Morphine and more ?

Members may remember that I am battling a long standing Sciatica problem - now awaiting a spinal de-compression - and taking a low-dose 30 mg. , slow release (12 hrs.) Zomorph for pain relief, one every 12 hours.

Two comments/problems - one is that the effect does not seem to last 12 hours - more like 9-10 hours max., leaving me in great discomfort unless I then take the next pill early. Is this a normal reaction to Morphine ?

Second point - I can take one pill late on in the evening, before bedtime, say at 10:00 pm, which theoretically should last 12 hours - but often when I get up to use the loo, e.g at 5am, my leg is so painful - so where has the 12 hour cover gone ?

And finally my GP has recommended I add to the Zomorph a nightly Amitriptyline 10mg. tablet. His view of my sometimes non-effective Zomorph is that it "is not good for nerve pain". Any views on this, please, fellow members.


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21 Replies

  • Hyia iv got the same thing goin on with the disc plus a fair few other problems chronic pain being one. Im on both plus a whole load more have to say when I started on Amitriptyline it did help at night. Coz it's nerve pain most pain meds don't work you should ask your GP about gabapentin or pregablan both are specifically for nerve pain. Good luck

  • Dan

    Your experience with prolonged release opioids/opiates is the same as mine, 6 - 8 hours at most, 12 hours is wishful thinking. Also, I needed to take additional immediate release opioid/opiate for breakthrough pain.

    My GP, whom I repect and trust, allows me sufficient discretion with my medication. One size doesn't fit all when it comes to pain. 10 mgs is a low dose amitriptyline, I am taking 100mgs, so your GP will probably want to increase this dosage.

    I am more than happy to share my experiences, but must stress that I am not an expert or a GP and what works for me will be different for you. All I can say is keep trying, it's a long road.

    Best Wishes


  • Hi there, I had surgery for decompression and fusion at L4/5 and differed from horrendous nerve pain when standing - so bad that I had to be in a wheelchair. My experience is that mot phone is useless as far as nerve pain is concerned, you need pain relief specifically for nerve pain. I tried amitriptylene but it didn't agree with me and was then given nortriptylene and if my memory serves me well I didn't get much relief from either but everyone is different. In my case I had no pain when sitting so I basically sat it out until surgery.

    Perhaps you could ask your GP to prescribe something for nerve pain?

    Good luck!

    By the way, the surgery gave me my life back. I hope it does the same for you.


  • Does anyone take both amitriptylene and gabapentin for nerve pain - or are they mutually exclusive ?


  • I take both gabapentin and amitriptylene for nerve pain amongst other things. The amitriptylene seems to help me sleep. I once forgot to take my morning pills and when I remembered it was to late by then to take them. This left me so scared that I now have alarms set on phone to remind me. So this diffently proved to you

  • Side effects ? - if any, please.

  • Yes I have taken Amitriptylene for about 5 yrs and Gabapentin for about 8-9 years. Togeather they work really good for my nerve pain so I can get some sleep at night. Hope you find some relief very soon.

  • I currently take nortriptyline and pregabalin for my nerve pain together with butrans patch for pain post spinal fusion. I know how much pain you must be in, I hope you get sorted

  • I agree with Daniel, the Oramoprh I find helps last thing at night , it is not a long lasting anelgesic, but the short relief of chronic nerve pain , allows you to drop of to sleep.

    I am taking the MST slow release morhine throughout the day , then take the last dose of 10 mg with 10 mls of Oramorph at night, however I do normally top myself up around 3am with another 10 mls of Oramoprh.

    I have had five major operations on my spine and all of my seven neck discs , in the last four years.

    This and Diazapam is the only relief I can find that helps me.

    Without I'd have no life, I'm still in pain , but these drugs are the only thing that keeps me going.

    I'm afraid I have to many side effects from Amittriptyline , and Pregabalin.

    I have known these to help a lot of people, if your lucky enough not to suffer server side effects, so it's always worth trying them.

    Kindest regards Imogen 😭😭😓

  • Please do comment further on your Amitriptyline side-effects ?

  • Hi Dan

    Your gp prescribes the lowest dose they think that you can cope with, that's not to say that you can't experiment and find your own dose, which maybe different on a daily basis. I take 30mg ms Contin slow release morphine every 10-12 hours and the liquid oramorph every 1-4 hours depending on what I'm doing during the day. I don't recommend anyone on here taking oramorph every hour unless you have built up a good resistance to it over some months but it does help for nerve pain when used with things like pregabalin, baclofen, topiramate etc

    Sarah xx

  • i have tried all of the above mentioned and was very allergic to gabapentin i was like a junkie shaking all the time and unable to stand at all,so came off them i then tried pregabalin same thing when i was in hospital with my heart problem i was given oramorph to take home as it took the edge off and i could sleep without crying and kicking my leg up the wall to try and stop the pain,i felt like getting my brothers chain saw and cutting it off truly before the oramorph and codeine,when i asked my doctor for a repeat he refused as he said as i take diazepam i was an addict i have been on 6mg for 20 plus years before the pain started and i had a heart attack at the age of 45 due to not being able to move around, a year before i had been working in a cafe running round till the pain stopped me i even used my walking stick in work but they layed me off after 7 years,now i have codiene and thats it as everything else messes with the 14 heart meds i take each day i was misdiagnosed and had a facsiotomy on my leg before the heart attack they did it in the shin area and i have bad discs in my spine and a trapped nerve between my groin and spine the experts have now said they can do no more for me,the only relief i have had was many years ago when i smoked a joint of weed i was without pain for 2 days but sadly i got crazy with it so that was no good either,the whacky thing is i missed the pain i am that used to it good luck and xxx stay strong

  • You are taking medication. Has anyone looked at your posture and muscle coordination?

  • Just to be clear, Amitriptylene is an anti-depressant which is used by Pain Management consultants and gps to help those of us with chronic pain to get some sleep. Gabapentin and Pregabalin are anti-epileptic drugs which are used to help with nerve pain. Like some, I found the Gaba drugs made me very ill with sickness, memory problems to frequent urinary infections which caused me incredible abdominal pain front and back and a number of visits to the hospital. As most of my problems are musculoskeletal, I did not find them at all useful for pain although I know of others who find it ok for some nerve pain. It frequently causes weight gain. Of the 11 people I know who have taken it, 10 have found the Gaba drugs cause more problems than solutions. I would love to do more physio and hydrotherapy but struggle with both as I have OA in most of my joints and spine. I have found fentanyl patches to be much more effective than Gaba or MST for pain, but gps are taking patients off Fentanyl these days and leaving us to struggle with everyday tasks as well as worsening pain. My gp even told a pharmacist (a chemist in partnership with my surgery) to call me and say that Fentalis had been withdrawn - not so!

    The sad thing is is that gps are no longer family doctors but accountants and patients are treated not on what medical problem they have, and amount of pain they are in, but on how much money they cost.

  • My wife has been able to take 3 x 300 mg/day of Gabapentin without side-effects problems as far as I know - what should I look out for ?

    I did try it once but got little extra pain relief over that given by my Zomorph MST. GP did say he did not much like Gabapentin.

  • Poor you, Sciatica is one of my pain problems, I am prescribed 30mg Mst the same as you, 20mgs amytryptilne night, pregabline, which treats neuropathic pain and oramorph for breakthrough pain also paracetemol 2 qds.I hope this helps. Catherine

  • Hi, I am suffering chronic back pain due to a 50ft fall from a tree, (I am or was a tree surgeon) I smashed my pelvis and broke my foot, my Doc then said I would suffer in later life, and man was he right. I was originally given Zomorph to which didn't even touch the pain, so now I am on Oramorph which Is liquid Morphine, and tramadol, these together give me a few hours of relief, but as long as I am active its bearable but on resting brings on the onslaught, so more morphine more tramadol, and so repeat, it is a lot better than Zomorph, and does do what it says on the box, but I truly feel that nothing rids the pain but it does help to live with it. I hope this helps. good luck .i also take amitriptyline 3 x 50mg at night, for anxiety and sleep and pain, I am also on a lot of other medication, to many to list but Oramorph would be my advice for pain, see what ya Doc says.

  • I had always thought that Tramadol was less powerful than Zomorph.

    I tried slow-release Tramadol but that did not seem to be, for me, as good as the Zomorph - but now even the Zomorph is not as effective as it was months ago.

  • tramadol is less powerful than zomorph but mixed with Oramorph it works great.

  • Hi Dan

    With the zoramorph you have to build up to the dose that helps you. Not the dose you start on. I'm on 60mgs MST and upto 160ml oramorph /zoramorph (same drug) per day depending on the day. Some days I barely need anything other than my 60mgs MST. I'm sure with time you will find the right dose to control your pain.

    Sarah xx

  • Thanks for all your helpful comments. My current position is that for some reason the pain has increased over the last very few weeks to an extent that my 2 x 30Mg Zomorph and 1 x 10MG Amytriptyline per 24 hours is just not enough - so where do I go now ? - more Zomorph or more Amyt., or more of both, and how much more is possible within the bounds of safety. A breakthru dose of 15Mg codeine helps but for a limited time only.

    My last couple of days have been especially bad so I need to do something soon, either myself or via my G.P. If age has a bearing on your answers be aware I am 73.

    As said in my opening post the pain is especially bad when getting out of bed in the morning.


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