Expert: Dr Ian Jackson - please note UK based - 7/29/2010

Question
QUESTION: I also take Nardil and thank you for your information about the general anesthesia problem. I am going to have a procedure called "minimally invasive micro discectomy". I have been told that the postoperative pain medications that are usually prescribed our counter indicated with Nardil. I cannot come off Nardil without going into a major depressive episode. What can be done to control postoperative pain given my circumstance?

ANSWER: Hi there
This is a bit of a problem for the team looking after you but they should be able to cope. We usually recommend that patients come off these drugs for at least 4 weeks prior to an operation. However there is a small group of patients that really cannot come off the drug. In this case we have to be careful with the drugs we use - especially pain killers. Microdiscectomy is an operation that is usually not too bad from the pain point of view. paracetamol and Non steroidal antiinflammatories can be very effective and are safe.
I wish you all the best
Dr Ian Jackson

---------- FOLLOW-UP ----------

QUESTION: There seems to be some mixed opinion from what I read on the Internet. Can I take Tylenol 3 (Tylenol with codeine) and Nardil?

Answer
In theory codeine is converted by 30-50% of the population to morphine compounds which are some of the ones contraindicated with your drug. The real question is this enough to cause problems. Answer we don't really know but I suspect not. However unlikely that they would use this because of that.
Dr Ian Jackson