# Painkiller advice please



## Slipper (Jun 17, 2010)

Hi,

I wonder if you can help me. I was chatting to a very good friend of mine last night and his wife is 10 weeks pregnant, she has what the doctors think is a herniated disc and her back pain has been severe and getting worse for weeks. They are hoping to get her admited to hospital in the next week or so but my friend is very worried about the effect of the pain medication she has been taking on their baby.

She is taking 1 gram of paracetamol every 4 hours, he said the paracetamol isn't really touching the pain though.

The doctors have also given her Tramadol, this is the one he is most worried about.

Are these medications (and the dosage of paracetamol) safe at this stage of pregnancy?

Thank you.


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## mazv (Jul 31, 2006)

Hi,

The maximum dose of paracetamol in a 24 hour period is 4grams, so she should take no more than 4 doses in a day. With back pain that severe then it is unlikely that paracetmol will be enough for the pain and opiate based drugs would be the next step. In the short term tramadol is not associated with any increased risk of problems in the baby, although data is limited. There is more information on the use of codeine during pregnancy so this would usually be used before tramadol, but all depends on the history of the patient (which I don't know).

Use of opiates at term in pregnancy is best avoided if possible as it can cause a withdrawal syndrome in the baby. But this can be safely managed and is short lived. From the sounds of it it is really important that your friend can get her back pain under control and her disc stabilised as this could have implications for her health during the rest of the pregnancy.

Hope this is helpful
Maz x


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