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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18759
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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My doctor prescribed Hydrocodone-APAP 5-325 tablets for pain

Customer Question

My doctor prescribed Hydrocodone-APAP 5-325 tablets for pain for my Pancreatic Cancer, but it's not working. Why?
Submitted: 1 year ago.
Category: Medical
Customer: replied 1 year ago.
It doesn't work. I'm in terrible pain. Can anyone suggest some other kind of drug? Also I have terrible stomach problems so I'd prefer not to take tablets or caps.
Customer: replied 1 year ago.
Posted by JustAnswer at customer's request) Hello. I would like to request the following Expert Service(s) from you: Live Phone Call. Let me know if you need more information, or send me the service offer(s) so we can proceed.
Expert:  Dr. D. Love replied 1 year ago.

Hello from JustAnswer.

I am sorry that you are having to deal with pancreatic cancer.

There are two primary reasons why hydrocodone/APAP is not working at controlling pain associated with pancreatic cancer. The most common reason is that the pain is of such severity that a stronger opiate is needed. The hydrocodone is one of the lower potency opiates, which is why it is also one of the controlled substances in the lower schedules. In this situation, the usual approach would be to use a stronger opiate, such as oxycodone or morphine. It is also frequently better to use one of these stronger opiates in a sustained release formulation, so that there is a steady level, rather than peaks and valleys.

The other primary reason is that certain pain can occur that even strong opiates are not good at controlling, with the moast common being pain from pressure on a nerve or the cancer growing into a nerve. In these situations, it is usually better to use a medicine that eases the firing of the nerve, and the most commonly used are gabapentin or pregabalin.

In some patients, both approaches are used - both a stronger opiate and a medicine to ease the firing of the nerve carrying the pain message.

Most of these products are available as liquid formulations, although the sustained release formulations of opiates are not. However, there are skin patches that are sustained release preparations of stronger opiates, such as Duragesic patches.

I had already typed most of the answer when you posted the request for a phone call. If you desire more information than in this answer and still would like a phone call, then I can send across the offer for additional services.

Expert:  Dr. D. Love replied 1 year ago.

I have not heard whether you still desire a phone call, so I will send the service offer.