[jim_morrison]

I have to go to the dentist to get my wisdom teeth extracted in a few weeks, and from what I hear the dentist will probly put me on Codeine.

The Question I have, is that I already take Mirtazapine (45-60 mg) and Klonopin (.5-1 mg) regularly (Both are sedatives) so will adding another sedative, the opioid pain killer Codeine be potentially dangerous, ie cause a problem such as respiratory depression, etc?

 

[bowlingpins]

It could, you could try OTC painkillers like Tylenol and NSAIDs like Ibuprofen, stay away from aspirin because its antiplatelet effect will cause bleeding.

 

[Cast Away]

I took loratab when i got a tooth pulled with my klonopin. I know of people that take benzodiazepines with opiods, although its not smart. Im not educated on Mirtazapine so i really cant tell you rather its ok. Did you tell your dentist what you were on?

 

[jim_morrison]

I took loratab when i got a tooth pulled with my klonopin. I know of people that take benzodiazepines with opiods, although its not smart. Im not educated on Mirtazapine so i really cant tell you rather its ok. Did you tell your dentist what you were on?

Nah I havnt had a chance to talk to the dentist yet.
Mirtazapine is basically an antidepressant which also has strong antihistamine properties, so it's sedation is pretty akin to that of a sedating antihistamine.

 

[RockiNToM]

Best just tell your dentist to be just to be sure. You never know with reactions with some of these various medications together at certain doses. Let's not make the same mistake Heath Ledger made with pain killers and benzos (I know he took sleeping pills as well but still...).

 

[UltraShy]

Talk to your dentist about it, though I doubt this is going to be a problem. Your benzo dose is minimal.

Let's not make the same mistake Heath Ledger made with pain killers and benzos (I know he took sleeping pills as well but still...).

Ledger was an exceptional case. While he had a bunch of different drugs in him, even in combination they were not in amounts that would typically be associated with death.

Actually, my worry about codeine would be it not working. My understanding is that codeine works by your body metabolizing it into morphine, something that some people are unable to do. The only time I ever took codeine (210 mg at once -- seven T3s) I felt nothing at all. If I ever get around to wisdom teeth removal after many years of delaying I'm going to expect at least Lortab 10/500 as my brother got for that procedure. Norco at 10/325 would be even better. If I suffer any pain the oral surgeon fails to medicate fully even my severe SA won't stop me from giving him an obscenity-laced call.

Ironically, most codeine as I understand is made by the conversion of morphine into codeine since only a small percentage of opium is codeine while morphine is the main opium alkaloid. Seems rather stupid to convert morphine into codeine simply so one's body can convert it back.

 

[jim_morrison]

I took loratab when i got a tooth pulled with my klonopin. I know of people that take benzodiazepines with opiods, although its not smart. Im not educated on Mirtazapine so i really cant tell you rather its ok. Did you tell your dentist what you were on?

What dosage of Klonopin and lortab were you taking at the time cast away?

 

[Ash09]

Actually, my worry about codeine would be it not working. My understanding is that codeine works by your body metabolizing it into morphine, something that some people are unable to do.

Only around 10% of it is converted to morphine so even those who are defficient in those enzymes will still get some analgesic effect from codeine-6-glucuronide. Interestingly antidepressants like fluoxetine and buproprion prevent the demethylation of codeine by inhibiting CYP2D6.

 

[meyaj]

Only around 10% of it is converted to morphine so even those who are defficient in those enzymes will still get some analgesic effect from codeine-6-glucuronide. Interestingly antidepressants like fluoxetine and buproprion prevent the demethylation of codeine by inhibiting CYP2D6.

But it's that 10% that gets converted to morphine that is responsible for vast majority of its effects. The analgesic effect in a Tylenol 3, to somebody deficient in CYP2D6, is going to be primarily from the tylenol itself.

In my opinion the combo sounds harmless, but check with your pharmacist if you're really concerned.

 

[euphoria]

Shouldn't be a problem with weak opioids like codeine, considering your low dose of Klonopin (the main interaction risk IMO), but it'd be wise to alert them to your medication regimen. Might be worth avoiding Klonopin within 12 hours of the procedure; codeine should provide plenty of anxiety relief.

 

[jim_morrison]

I was just getting a bit freaked out after I read this

http://www.mtv.com/news/articles/1577017/20071220/hawthorne_heights.jhtml

This guy died from a combination of Klonopin and Vicodin. He was taking the Vicodin after a dental visit for a root canal.

 

[John_in_SF]

Here's the correct answer: can you sue anonymous internet voices for malpractice? How about your dentist? Therefore, tell your dentist about every medication you're taking. That's why she or he asks. Really, they're not being nosy . . . they want you to live and they don't want to get sued!

 

[DMBfan]

I don't know, I had Vicodin when I had my wisdom teeth pulled but it did nothing for me but fortunately I had no pain so I didn't need it (wasn't taking benzos.) If you're sufficiently scared than just suck it up and use the OTC meds in higher doses. I don't think you have anything to worry about if you stick to the prescribed doseage. The article you linked to is hardly anything to get worked up over (the media loves a scare story.)

So many people are taking these drugs, and sometimes the side effects are so minimal - one in 100,000 or something - that it's never going to be possible to list every possible side effect or interaction. You can't do it."

It's not known whether Calvert ever informed the doctor who prescribed him the Vicodin that he was also taking clonazepam. Even if he did, it's not certain that the combination of the two medications is what killed him (Mendelson speculated that his death was probably due to an arrhythmia).