Commonly Required Medication

Tips, Uses and Side Effects

NF2 Information and Services primary focus is for people with Neurofibromatosis Type 2 (NF2). However, the combination of medications discussed here and discussed conflicts would also help anyone with Vestibular Schwannoma also known as Acoustic Neuroma for any other reason.

Vestibular Nerve damage results in an almost constant state of imbalance, even when some points this issue is not noticeable. This issue is difficult to overcome is Vestibular Nerve is damaged bilaterally, on both sides of the brain.

Common medications often necessary at different points include more than pain killers for headcheese.

1. General Prescription Warning

1.1. Prescription - 3 Month Rule

There are many prescriptions in which individuals who take them face a three-month period of withdrawal symptoms. While this happens with many medications, some of the more common medications this might occur with include; 1) Seizure medication, 2) following long term use of Steroidal treatment, over 10 days, like Dexamethasone, 3) Antidepressants, 4) Antidepressants or 5) Antianxiety. The three months of withdrawal also applies when a medication is stopped to switch over to a new medication of a similar type.

These medications are dangerous to stop without tapering, or tapering is done too fast. Ask a doctor specifically how to do this for the medication in question. The tapering method could vary based on the dose an individual is taking and the specific reason for the medication. Do not be embarrassed to ask the doctor to write out the tapering schedule.

1.2. Supplements and Food

When starting a new prescription, it is important to notify your doctor of any supplements, herbal treatment, or special diet that are used. Before starting new supplements, herbs or switching to a new diet, it is also best to mention it to a doctor when prescriptions are being taken. Using alternate sources for this information like the internet could easily result in not seeing dangers for many reasons. Be sure to talk to your doctor and pharmacist.

Before starting a new supplement, herbal treatment or special diet while taking prescriptions, talk to your doctor. An example is grapefruit. Grapefruit is known to interact with certain drugs and therefore must be avoided.

Examples:

• Chemotherapies Target Tumor Treatment of Nilotinib (Tasigna™) and Sunitinib (Sutent™) should not be taken the same time as eating or drinking grapefruit.
• Vitamin D and Vitamin C in Vitamins or food like milk and orange cannot be taken at the same time; the acidity in the oranges kills possible benefits of Vitamin D. The acidity also means milk in coffee will not give the body Vitamin D and calcium.
• Blood thinners are in many medications both prescription and over the counter, some supplements are also blood thinners. This is part of why it is necessary to stop supplements two weeks prior to surgery.

1.3. Dehydration (Water and Alcohol)

Many of these are best taken with water to increase circulation and help with hydration. Since alcohol causes dehydration it should be avoided at least a few hours before or after taking any pills. Death is a possible side effect of taking a combination of the above with alcohol. Please be careful.

1.4. Medication and Organ Failure

• Gadolinium (MRI Contrast Injection): Kidney Failure / Renal Failure

2. Pain Killers: Over the Counter (OTC) and Prescription

2.1. Side effects that can make a situation more uncomfortable

Seizures, Tinnitus, Dizziness and Headaches are not always from tumor pressure, tumor change or even your actual treatment, but instead from pain and other treatment medications. Read the side effects for; Aspirin, Codeine, Oxycodone/Acetaminophen (Percocet), Prednisone (steroid) and Morphine (Injection).

Most people think nothing of possible side effects of painkillers, while consideration on this as an issue is more likely to be realized with prescriptions, few think of over the counter medications as being harmful at all.

Some medications like Tylenol, a medication few thing of as possibly dangerous, recently chanced suggested number of pills per day because too many pills a day or over a certain number of days caused Liver Damage or Death.

Then there is Ibuprofen (Motrin), which many take for nerve pain; that can cause Kidney Failure, as can MRO contrast. Talking to doctors about alternate painkillers or looking to eat healthy to minimize damage is a good idea since it is harder to recover from Kidney Failure than it is to keep it healthy.

As long as the stomach medication is taken, it can results in an inability to absorb B12. Talk to your doctor.

1. Dramamine
   

Many of the pain killers mentioned below can induce side effects that can make balance recovery more complicated. Aid against: nausea, vomiting, and dizziness.

2. Acetaminophen (Tylenol)^[1]
• Dark Urine - Clay-Colored Stools
• Jaundice - Yellowing of the Skin or Eyes)
• Low Fever with Nausea
• Loss of Appetite
• Stomach Pain

The following severe side effects can result from exceeding the daily dose or from taking maximum dose for two weeks.

• Death
• Liver Damage


3. Aspirin^[2]
• Blood in Stools or Urine
• Bloody Vomit or Vomit that looks like Coffee Grounds
• Severe Dizziness or Drowsiness
• Severe Stomach Pain
• Skin Rash or Hives with Intense Itching
• Swelling of the Face or Eyelids
• Tinnitus - Ringing in the Ears
• Wheezing - Trouble Breathing


4. Ibuprofen (Motrin)^[3]
• Kidney Failure / Renal Failure
• Bleeding and Ulcers in the Stomach or Intestines
• Higher risk of Heart Attack or Stroke
• Liver Damage
• Vision Problems


5. Codeine^[4]
• Constipation
• Lightheadedness
• Nausea with or without actual Vomiting
• Sleepiness


6. Tylenol #3 (Tylenol-Codeine)^[5]
• Possible Issues Include
• Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
• Extreme Drowsiness or Confusion
• Lightheadedness, Dizziness, or Fainting
• Mild Dizziness or Drowsiness
• Mild Nausea or Vomiting, Constipation
• Rash or Itching Skin
• Seizures
• Trouble Breathing, Shallow Breathing, Blue Lips or Nails
• Unusual Bleeding, Bruising, or Weakness
• Allergic Reaction
• Chest Tightness
• Itching or Hives
• Swelling in Face or Hands
• Swelling or Tingling in Mouth or Throat
• Trouble Breathing


7. Oxycodone/Acetaminophen (Percocet)^[6]
• Dark Urine or Pale Stools
• Extreme Weakness
• Jaundice - Yellow Skin or Eyes
• Lightheadedness, Dizziness, or Fainting
• Nausea, Vomiting, Loss of Appetite
• Seizures
• Shallow Breathing
• Stomach Pain
• Sweating, or cold or clammy skin
• Trouble Breathing - Shortness of Breath
• Uneven Heartbeat


8. Prednisone (Steroid)^[7]
   • Possible Issues Include
   • Color changes on the Skin, Dark Freckles, Bruising
   • Depression, Unusual Thoughts, Feelings, or Behaviors
   • Fast, Slow, or Uneven Heartbeat
   • Fever, Chills, Cough, Sore Throat, and Body Aches
   • Headache, Changes in Vision, or Eye Pain or Swelling
   • Lightheadedness, Dizziness, or Fainting
   • Muscle Pain or Weakness
   • Numbness, Tingling, or Burning Pain in your Hands, Arms, Legs, or Feet
   • Rapid Weight Gain, Swelling in your Hands, Ankles, or Feet
   • Seizures
   • Severe stomach pain, nausea, vomiting, or red or black stools
   • Trouble Breathing, Cold Sweat, Bluish-colored Skin
   • Allergic Reaction
   • Chest Tightness
   • Itching or Hives
   • Swelling in your Face or Hands
   • Swelling or Tingling in your Mouth or Throat
   • Trouble Breathing
   
   
9. Morphine (Injection)^[8]
• Pain, Burning, or Swelling where the IV is given
• Trouble Breathing - Shortness of Breath
• Skin Rash, Itching, or Hives
• Slow Heartbeat
• Swelling in the Legs, Ankles, or Feet
• Trouble going to the Bathroom (Urinating)

2.2. Increase of Pain

Opioid-induced hyperalgesia (OIH) is defined as a paradoxical state of nociceptive sensitization caused by exposure to opioids. An issue where an individual becomes even more sensitive to painful stimuli. ^NCBI

As a result of nerve pain and during healing points following surgeries or other treatment, Opiates may be prescribed for some period of time. Unfortunately, after time if an individual's pain becomes worse and feels a higher dose is needed, lower dose may be the right option. ^ScienceMag

Opioid drugs include:

• Codeine (Only Available in Generic Form)
• Fentanyl (Actiq, Duragesic, Fentora)
• Hydrocodone (Hysingla Er, Zohydro Er)
• Hydrocodone/Acetaminophen (Lorcet, Lortab, Norco, Vicodin)
• Hydromorphone (Dilaudid, Exalgo)
• Meperidine (Demerol)
• Methadone (Dolophine, Methadose)
• Morphine (Astramorph, Avinza, Kadian, Ms Contin, Ora-Morph Sr)
• Oxycodone (Oxycontin, Oxecta, Roxicodone)
• Oxycodone And Acetaminophen (Percocet, Endocet, Roxicet)
• Oxycodone And Naloxone (Targiniq Er)

3. Sources

1. LA Times. "For all their risks, opioids had no pain-relieving advantage in a yearlong clinical trial." (MArch 2016)
   http://www.latimes.com/science/sciencenow/la-sci-sn-opioid-painkillers-no-better-20180306-story.html
2. Rx List. Acetaminophen - Tylenol. http://www.rxlist.com/tylenol-side-effects-drug-center.htm
3. National Library of Medicine. PubMed Health. Aspirin. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0009123
4. National Library of Medicine. PubMed Health. Ibuprofen (By mouth). http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0010648/?report=details
5. National Library of Medicine. PubMed Health. Codeine. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0009704
6. National Library of Medicine. PubMed Health. Tylenol #3 (Tylenol-Codeine). http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0008795/
7. National Library of Medicine. PubMed Health. Oxycodone/Acetaminophen (Percocet). http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0011543
8. National Library of Medicine. PubMed Health. Prednisone (Steroid). http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0011828
9. National Library of Medicine. PubMed Health. Morphine (Injection). http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0011276
10. NCBI
11. ScienceMag. Why Painkillers Sometimes Make Pain Worse. (2016) www.sciencemag.org/news/2016/11/why-painkillers-sometimes-make-pain-worse
12. Jessica S.MerlinMD, PhD, MBA. "Managing chronic pain in cancer survivors prescribed long-term opioid therapy: a national survey of ambulatory palliative care providers." Journal of Pain and Symptom Management(October 2018)
    https://www.sciencedirect.com/science/article/pii/S0885392418310005 | https://doi.org/10.1016/j.jpainsymman.2018.10.493
    Link Quote "Palliative care providers are comfortable with many aspects of managing chronic pain in cancer survivors on long-term opioid therapy (LTOT), although challenges persist, including the lack of systems-based approaches and training in addiction treatment."