Hi has anyone ever used Codeine for break through nerve pain? I’m on 900mg of Gabapentin 4 times a day and 50mg of Amitryptiline, at night for nerve pain but lately I’ve been getting pain inbetween doses and sometimes its unbearable. I got Codeine Phosphate off my GP but I haven’t noticed a big improvement during the day. I have been sleeping better so that is a bonus, I used to sleep very little before due to the ‘crawly’ feelings down my back.
Lynne xx
Hello there. A simplified scale for medications is roughly as follows.There are gaps which I know will be filled,and if it’s wrong …it will be rectified,and I’ll be told off !
Coedine…1
Tramadol…4/5 *
Butrans patches/Oromorph…6/7 *
Diamorphine(Heroin)…10 *
I hope this may be of some help,and oh,I’ve never had Coedine for Neuropathetic pain,and haven’t bothered with Heroin
Wb
Hi Lynne, I had severe neuropathic pain during my last relapse and was already on the max. dose of Gabapentin. The pain was becoming unbearable and my m.s. nurse suggested to my G.P. to swop to Pregabalin. After a difficult few days while I came off the Gabapentin and built up the dose of Pregabalin my pain levels were much better controlled. It might be worth talking to your m.s. nurse. Mine is great at suggesting things to my G.P. as he doesn’t have a lot of experience with M.S. and is happy to take guidance from my m.s. nurse. Amily x
Codeine (at high strength) might dope you up enough to be less bothered about the pain, but it won’t actually suppress it. What’s needed are things that dampen down the nervous system and that means gabapentin, pregabalin, etc. An anti-depressant in combination with gabapentin or pregabalin increases the effect, but you’re already on amitriptyline. So maybe a switch to pregabalin, an increase in the amitriptyline, a switch to a more effective anti-depressant, or any combination of these? Codeine is really not a great option 
Karen x
Hi and thanks for your replies, I’ve tried Pregablin but it didn’t help at all so I went back onto Gabapentin. I agree with the comment that I could take a high dose of Codeine so that I’d be so dopey that I probably wouldn’t bother about the pain but don’t want to feel like a zombie. I’ve noticed it’s worse when I walk with my crutches, when I’m cold and if I lean forward when sitting at a table. I’ll just have to stop walking, stay in where its warm and never move from the settee. Urg !!!
Lynne xx