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Messed up my drugs again...

Right, I’ve just (about an hour ago) scoffed down a load of medication. I was impatient, and didn’t really pay attention to what I was doing.

Here’s what I’m sure I’ve taken:

  • Skin hair & nail supplements (nothing to do with MS)
  • Ibuprofen
  • Codeine
  • Quinine
  • Contraceptive pill

Here’s what I’m not sure I’ve taken, but should be due, to make myself comfortable for the night ahead:

  • Baclofen (2x10mg)
  • Diazepam 5mg

I’m suspicious I didn’t take them - partly because I just had a feeling something was missing that should have been there, but partly that after waiting an hour, I’m not sure I’m getting the symptom relief I should usually expect, which adds to my suspicions…

In the past, I have been on much higher doses of diazepam without ill effect, so I’m satisfied that if I split the difference and take half a tablet, to make up for the one I may or may not have taken, nothing bad will happen if I’ve taken it after all, bringing my total to one-and-a-half.

Baclofen is the one I’m not sure about. I take six pills a day, in divided doses - but never more than two at once. I’m absolutely fine with that.

Do you reckon it’s OK to take another one, even though I may have taken two already? Obviously, the longer I bide my time, the less dodgy it is, as my metabolism will have had more time to process the first two - IF I ever took them!

I won’t chance taking two, which might bring my total to four, but do you think three would still be OK if I’m always fine with two?

The alternative is to go to bed with a chance I’ve had no baclofen at all, which is simply asking for trouble, and likely to lead to a very distressing night.

I know I should have been more careful, but it’s too late now. What do you reckon is the best tactic for a safe but not too symptom-dominated night?

Tina

OK, well I’m desperate to get to bed. It’s been nearly two hours since I took whatever it was I took, so if I am accidentally taking extra of anything, the first lot has had a two hour head start. I find baclofen wears off after about four hours anyway, so we’re halfway there - I’m going to take “another” pill - or the first one, if none was taken.

I think the worst outcome is I might get a bit weak and drowsy, but shouldn’t matter if I’m in bed anyway. I doubt an extra tablet is enough to stop breathing or anything.

Tina every morning I put my pills for the day in a pill box, that way I know if I have forgotten to take any.

Im sure if you have taken one too many of either Diazepam or Baclofen you will be fine more drowsy perhaps but you’ll be sleeping anyway.

Jan x

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Yeah, I think it’s going to be fine. I know the diazepam are fine, because I was briefly on a much higher dose a few years ago, so I know I wouldn’t be off my head if I took 7.5 mg instead of 5 - I’ve taken a lot more than that in my time (all legally prescribed, I hasten to add).

It was just the baclofen I wasn’t really sure how much margin of error I’ve got. I know six a day is not the max dose anyway, but I don’t think they usually recommend more than two pills at once.

Having said all that, I’m still sitting here typing pretty rationally (I think!) - you’d tell me if it’s all coming out as gobbledigook. So that suggests that whatever I’ve taken, I’m not mentally or physically incapacitated by it.

That looks like I probably didn’t take them, doesn’t it, so I’ve probably undermedicated rather than ODed. I think if you can’t be positive whether you’ve taken something or not, half dose is a reasonable compromise. It’s better than nothing if you had forgotten them, but doesn’t risk taking as much as double.

I’m feeling pretty normal (for the time of night) so don’t think there’s anything to worry about.

Tina

x

Oh dear Tina, we’ve all done this. When you routinely take pills three times a day, you do tend to do it on automatic pilot whilst your mind’s elsewhere. Like Jan, I put the day’s supply out each morning. I also keep a drug diary, jotting down the time I take them as another check. I’ve done just what you’ve done more than once, and ended up going around in circles, it does my head in. If it’s the night-time dose, I usually get into bed and watch a film or two as a distraction, often nodding off mid-plot.

I would under-medicate rather then over, it has to be safer. Btw, it might sound silly, but one of my pills always leaves a dark stain on my tongue, so that one’s easy to check.

Hoping you’re now sound asleep and don’t read this 'till morning.

Ben

Morning! All fine! Still don’t really know if I took too much or too little, but don’t seem any the worse for it, either way.

I suspect it was probably “too much”, which could be re-interpreted as: “enough”, because I don’t want to tempt fate, but so far I think my feet are slightly less painful than usual this morning, which might suggest the pain is not adequately addressed by my usual dose! I know I can’t move up to “overdosing” permanently - not without discussing the increase, anyway, but it’s interesting that after I suspect I’ve taken “too much”, things seem better. This may mean my routine dose is insufficient, but I’ve just been putting up with it.

Under medicating, in this case, would have meant no muscle relaxants the whole night - as both baclofen and diazepam (the two I might/might not have forgotten) serve a similar purpose. So I knew being without them the whole night would not be OK, and I had to act, even if it meant taking slightly too much (but not double, as I halved the dose, just in case).

There is only one drug I absolutely know I can’t chance it with, and that’s the quinine. That one is highly dose sensitive, so if I’m ever unsure whether I took it or not, that’s the chance missed, for that night, as I certainly can’t risk taking two. The packaging of that one comes already marked with the days of the week - presumably for that precise reason - it’s NOT OK to accidentally take more - and I know it. I think the rest have quite a wide margin of error, so it’s unlikely to be catastrophic.

I once heard of a silly woman who took a dozen diazepam (60mg total) in one go - not as a suicide bid, incredibly enough - but because a friend gave them to her for muscular pain, and having no idea of the dosage, she just took all of them. Apparently, it never crossed her mind that the standard dosing regime for tablets would NEVER require you to take twelve at once, so whatever the correct dose was, it couldn’t be “all of them”.

Of course, when she heard what had happened, the friend, who knew it should be only one or two, was horrified, and gasped: “You did what? Are you alright?” Apparently, there were no repercussions at all. So if someone took 60mg at once but wasn’t ill, me taking 7.5 instead of 5 isn’t exactly dicing with death - haha. I still can’t believe she was so daft. Wouldn’t you think to yourself: “A dozen of anything at one time doesn’t seem right - if you needed that much, they’d come in a higher dose.”?

I sometimes wonder how some people have survived as long they have, when they don’t show a scrap of common sense.

Tina

x

I probably would’ve taken the two baclofen as it was a couple of hours after the maybe dose. The maximum baclofen you should take per day is (I think) 100mg so an extra 10-20mg should only have the effect of making your muscles a bit weaker. I was in the habit of taking an extra baclofen when I awoke in the night because their effect is supposed to wear off after 4 hours and I’d wake up with spasms. It took my daily average up to about 80mg. I’ve recently started taking Cloneazepam which has meant I can reduce the baclofen down to about 50-60mgs but I still wouldn’t be worried about taking an extra 1 if necessary.

Sue

Hi Sue,

I knew I wouldn’t be exceeding the maximum for the day, in any event. I was just concerned about taking too many in close succession. I don’t know how many is OK within the same four hour period, for example. I doubt more than two is recommended, but as a one-off due to an error, it’s probably not sufficient to harm you, either. Well, I’ve tried it now, and nothing bad happened, so if I should be in that position again, I’d do similar. Being a bit weak and sleepy shouldn’t matter if you’re going to bed anyway. I don’t think it would be a good idea to chance it if you were planning to drive anywhere, but I’m a non-driver, and can’t come to much harm at home in bed. Certainly better than the alternative of being up all night with uncontrolled cramp!

Sometimes you just have to weigh things up and be practical, don’t you? I’m reasonably clued up about my drugs, so I know the same wouldn’t be OK with quinine. Although I’m not on the max dose, even with that, so probably would be alright - but not the sort of thing you really want to chance your luck with.

Quinine is a very odd sort of drug - they don’t really understand how it works, it’s very dose sensitive, and I’ve been warned it can (very rarely) cause heart arrhythmia , unrelated to the duration of use - e.g. you could take it uneventfully for years, and suddenly have a heart arrhythmia, or have one very soon after starting. Definitely don’t want to play games with any drug that might potentially mess with my heart, so if I suspected I’d missed that one, I’d always err on the side of caution, and NOT take a replacement - but usually it’s easy to tell anyway, because of the days all marked on the card. So as long as I don’t forget which day of the week it is (I did put the rubbish out yesterday, and wonder why nobody else had!), it’s OK.

Tina

x

Well I’m glad you’re OK Tina.

I’m familiar with Valium and both your standard painkillers, but I’ve no experience of Quinine. Having just had a quick look on Wiki, I now realise just how carefully it has to be treated and understand your caution.

I’m now off to sit in the garden, it’s time to relax.

Ben