Vicodin 10-660 Tolerance

Black Satin,

Sorry, I didn't see the part where you said you already had very bad reactions to Nucynta.

I just recently came off Nucynta as the RNF procedure has helped with the pain, but my doctor prescribed me an ample amount so that if I have a flare up, I can treat it. Hopefully I can stay off of it for a while though :)

Anyways, I do understand where you are coming from with the Seratonin Syndrome risk. I do personally feel the risk is lower with nucynta than with tramadol but I agree, people should be aware that this risk does exist, mainly in higher doses alone or when mixed with a seratonin raising agent. For me, most of the time I did not have issues.

I take a low dose of my prescribed ADD medication, 7.5 mgs of the generic salts (normal adult dose is 20 to 30 mgs per dose), which produces on a slight elevation of seratonin levels. However, on a few occasions (mainly when there was no break between the 6 hour tapentadol dosing) 100 mgs taking with the ADD medication caused mild hallucinations and on a few of those occasions caused very uncomfrotable but short lived cold sweats +nausea. The same thing happened when I took 150 mgs for break through pain when dosing had little or no separation period. It wasn't enough for me to discontinue using the medication as it only occured on rare occasions during the 6 months of use, and the symptoms would be considered a mild level of seratonin syndrome, as severe cases do require hospitalization. Tapentadol and ADD medications both raise seratonin levels slightly, but both medications have a more moderate impact of Norephedrine levels, which indirectly raises seratonin levels. Unless you are using Tapentadol with an SSRI, you probably won't have an severe incidents, but even milder incidents can cause very dangerous driving situation and can lead to panic attacks. Remember that severe cases of seratonin syndrome can kill you, so call you PM doctor immeditately even if you think its mild, because the syndrome can progress quickly!

Straydog, once again you are on the money. It very much is hit or miss. It was supposed to have much fewer *negative* effects than other opioids, and this was supposed to be pretty much across the board. While the decrease in GI effects is pretty much across the board, the incidents of Seratonin Syndrome was higher than first expected. As I stated, at the higher doses I had trouble even tolerating it, but at the 50 to 100 mg range the side effects were very few. The problem is, a lot of people havwe severe chronic pain, not moderate to moderate severe like I do so while 100 mgs worked well for me 90 percent of the time, its probably not even going to touch the level 9 pain cases for most people at that dose. At 150 to 200 mgs it probably would, but thats really the dose where the strong negative side effects come in.

For me it was a wonderful medication and I would highly recommend a short term trial IF you have neuropathic pain. Just keep in mind that it might work extremely well (as an above poster stated, it worked for him better than oc, and I personally agree on that one), or it might cause some very nasty side effects that make it hardly tolerable and not even touch your pain. It is very expensive but CIGNA does cover it. It's also being looked at to replace oc since it is considered less addictive. Both medications, regardless of addiction risk have very nasty withdraws if used over time (and tappered to quickly, PLEASE don't tapper quickly like I did) so be informed before you fill (or don't fill, hehe) :)