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Is there a Codeine free-Asthma safe prescription pain medicine?
activetexaslady posted:
I recently had extensive foot surgery. "Oh Wow". When they tell you it will be very painful, please believe them. Except no one can ever anticiipate how much pain until it happens. My problem is I have asthma and am highly allergic to codeine and any of its by products. So, taking pain meds for me was a huge problem. I had to suffer alot on my on with only Tylenol. This has not been a good time for me. My question is, "Does anyone know of a safe pain medication for someone like me that will not effect their asthma or is codeine free".
ctbeth responded:
Hi activetexaslady,
There are many opiate pain meds that do not contain codeine; your MD knows this.

Actually, very few do contain codeine.

Of course, tell your treating physicians of your allergies, and they all should ask.

There are really no "by products" of codeine that would be present in pain med preparations.

What effects asthma is very personalized. Again, your MD should be aware of substances that aggravate your asthma.

Percocet, Vicodin,Lortab, Tramadol are all pain meds that do not contain codeine. There are also meds for long-term pain that do not contain codeine. Codeine is sort-of an older medicine and seldom used, at least in my region of the USA.

Tylenol #2,#3, #4, are Tylenol with codeine and should be avoided, naturally.

If you require long-term pain management, your MD has plenty of options for pain med that does not contain codeine.

Good luck.
Peter Abaci, MD responded:
One of the side effects of opioids is that they can cause histamine to be released from certain immune cells in the body called mast cells. This release of histamine can have a number of effects on the body including a serious aggravation of asthma. Certain opioids are more prone to causing histamine release than others. It turns out that codeine, morphine, and meperidine (also known as demerol) cause the most histamine release and therefore are the most likely to aggravate a person's asthma. Other opioids that are associated with low levels of histamine release that you could ask your doctor about would include compounds containing hydromorphone (dilaudid) and fentanyl.

In cases of a true codeine allergy, it is common to see allergic reactions to other opioids as well. The odds of this happening go down if an alternative opioid is chosen from a different chemical class. Unfortunately, most of the typical opioids used for post-operative pain control are in the same class as codeine, but one that isn't is fentanyl. I hope this helps!

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