Methocarbamol . Safe with other Drugs ?

[TILTNTURN62]

Hello all . Im new on here . Hope this finds you all getting by and staying safe .

I have RLS . Had it on and off for a good while . Finally had to ask my GP to prescribe something for it . She prescribed Methocarbamol .

What is my question > Simply put . I am already on Morphine based drugs for Advanced Arthritis because I had an emergency triple bypass after 3 yrs of Diclofenac max dose had collapsed my major arteries.

I am on Morphine along with Pregablin and Ramapril .

My GP assured me this was a wonder drug . I asked if it would work fine with my other medication and was told yes.

I have since looked online and its suggested that the 3 above are red flags for mixing with Metho .

Does anyone on here have any knowledge or experience with similar combinations of drugs that either was a no no or it caused issues .

I havent actually started the Metho as yet because of my concerns and obviously previous bad advice regards drugs being fine to take .

Many Many thanks in advance . They dont always get it right .

Frank.

[Joolsg]

Frank- what dose of morphine & pregabalin are you taking? Both are commonly prescribed for RLS so I don’t understand why they’re not helping.

Are you taking any anti depressants or anti histamines or OTC cough & cold meds? Did the GP order blood tests? That is the first thing he/she should have done as low iron can cause RLS. Serum ferritin needs to be above 100, preferably 250. Raising iron improves a great many cases.

Methocarbamol is a muscle relaxant and I have NO idea why you’ve been prescribed it. There are reports that it actually WORSENS RLS so avoid taking it!

It sounds like you’re another victim of useless doctor advice & believe me, there are horror stories on this site ( mostly due to overprescribing of dopamine agonists or drugs that worsen RLS).

You were right to look up interactions.

I suggest you ask for a referral to a neurologist. There are quite a few who do have some expertise . Kaarina, the moderator, has a list of good neurologists around the UK recommended by members.

[TILTNTURN62 in reply to Joolsg]

Hi Jools.

My previous GP should have warned me about Diclofenac , I did ask her at the time if it was ok to be on as much without taking a break . End result was not good . She left the practise 2 weeks after I came out of hospital .

Medication I am currently on >

Zomorph 60mg x2 .

Oramorph , as and when I need it for my arthritis .

225mg x1 PreGablin Ive been on them for approx 7 years .

Sertraline 100mg x 1.

Lanzoprazole 15mg x 1.

Rosuvastatin 10mg at night .

Ramapril 2.5mg x 1 .

Glyceryl Trinitrate for unstable angina , had it since CABG .

Thats as far as I know everything I take medication wise . Not sure if any of those are incompatible .

Many thanks for your info . Its much appreciated .

Frank

[Joolsg in reply to TILTNTURN62]

Sertraline causes RLS. Safe anti depressants are Trazodone or wellbutrin. Lanzaprazole is a PPI & also causes or worsens RLS.

The zomorph, oramorph and pregabalin are all more than enough to give adequate cover for your RLS so it’s clear the triggers for you are the Sertraline anti depressant and the PPI .

I suggest you try reducing one of these meds at a time & substitute a safe alternative.

It would appear you have major health issues related to heart/high blood pressure/ dietary issues.

You might be someone who would benefit from following a keto diet for auto immune conditions or a paleo or low carb/low sugar diet. They don’t help everyone but several people report excellent results.

Also consider joining the RLS USA foundation so you can access their detailed website and webinars by RLS experts.

NICE guidelines in the UK clearly state that anti depressants worsen RLS so send a copy to GP as she should know about this.

[TILTNTURN62 in reply to Joolsg]

As ever your help is very much appreciated and has helped me mentally knowing that I was right to question it . GP was due to call me back yesterday and then again today {now 7pm } she hasnt . Will now have to wait until Tuesday to hopefully have a response . Trust me she stated to my partner that this was a wonder drug and did not interact with any of my medication.

The Keto sounds good. I am on a diet . Have pretty much cut out Sugar { was taking way too much before} alcohol and eat much more healthy than I used to . I will certainly look at what you suggest . Thanks again . Frank.

[TILTNTURN62 in reply to TILTNTURN62]

Reply by Email to my partner Lesley from my GP.If I felt stressed before , I seriously do not know what to do ??????.

Dear Lesley

Thank you for your email regarding Frank's medications. The medication should hopefully help with both, if this doesn't work, I am happy to look at more specific medication for the jumpy legs.

I had our Practice Pharmacist check for drug interactions so I am as certain as I can be that it is safe for Frank to take these with his other medications.

Kind regards

In accordance with the instruction on the Doctor's email I have deleted all reference to the name and practice. Kaarina (Admin)

[Hidden]

Pregabalin IS identified as interacting with methocarbamol as both can have Central Nervous System depressant effects.

Follow this link and scroll down to pregabalin.

bnf.nice.org.uk/interaction...

In addition, since both morphine also and pregabalin can have respiratory depressant effects, there is a risk of respiratory distress.

The US Food and Drug Administartion said this about pregabalin/gabapentin

"using pregabalin alone and using it with an opioid pain reliever can depress breathing function"

Follow this link and click on "What did FDA find?"

fda.gov/drugs/drug-safety-a...

This doesn't exlude you from taking the combination, but it does mean you should be carefully monitored.

Far from being a "wonder drug" for RLS, it seems illogical that a doctor might think that a drug that relaxes muscles can have any effect on RLS which is not a muscular problem, it's neurological.

[TILTNTURN62 in reply to Hidden]

Many thanks Manerva . I have breathing problems . Have had since just before my CABG. It worsened after surgery after one of the tubes punctured a lung. I did suggest to my GP that I had read up that RLS was neurological . She skirted around my commen/concernst and suggested I try not to google things . She loves me really . As I say many thanks for your help . Frank.

[Joolsg in reply to TILTNTURN62]

I loathe GPs who tell us not to ‘google’ about our health! They know nothing about RLS so we have to do the research ourselves. Any decent Doctor will acknowledge they cannot be an expert on every health condition and accept their patients can know more about their own health condition than most GPs.

Keep doing your own research - it’s the only way you can get the proper help and care you need.

[Hidden in reply to TILTNTURN62]

Both the sources I previously gave you links to are national authorities.

The first link is to the British National Formulary (BNF) which is published by the UK National Insitute for Health and Care Excellence (NICE).

The second is to the US Food and Drug Administration.

Below is a link to the NICE guidance for GPs on the management of RLS which is a useful source of evidence based information. It was updated earlier this year. There is no mention of using muscle relaxants anywhere in the guidance.

You can safely refer your GP to these sources.

cks.nice.org.uk/topics/rest...

Your doctor is in no position to dispute any of these.

Please note that no doctor can expect you to consent to any treatment they prescribe without informing you of the risks as well as the benefits of the treatment. This is contrary to the General Medical Councils guidance on shared decision making and informed consent. It's also possibly illegal (law of informed consent).

It seems to me they have prescribed you a dangerous combination especially as you have lung issues.