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Toothache relieved only after freezing and morphine

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I have a cracked tooth, diagnosed yesterday at the dentist. I was given Amoxcillan to clear any infection and have an apt next week to see a specialist about getting it extracted and an implant put in. My dentist said to take Tylenol for any pain. My pain was so severe even after taking 2 Tylenol 3's that I went to Emergency last night crying in pain. The doctor on call gave me long lasting freezing to get me through the night and 2 10-mg of Morphine for this morning when the freezing comes out. As I wasn't sure if I was supposed to take both Morphine or one at a time, I took 2 Tylenol 3's instead this morning...about an hour ago...so I am not sure what to do next?

Thank you
Sandy


Category: Family Physician-GP

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Expert:  Dr. replied 4 Days.

Hello Sandy,

Thank you for asking your query at DoctorSpring.

You need to take only one Morphine 10mg at a time. Most Morphine tablets are slow release preparations. So the pain relief should last for upto 24hours. The next dose you can take after a day, if there is no pain. However if there is significant pain you can take that dose 6-8 hours earlier.

Please do not crush or chew the medication. You should NOT take alcohol while on Morphine. Also do not operate machinery or drive.

Instead of Tylenol I recommend an OTC NSAID like Ibuprofen 400mg twice -thrice a day.
Take this only if required in addition to the Morphine.

Hope this helps
Please feel free to ask followup questions.

Thank you


Patient replied :

Thank you. I am allergic to ibuprofen(naproxen). I did only take one morphine and did not feel any relief. I am scheduled to see my family doctor in about an hour and I will take the second morphine tablet before I leave the house. I called the dentist and he wants to see me today to remove the tooth. I have never had so much pain in my life. I don't have a handle on it and I feel like I am going to go mental. I will take any pill or do anything to take this pain away. Can I take Tylenol 3's...one or two right now?


Expert:  Dr. replied 3 Days.

Hello,

Do not take Tylenol 3 as it contains codeine. (Usual T3 preparations contain codeine).
Since you already had 2 Morphine, you have enough opioids in your system and additional opioid in form of codeine is not going to help. (+possible side effects)

You can take a 500mg Tylenol (Acetaminophen) if you have it handy.

Honestly only thing that is going to help you is doing something about the teeth - removal / restructuring / denervating.
Sever pain is a good enough indication for this. Please mention about this Opioid non responsive pain to your Dentist.
In this case you need not wait for the antibiotic dose to be complete.

Hope this helps
Thank you


Dr.
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