Morphine Er Vs. Dilaudid Issue

After a brain & spine surgery a 1.5yr. ago (forever living w/ Chiari Malformation & related conditions, permanent damage, more surgery) I've been on 30mg. Morphine ER & Tramadol for breakthrough....but... (30mg. Morphine ER 2x's per day, a 15mg. Morphine midday and 2-4 Tramadol for breakthrough when needed...try to keep that very limited) my condition comes w/ headaches. Common. But they have been a bit more than expected-even w/ my sumatriptan, etc. Daily, a nagging heavy headache - not always a migraine / the Chiari h/a I know so well. However, it dawned on me that when in ICU, in a hospital stay recently for kidney stones (after last surgery especially, brain & spine) the nurses & Dr's realized that when they gave me the morphine (IV, not oral obviously), I ended up w/ either my headache getting FAR worse (as they noticed after my brain surgery hospital stay) or it gave me a migraine/headache (as in the kidney stone hospital stay recently)... in both of those situations, they switched me from morphine to dilaudid. In the brain surgery stay, the moment they switched, the mind-bending migraine lifted-though, a lot of head pain remained b/c...well...my entire back of my head had just been cracked open. But, it was a dramatic difference. Same with the recent kidney stone experience...no real help w/ morphine, headache came on, they switched it & that was a drastically helpful switch.

So, I'm wondering if the oral Morphine ER that my PM team has me on could be causing the same problem- w/ a daily headache. I know headaches are a part of my condition, but, it seems egged on...not the headaches/migraines I'm so familiar with (w/ my condition. I know the triggers, the typical lead up to one, feeling, etc.) These h/a's suddenly clicked- they remind me of what happened in the hospital. So, question is- would the same thing be happening w/ the oral Morphine ER meds as it did w/ the IV Morphine in hospital? If so, would there be an equivalent of a dilaudid ER med to switch to? Are they the same in mg. to mg.? If so, is it something PM dr's do use for chronic pain patients as an alternative to Morphine ER? It would certainly be nice to get max pain relief w/o unnecessary headaches! That would be lovely! Has anyone heard of same reaction to both types of Morphine (oral ER and IV in hospital)? Any help at all w/ this or insight would be greatly appreciated!!! I tried googling this, but it got me more confused, and can't find the answers about the headache issue. Thanks so kindly for any help w/ this situation!

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REPORT

Oh yes, it is well known that opiates can cause headaches as a side effect, in some people that take them. Dilaudid is the one that always did it to me.

The FDA warns that these medications carry the risk of being habit forming and may cause other side effects, such as nausea, dizziness, dry mouth, and constipation.

You are correct, there is a time released formulation of Dilaudid that can be prescribed, it's in a capsule form. It doesn't hurt to ask your doctor about switching to it. Dilaudid is actually stronger than Morphine, so you'd only need to take 7.5mgs of it to be equal to each 30mgs of Morphine.

Is there anything else I can help with?

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Emma,

As usual Verwon has explained this better then most however when your faced with conditions that are intractable its best to discuss this with specialists that have experience treating these debilitating migraines . Most narcotic opiate/opiods Ie; morphine, dilaudid have a tendency to cause rebound headaches. There are far more effective non narcotic medications that provide relief without the risk of being habit forming. A neurologist would be best suited to treat this excruciatingly painful condition . I hope you find a speedy resolution to your condition . Best wishes ....

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