[Susanne C.]

For the past two weeks I have been suffering from a sudden escalation in my symptoms. I usually have pain in my legs and feet, also hands and arms, muscle weakness, extensive numbness, difficulty in going up steps, etc. all very manageable and predictable. Lately though, I have full body burning symptoms, as if I were badly sunburned. Sitting, lying down, most clothing, anything in contact with my skin hurts like crazy. My oxycodone barely touches it. I was beginning to think that ths was the new normal. It is definitely a nerve type of pain and gets worse as the day goes on. My quality of life has deteriorated severely.
I went to the doctor to report the symptoms and ask for an increase in my pain meds. When I mentioned that the sunburned feeling dates from a change in the manufacturer of my gabapentin, my doctor said that could easily be the cause- an allergic reaction to something in the new meds, as apart from the active ingredient, the compounds could be very different and contain something which set off this reaction.
He insisted that I refill immediately at the old pharmacy with the previous brand. I am really hopeful that it is this simple, but the pharmacist seemed skeptical. My doctor seemed very convinced, however.

Has anyone had an experience like this? Mrs. D., is this even possible?

[mrsD]

You can ask the pharmacy for an insert, and all inert ingredients will appear on it.

Then you can get one from the type you previously used, and compare them.

I really don't think inert ingredients are commonly causitive of issues.
But coatings, dyes might be. Povidione, is in some pills and some people are allergic to it.(organic iodine).

Gabapentin can cause allergic reactions all by itself. And different generics may be absorbed at a slightly different rate, and you have a rebound or breakthru, if one is slower than the other. Gabapentin has poor absorption in the first place.

So there may be several variables.

People do react differently to generics. I cannot take Lupin lisinopril...it makes me very dizzy. But Watson brand, is okay. Only slight dizziness. I think it has to due with the rate of absorption over time. I have Kroger's special order Watson brand for me, and they roll their eyes, but they do it. WalMart had the Lupin brand years ago and I transferred to Kroger because of it, and now ALL of them have Lupin!

[Susanne C.]

They are both white, so no difference there, but the one is shiny, the other matte, so definitely a difference there.
I did just notice that there is a side effect warning on the oxycodone about burning, and feelings of warmth. This is not an overall flushing or warmth, I am usually quite cold, it is a localized sense of sunburned or burned skin, and sensitivity to clothing or pressure. Could it be the oxycodone? I have taken it at low dosages for years without side effects, but have doubled my usage in response to this problem, to 3 5 mg pills per day.
Would it be worthwhile to taper off the gabapentin altogether (i know that is a gradual process ) and discontinue the pain pills to eliminate them as possibilities? I am in so much discomfort even with them I am willing to try anything.

[idiopathic]

I have been taking 800-1600 mg's of gabapentin a day for neuropathy in hands and feet and described my doctor as idiopathic(no known reason). My symptoms too are worsening and it is my theory that my b12 is not absorbing resulting in low b12 values. b12 deficiency especially if other family members have had b12 deficiency can cause neuropathy. I was not aware of this but am in the process of research. Good luck.

[mrsD]

Oxycodone has a vague effect in some people of releasing serotonin. This leads to itching skin, and flushing for some.
http://www.ehow.com/how-does_5481160...head-itch.html

It is difficult to say. But gabapentin itself causes some skin reactions.

Try taking an antihistamine like Benadryl. If it helps, then
an allergic histamine reaction is happening.

I always suspect the drugs.

Originally Posted by Susanne C.

They are both white, so no difference there, but the one is shiny, the other matte, so definitely a difference there.
I did just notice that there is a side effect warning on the oxycodone about burning, and feelings of warmth. This is not an overall flushing or warmth, I am usually quite cold, it is a localized sense of sunburned or burned skin, and sensitivity to clothing or pressure. Could it be the oxycodone? I have taken it at low dosages for years without side effects, but have doubled my usage in response to this problem, to 3 5 mg pills per day.
Would it be worthwhile to taper off the gabapentin altogether (i know that is a gradual process ) and discontinue the pain pills to eliminate them as possibilities? I am in so much discomfort even with them I am willing to try anything.

[mrsD]

Also you will want to look at your diet.

Specifically MSG, and histamine releasing foods or histamine in foods. Here is a list for both:

http://www.michiganallergy.com/food_and_histamine.shtml

The nightshade family of veggies:

Potatoes have solanine in them.
http://www.michaellebowitzdc.com/html/Solanine.html

http://chronicfatigue.about.com/b/20...e-syndrome.htm

I do think doing an elimination for nightshades may be helpful.
This link is very good and explains further:
http://www.earthmedicine.com/common-...u-pain-disease

and:
http://sweetrocket.blogspot.com/2009...-and-pain.html

It took me almost a whole lifetime to connect potatoes to my burning attacks. Peppers also.

[Susanne C.]

Thank you so much for your responses!
I tried the Benadryl when you first suggested it. It certainly allowed me to sleep better, but I am not sure it lessened my symptoms. I am going to give it a daytime trial for a few days when I do not have to teach, it knocks me out.
If the drugs are implicated, I agree that it is more likely to be the gabapentin. I have heard of people developing intolerances to medication after several years. I have been on 1800 mg for nearly 3 years. I think it would be worthwhile to see what happens without it, but I will wait until I have fewer obligations to try that.
I do take B-12, and fish oil. I had started with vitamin D but stopped when these symptoms started just in case it was part of the problem.
Since I have CMT, most supplements aren't going to make any difference, and it does progress, so this body-wide burning could just be the new normal. It just seems like it shouldn't be so sudden, and I am not sure that the doctor believed how life changing this symptom has been. I cannot get comfortable at all.

Again, this is very confusing and difficult to deal with and I appreciate both of you immensely.

[bent98]

If your taking opiods like oxycodine you can develop allodyina which is the sunburn your feeling. Its quite common. It may not be the gabapentin.

http://www.painphysicianjournal.com/...14;145-161.pdf

[mrsD]

That is a very interesting article.

It seems similar to MOH, medication overuse headache, which is also a chronic pain condition.

[Susanne C.]

Thank you for that article. I had begun to question whether the oxycodone was part of the problem, I had increased my use in response to my usual worsening of leg pains during my period, which then turned into this problem. I did not think that my current usage of 7.5 mg twice per day which has only been in the past two weeks could be enough. The article seems to be primarily implicating larger dosages, but does hint at possibilities of smaller doses creating a problem.
I am going to experiment with taking Benadryl and not taking the oxycodone for 4-5 days. I have very little that must be done this weekend. Normally I rely on the oxycodone when I have to get things done, ride in the car, go to church, laundry, shopping, etc. but my usage is not such that I experience withdrawl symptoms, I have not been a heavy or consistent user, so I only anticipate an energy drop and increase in muscle pain due to the CMT which it does help with. Steps are the very devil without it!
It has not helped much, if at all with the sunburned feeling.
I did notice that the article recommended butrans as a substitute for opiates. My doctor had wanted me to try this before, and I preferred to stay as I was with the as needed oxycodone rather than a 24/7 patch. I may need to re-think this.
If it is the oxycodone causing the burning, should I know within 4 days?
Thank you again.