Medications

Medication Instructions based on medications given (prescribed)

For all medications, please read package insert thoroughly to understand side effects and interactions. You should also speak with your pharmacist about any warnings associated with the medication or drug interactions with other medications you are taking.

Oxycontin: This is a long acting pain medication. Typically, it is given to help with pain for the first 5-7 post-operative days. I usually will give it to patients that have had nerve blocks due to the fact that they can take it the evening of surgery and this allows for a baseline pain relief so that when the block wears off you have some pain medication on board. This is typically given so that you take one pill every 12 hours for the first few days after surgery.

Oxycodone: These are shorter acting medications, but still require 30-45 min to begin working. The key is not to get behind on the pain the first couple of days. I typically will tell patients to take 1 of every 6 hours to prevent getting behind and having to play catch up. You can take up to two every 4 hours as needed for pain. There are varying strengths so if not working for you or if it is too strong please call Dr. Mall. This medication does not contain Tylenol (acetaminophen) so you can take Tylenol and these medications together. You can take two over the counter extra strength Tylenol (500 mg each-total of 1000 mg) 4 times per day (total of 4000 mg per day maximum). However, as you wean off these narcotic pain medications, Tylenol is a great pain reliever and can be used. The maximum Tylenol dosage is 4000 mg per day.

Percocet (oxycodone/apap OR oxycodone/acetaminophen): These are shorter acting medications, but still require 30-45 min to begin working. The key is not to get behind on the pain the first couple of days. I typically will tell patients to take 1 of every 6 hours to prevent getting behind and having to play catch up. You can take up to two every 4 hours as needed for pain. There are varying strengths so if not working for you or if it is too strong please call Dr. Mall. These medications contain Tylenol (acetaminophen) so you cannot take Tylenol and these medications together. However, as you wean off these narcotic pain medications, Tylenol is a great pain reliever and can be used. The maximum Tylenol dosage is 4000 mg per day.

Norco (Hydrocodone/apap OR hydrocodone/acetamoniphen): These are shorter acting medications, but still require 30-45 min to begin working. The key is not to get behind on the pain the first couple of days. I typically will tell patients to take 1 of every 6 hours to prevent getting behind and having to play catch up. You can take up to two every 4 hours as needed for pain. There are varying strengths so if not working for you or if it is too strong please call Dr. Mall. These medications contain Tylenol (acetaminophen) so you cannot take Tylenol and these medications together. However, as you wean off these narcotic pain medications, Tylenol is a great pain reliever and can be used. The maximum Tylenol dosage is 4000 mg per day.

Nucynta (tapentadol): this is a newer pain medication that may have fewer side effects than some of the other narcotic pain medications. There are both long-acting and short acting medications. However, these are typically reserved for those with allergies to other pain medications as they are quite expensive.

Tramadol (Ultram): this is not considered a narcotic pain medication but can have many of the same effects on the brain and other organs as narcotic pain medications.

Tylenol/Acetaminophen: Tylenol is actually a very good pain medication. It is often times used in the intravenous form to control pain during surgery. This is a good way to transition off of pain medications following surgery. Recommendation are to not exceed a total of 3000-4000 mg per day. This equates to about 2 over the counter extra-strength tablets every 6 hours. Acetaminophen can affect the liver when taken for long periods of time, and is often avoided in those with certain liver conditions.

Vistaril (hydroxyzine): This is actually an anti-itch, anti-anxiety medication; however, it doesn't do either of these very well. It does, however, help the pain medications work better so you have to take less pain medications, which all have similar side effects. Therefore, the less of them you take the better. You can take one Vistaril every 6-8 hours as needed.

NSAIDS (Mobic/meloxicam, Celebrex, Advil/Ibuprofen, Aleve/naproxen, diclofenac): These medications help reduce inflammation, which can cause swelling and be a source of pain. Therefore, they are actually going directly after the source of the pain, rather than masking the pain at the brain level like the narcotic pain medications. There are some reports of impaired bone healing in certain fractures or spinal surgery, and some concern that these medications may impede healing in certain surgeries that Dr. Mall performs. While these medications can improve pain control, they may be detrimental to healing in some cases. Therefore, if Dr. Mall prescribed them to you, you can assume it is safe to take them for your particular procedure.

Toradol: Toradol is a very potent anti-inflammatory and can affect the kidneys. It is usually not recommended for patients over the age of 65 for this reason, but is a great medication to help with pain control, especially when used only for the first 3-4 days' post-surgery.

Valium: valium is a very good muscle relaxer and typically I will use it for these properties. This may be prescribed for you after a surgery in which some muscle must be cut or after a tendon/ligament repair to prevent spasm.

Xanax: Dr. Mall may have prescribed this for you if you have some anxiety about closed MRIs. This medication requires that someone drive you to and from your MRI or other test/procedure for which this was prescribed. Start by taking one pill about 45 min to an hour before your test and then you can take another one about 15 minutes before if you are still very anxious. There should be a third pill prescribed in case you have additional anxiety immediately following the test.