Expert: Jacqueline Jacques, ND - 6/30/2011

Question
I had a gastric bypass done in 2008, and have noticed that with my pain medications for chronic back pain only seems to last about 2 hours. I am on oxycodone 15mg. I really don't want to complain to my pain management doctor, but if I take them when I start to hurt each time I wouldn't have enough to last. I can't find anything at all about absorption and pain meds. But I know I am malnutrition and have trouble gain weight and keeping it on.

Answer
Hi Dee,

While not much is published in literature on the subject, there are definitely medications that are processed differently after gastric bypass.  Frequent dosing of oxycodone is really not going to be a good solution, but living with constant break-through pain is not healthy either, so this is something you should talk to your doctor about.  

There are articles available on medication absorption after gastric bypass - I can't add attachments in this program, but these are two I like (These links should take you to full-text):

1) http://www.ajhp.org/content/63/19/1852.full
2) http://www.uspharmacist.com/content/d/health%20systems/c/10242/

Here are my suggestions:
1) If you think you are having challenges keeping weight on and with nutrition, you need to make an appoint with your bariatric surgeon to discuss these issues.  When you do that, please also discuss your pain issues with your surgeon and get his recommendation.  Ask if he will write it down for you and/or if he would be willing to communicate with your pain doctor)
2) When you have the recommendation of your surgeon, make an appointment with your pain doctor to specifically discuss what is not working in your medication and to share the guidance form your surgeon.

I hope this helps.

In Health,

Dr Jacques