (cerebral edema/pressure compounding) I was alone, and thought I would never get through it! I was honestly too sick to call 911! I got in the shower and stayed there for hours until finally It calmed down. I can only assume that codiene, oxycodone, and hydracodone are all equally toxic to me. I am not sure about morphine! OH, very important, I can take darvocet, which is perpoxyphine!!!!! It was a lifesaver after my root canal! Now have learned it has been taken off the market!!!! Also I get occasional Migraines and am able to take fiorcet which has saved me from a round of cluster migraines and I use if BC powders dont do the trick!

Also I have another good piece of advice! I once drank an alcohol called Yagermeister... I was severely sicken by this stuff with very much the same symptoms as codeine.. Later I heard it has codiene derivatives in it!!!! So BEWARE!

I am now very concerned for my safety when it comes to pain meds! I was actually told that it was normal to get violently ill from pain meds that renders a trip to thr ER by a well respected pharmacist! In my opinion I had an idiosyncratic reaction! Pain meds should Never cause severe pain that far surpasses the pain you had before you you took the pain pill!

I have since tried Demerol for yet another tooth problem and it litterally drugged me out and left me unable to move and had no pain relieving benefits whatsoever for me! Hated it.
Thanks, please post if you have any comments. I am interested in your opions.

Anonymous said...

I found out the hard way that i have quite the codeine allergy. I'm afraid to try morphine, and my doctor advised againnst it due to the level of my reaction to codeine. I get:
chills, sweats, shaking AND random muscle twitches, a rash, an all over itch, a pounding headache, dizzy to the point where i have to hold on to even manage lying down- moving is not an option, i can't breathe, my heart rate goes nuts- really fast, then it drops to really slow, then back again. All in all- it was NOT a fun experience.

I have other meds im sensitive to, but they only make me nauseous nothing i cant handle once it deals with the pain.

I have a stupid pain thing going on, and the only pain-killers that seem to help any are terrible for my stomach lining (had to get it rebuilt. twice), so now take pain pills, and stomach pills, every day. for 6 months. having had 4 months of trial and error in finding anything that helps.

I have many fun food allergies too, so lots of shots and stuff i could get, i can't. Food that might help, im allergic to. If anyone can find something that has the same pain relieving powers of codeine/morphine- but none of the "killing me" powers, please post them! doing an ibuprofen/paracetamol balancing trick at the moment, but man, its a lot of pills.


Anonymous said...

Dear Anon
My husband is allergic to Morpihne. This summer had a torn up knee so they gave him tramadol waiting for knee surgrey He had adverse reaction. swelled one hand then back to other, lost 20lbs was curled over like 90 not 55. They gave him predisone. Helped..Now cannot get off it or swelling and aches comes right back. Doctor says see Arthritis Doc. He doesn t have arthur. His Neutrophils off the charts.Any ideas???

K9Lady said...

I am trying my hardest to figure out why those with "true" allergic reactions are saying those who have severe reactions are "crying wolf" as one person said and what difference it makes to them? They get a medication to live and don't have to have the medication ever again, while those of us who aren't taken seriously have to suffer needlessly! What, do you want a badge or something?!
My first experience with morphine and codeine was 22 years ago after an extensive 8 hour surgery. I got all the reactions: hallucinations, hives, itching,tried to stop breathing, low BP, vomiting, nothing serious, right? I can't remember what they gave me in place of all of it but I was told to never take either med ever again! That was 22 yrs ago. I haven't had any opiates since until I had a shoulder surgery recently. My surgeon decided he would try me on a different derivative of morphine, it was horrible! Hives, itching came first, then the mental changes (I was nice and calm one minute and a raving lunatic the next)...that was a nice change...not! I was also given an anti-anemic but I almost stopped breathing so we cut back on that. The doctor decided to try an different pain med, still an opiate although I protested, and I became violently ill with projectile vomiting and then due to the severe pain and mental confusion, actually tried to kill myself!! This is not me! I eventually ended up with numbness on one side of my body and chest pains and a trip to the ER. I thought I was having a stroke by then! The doctor wanted me to try one more opiate and I screamed no, told them I would suffer in pain (which I did with aleve and ice). I would never have had the surgery had I known I would not have adequate pain control afterwards. There were other things he could have done for me (a long lasting block) strong NASID with muscle relaxer, etc., but he do any of them. I am also shocked that my pharmacy filled the prescriptions as I have allergy alerts in my records. If you are wondering why I took the meds anyway, please understand that when you have surgery and are in that much pain, you will do just about anything (I said just about) to make it stop and after all they weren't allergies, just side effects, right? I am thinking of turning both into the Board of Medicine over this.
When a human body reacts negatively to a substance such as breaking out in hives, becoming nauseous, having mental changes, going numb, heart palpitations and/or pain THAT is a allergic reaction. Perhaps you aren't going to die from it, but your body is saying it doesn't like it. If something like Benedryl can take care of some of the side effects and it is a antihistamine, then you have an allergy.
Since my little "side effect" led to such a severe mental change that I was going to kill myself...I'd say that was life threatening and therefore an allergic reaction. But hey, I guess you can only say you are allergic if it's an immediate life threatening event!
Many of the "side effects" from opiates can create life threatening events and I don't understand why they are downplayed or ignored. I don't even know the words to explain the horror I was in during those days after my surgery, first because of the reactions but then the pain from the pins and bone grafts in my shoulder. No one should have to go through that without pain control of some one!
Maybe they could label it different? Something like: Severe allergy, allergy, adverse effects. To tell someone they need to suffer more than their pain isn't worth it and such a cavalier attitude needs to stop.