CAN TOPAMAS,TRICOR,AMBIEN,MORPHINE ER, MORHINE IR, DARVOCET,AMBIEN, LEXAPRO, BE TAKENTOGETHER SAFEL

Dear Aliscyn,

There are a number of issues I see here...

1) Any potential interactions between the medications you listed.

2) Any potential interactions with any over-the-counter medications, dietary supplements, and even topical pain relief products that you may be using.

3) Doctors. Are all of your medications prescribed by the same doctor? If not, are all of your doctors aware of all of your medications? Do your doctors consult with each other, especially about medications? If not, they should.

4) Do you get all your medications -- prescription and all others -- at the same pharmacy? This can be an important point as your pharmacist is a part of your healthcare team, and can help you avoid interactions and complications if he or she knows all of the medications you use.

5) Your problems with low blood pressure.

6) The tingling lips issue you mentioned.

7) The possibility of medication overuse headache complicating your Migraines.

Let's go through these. On the surface, when looking at possible drug interactions, there are minimal issues with the medications you listed, but that doesn't tell the whole story. ARE you taking anything over-the-counter -- dietary supplements, pain relievers such as acetaminophen or others, or using any topical medications? All of this must be taken into account when trying to determine if it's safe to take the medications you listed together. But, we don't have that information, and -- truthfylly -- even if we did, it's far too complex an issue to be handled in an online venue such as this one. Also coming into play with your question is ALL health issues you may have. This question also needs to be answered in light of your complete medical history and condition.

Your low blood pressure is a concern. It may or may not be a result of taking multiple pain medications. This is absolutely something you need to discuss with your doctor -- sooner rather than later.

Tingling of the lips could be a Migraine symptom, but if so, it would occur only during a Migraine attack. Now, that can include the prodrome phase, which can begin up to two days before the headache phase. Take a look at Anatomy of a Migraine for more on this, please.

I do know how difficult it is to be in a chronic pain situation managing multiple health issues, so I hate to even mention this, but how are your Migraines doing with you taking the pain meds for your chronic pain? Unfortunately, taking pain medications more than two or three days a week, even when they're not for a headache or Migraine attack can lead to medication overuse headache (MOH), aka rebound. I mention this at least in part because of seeing Darvocet listed as well as both sustained and instant release morphine and Diclofenac. Darvocet is a compound drug with multiple ingredints that can lead to MOH. Diclofenac can also cause MOH. You can find more information on this in Medication Overuse Headache - When the Remedy Backfires.

Your sleep issues are another troublesome issue, and it's certainly not going to help your pain issues.

Aliscyn, I wish I could give you some actual answers instead of "Maybe" and "Talk to your doctor," but your situation is very complex. Nobody can fully answer your question about taking all of these medications together except your own doctor(s) who can examine you, review all of your medical records, and talk with you. I hope this at least gives you some information that will be helpful when you talk with your doctor.

Please let us know how you're doing?

Best wishes,

Teri

PS: A good place to list the meds you're taking and look for possible interactions this site, Drug Digest. Also, just for your information, typing in all caps online is considered shouting, and it makes it more difficult for many people to read what you've written. The traditional combination of upper and lower case letters really does work best.