Medication Questions

[kevin86]

I am curious how do medications like ibuprofen, flexeril, lortab work after this surgery? Can your system still handle these medications? The reason I ask is because I suffer from chronic neck and back pain after a work related accident about six years ago. I'm sure getting all this weight off will help tremendously but in the mean time I wasn't sure how pain management and this procedure got along. As usual thank you everyone for taking the time to reply.

 

[newanatomy]

I don't know about flexeril, haven't had it for many years but, ibuprofen works the same for me now as before surgery. I have not had any Lortab but was given Percocet post-op and it worked just fine.

 

[southernlady]

I use ibuprofen every night.
Never used flexeril.
Super sensitive (treated as allergic) to lortab tho. It was working post op when we discovered I was extremely sensitive and had to stop using it.

With the DS, (and VSG and the SADI/LoopDS/SIPS) you can take NSAIDS (like ibuprofen) BUT

1. You have to be healed INSIDE not just outside.
2. You need to take it with food. I have a snack just before bed just because of this.
3. You do NOT exceed the recommended OTC or prescription daily dosage.

The ASMBS stance on NSAIDS is to avoid them due to ulcer risk. However, they also state this:

Q: Which medications should I avoid after weight loss surgery?
A: Your surgeon or bariatric physician can offer guidance on this topic. One clear class of medications to avoid after Roux-en-Y gastric bypass is the “Non-steroidal anti-inflammatory drugs” (NSAIDs), which can cause ulcers or stomach irritation in anyone but are especially linked to a kind of ulcer called “marginal ulcer” after gastric bypass. Marginal ulcers can bleed or perforate. Usually they are not fatal, but they can cause a lot of months or years of misery, and are a common cause of re-operation, and even (rarely) reversal of gastric bypass.

Some surgeons advise limiting the use of NSAIDs after sleeve gastrectomy and adjustable gastric banding as well. Corticosteroids (such as prednisone) can also cause ulcers and poor healing but may be necessary in some situations. Some long-acting, extended-release, or enteric coated medications may not be absorbed as well after bariatric surgery, so it is important that you work with your surgeon and primary care physician to monitor how well your medications are working. Your doctor may choose an immediate-release medication in some cases if the concern is high enough. Finally, some prescription medications can be associated with weight gain, so you and your doctor can weigh the risk of weight gain versus the benefit of that medication. There may be alternative medications in some cases with less weight gain as a side effect.

Notice that RNY'ers are never allowed NSAIDS and that includes topicals. Even topicals enter the blood stream and RNY'ers can easily develop an ulcer in the remnant aka blind stomach left after creating the pouch.

Since anyone with a sleeve does NOT have a remnant stomach, we can not get an ulcer in something that is no longer in our body.

 

[Charris]

Since surgery I've taken oxytocin 30mg, Soma, Flexeril, Percocet, oxycodone 5 and 10 and now Fentnal patches with oxycodone for break through pain. After the DS I had break through pain more often than usual with the oxycotin which is an extended release.

 

[Larra]

One of the biggest disadvantages of gastric bypass is never being able to use NSAIDs again due to risk of ulcer of either the stoma (the connection of the pouch to the small intestine) or the blind stomach. Both DS and sleeve avoid this problem. I use NSAIDs occasionally, but I'm careful to stay within the proper dose recommendations and only use them when needed, and have some food with them. I do agree that the weight loss will help with your neck and back issues but there are lots of reasons people need NSAIDs that are not changed with weight loss, so being able to use them is important.

 

[Munchkin]

For me, they all worked the same post-op. I don't take them often but they have never been a problem.

 

[kevin86]

Thank you everyone for all the info. It's nice to know that I will still be able to take these as needed. Like I said before my goal is to hopefully be able to ween my way off of them as the weight goes down (my back and neck doctor and personal trainer also believe this may be able to happen) but it's good to know if ever I need one I should be fine to take one.