Maximum dose of narcotics

[Guest guest]

The " maximum " dose of  any " pure " (no tylenol, nsaid or ASA) agonist (morphine

like) narcotic (with the exception of ultram) does not exist.  Of course, there

are recommended doses for opiate naive patients.   The appropriate dose of

any pure narcotic is the dosage in which the patients pain is  fairly well

controlled and the side effects are minimal/tolerable.  If anyone is seeing a

physician that states, " I am sorry the Physician Desk Reference states that the

maximum dose is ___ , In essence the doctor is failing to individualize care for

that particular patient.  The dose of medication for the 90 year old patient

that is 85 lbs with low blodd pressure and heart disease is going to be very

different then the 30 year old guy who is 250 lbs with new onset hypertension

due to out of control pain.    My suggestion would be to search for a new

physician.  

When first starting to initiate pain treatment it is appropriate for the patient

to have office visits scheduled frequently.  By frequently, I mean 7-14 days so

that the medication can be titrated up or down, or changed altogether if the

side effects are intolerable.,  Also, upon initiation of a new medication if

nausea, vomiting, itching is experienced, do not wait for the next appointment,

call and speak with your physicians staff.  Please never just suffer thru side

effects because of fear that the physician will just stop pain control.

Deb RN

Debra