Talk to me about pain meds (France/Germany)

Cate, it is always better to take your own meds along on vacation. Murphy's law will tell you that your injury will flare up on a Sunday night when the pharmacy on your street in Paris might not be on call. Otherwise, make sure you know the name of the INGREDIENT of your desired medication when you go into a local pharmacy, e.g. paracetamol or acetaminophen for Tylenol.

I'll take aspirin with me, but I don't know if it will be strong enough in this scenario. I might check with my doctor to see if he will prescribe Vicodin, as a "just in case." It's funny, because I shy away from frequent use, and seem to have medical providers who feel the same, yet I have run across people who get much stronger stuff prescribed like candy!

Cate, I'm totally agreeing with the previous poster: get your Vicodin before leaving home! Take the prescription with you as well, and the generic description but take the meds along on your trip. You don't want to ruin your vacation by collapsing in pain. By the way, there is an American hospital in Paris....

It's been my experience that "prescription" drugs are available without a prescription so long as you request the main generic name for it. Don't go in the pharmacy and tell them you need something "strong" for the pain. Tell them you need "generic name". That being said, I've only had to get antibiotics so far:) so I can't swear about their limitations, if any, on pain meds.

The rules and regulations differ in each country, especially when compared to here, when it comes to prescription drugs. You'd want to be cautious about assuming that what is available here is available there, that the names will be the same, or that you will be able to get drugs that you can get here. What you think you might need, you should bring with you.

For Germany: "Aspirin" is still a Bayer trademark not a generic term. ASS (or the long form Acetylsalicylsäure) are the generic names. ASS is free over pharmacy counters. The active ingredient of Tylenol(TM) (not available in Germany) is called paracetamol in German (and I think in most European countries), not acetaminophen. Paracetamol under 10g per package is free over pharmacy counters, bigger packages need a prescription. The active ingrediance of Vicodin(TM) (not available in Germany) is hydrocodone. It is listed in the German narcotics act and has quite high hurdles for prescription. If you take it with you, take the prescription too.

When people say, "take the prescription with you," do you mean to bring it in the bottle with the label from the pharmacy? Or bring the actual piece of paper the doctor writes on? I usually leave prescription meds in their bottles from the pharmacy, but I don't keep the paper, because the pharmacy takes that.

'Typically' the labeled bottle is enough, but I'd take a copy of the prescription also if bringing Vicodin into another counrty...paper trails are good. I'd like to think your doctor would prescribe a few pills, esp. since he/she has found it warranted in the past...

Cate,, since your doctor already prescribes the drug for you,, why not take the ones you have, in their labelled container. If you are out, explain to doctor you will be away , and could he please prescribe you 10 or so to take with you "just in case" , fill prespription and take with you. This would simplify your trip ,, not having to waste time finding a pharmacy that will assist you.

The doctor doesn't regularly prescribe it for me. It's just a one-off thing for me when some-thing comes up. The one doctor (specialist) I see for head-aches was prescribing an NSAID based pain killer, and I haven't seen him since my other doctor found the problem that rules out the NSAIDs. Depending on the doctor, some are iffy about writing out a prescription for Vicodin, "just because," (when I have had something come up, I've had about 10-15 pills prescribed) while others will write it out for people to take regularly. That's one of the reasons why, if it's true that you can get aspirin with (small doses of) codeine in French or German pharmacies, that might be the easier route. I can pick up a small packet, just in case, the first day.

Play it smart get a prescription AND YOUR MEDS from your regular doctor. You dont want to spoil your vacation suffering until the pharmacy opens, and possibly having to use something milder than you need.

"...if it's true that you can get aspirin with (small doses of) codeine in [...] German pharmacies...." ........... No, you definitely can't without a prescription. Like I said codeine and its close derivatives fall under the narcotics act. Which means that it is legally treated just like e.g. Morphine. That's why I cautioned you to bring the prescription, because simply owning it "unauthorized" is possession of narcotics.

"[...] do you mean to bring it in the bottle with the label from the pharmacy? [...]" ............ For codeine and similar narcotics and psychotropic substances you actually need a certificate as prescribed in to article 75 of the Schengen Implementing Convention: pdf at: http://tinyurl.com/37uhj73

Cate, just to clarify, in Canada (at least here in B.C.), both Tylenol with Codeine (Tylenol 3) and "Aspirin with muscle relaxers" (are you referring to 292's?) are ONLY available by prescription. These both contain codeine and caffeine, but the "medicinal ingredient" is the main difference (ASA or Acetominophen). ¶ If you're going to take a written prescription, be sure that the generic names is specified, as medications names can sometimes refer to different medications in other parts of the world. Keep in mind that there may be "language issues" when you try to fill the prescription, so it needs to be as CLEAR as possible (I've had that happen in Italy). ¶ It would also be a good idea to have the prescription at hand, as that particular medication may be illegal for possession in some areas. Good luck!

Cate, a physician in the state of Washington is necessarily careful about prescribing opiates because of the potential for abuse. If you have a regular doctor who knows you and your medical history, he or she should be willing to prescribe enough Vicodin for your potential needs on a short trip abroad. I wouldn't count on getting this in France, at least without seeing a doctor there. The codeine available in Canada from the pharmacy comes in a small dose combined with Tylenol and so much caffeine it is not reasonably susceptible to abuse. Pure Vicodin is, so respect your doctor's advice on this. Get what is reasonably necessary here, and carry it with the prescription label just in case you are asked about it.

I totally agree with doctors hesitating on prescribing more. I've known of 3 people who died of Opiate (Oxycontin) overdoses in the last 6 years in this state. I am not thrilled with being unable to take Alleve or Ibuprofen, as they are much better for certain types of pain, anyway. I don't like using Vicodin much, either, because it has Tylenol as its base, which causes liver damage.

PAT, I wasn't sure which medications available in Canada that Cate was referring to? Given her description of the pain she's suffering, and the fact this is best relieved by stronger opiates, I doubt that the non-prescription codeine analgesics would be adequate to offer any relief. Cheers!

Acetaminophan only causes liver damage in OVERDOSE or in people with pre-existing liver disease. Taken as prescribed, it is a very safe medication, as is paracetamol, which others have noted, is pharmacologically almost identical to acetaminophan. I´m not going to speculate online why you can´t take NSAIDs (it is probably one of two reasons), mostly likely), but without you having to share any medical information online, you may want to ask your doctor about a COX2 inhibitor, if you haven´t already tried one. These work like normal NSAIDs, but avoid one of the major side effects. But back to your original question, if you have chronic pain issues, you are VERY unlikely to get a kind of prescription while in Europe for any narcotic, unless you have an established relationship with a physician over here.

Cate,, I do understand Kens point,, yes, you can get codeine products over the counter here, but, they may not be strong enough for you ,, if you are used to using a stronger drug like Vicodin. Hopefully none of this will matter and you will not have any flare ups.

Ken,, to clarify , you can most certainly get muscle painkiller with codeine here,, over the counter,, go to Safeway and ask if you don't beleive me,, BUT they will not have the same concentration of codeine in them as T3s,, they have much less codiene. Same with muscle relaxers. Cate,, I think Lolas post had some great advice. ( ps,, any child birth injury that causes you so much pain you need to stay home from work, ,, well, frankly, get it fixed, its not ok to figure you can take opiates for life every time it flares up.. you will find the doctor questioning you sooner or later) . I think living with that sort of issue must be very limiting,, even if it doesn't act up often,, it seems unpredictable.

Thank you, Pat! I knew that you could get the medication in Canada. I don't buy it, but I know people who do, as we are close to the border. To clarify, I haven't had a flare-up of the childbirth injury since my last pregnancy 4 1/2 years ago (which is expected). I am shocked this is happening now, but my trip is just a few months away. (I was also in a minor traffic accident a few weeks ago and seemed fine at the time, so maybe there is a link, but it's probably too late to show that.) I will try to go to a chiro, since the only traditional treatments for this are either a surgery that may or may not fix it or a steroid shot to the pelvis. The only time I received pain meds for it were post-partum and one of the two times I didn't get the prescription filled. The no-NSAIDs also just came up in the last six months, when I had blood work done for something else, but I also happened to be in the middle of extensive dental/oral surgery work. Thanks, everyone.

Cate- I'm going to infer from the information you provided that a COX2 inhibitor may not be appropriate for you.

Hi Cate... You have my utmost sympathy on your pain levels I haven't posted on this board in quite awhile, but I saw your post and I thought I might be of assistance to you. I have stage 4 endometriosis and am part of a Chronic Pain Protocol program. I always carry my pain meds (vicodin, previously tylenol #3) in a labeled pharmaceutical bottle, and in my case I travel with a letter from my doctor with my diagnosis. Each country I have been in throughout Europe I have gone into a pharmacy and shown my pain med bottle to and asked if they could refill it. Not every pharmacist knew what our name brand was, but they recognized the pharmeceutical term. My doctors were curious if it could be filled abroad if I was ever delayed for some reason. You asked about France and Germany. I was told that I needed to see a doctor to get a prescription. Under no circumstances would they fill it even though I had the actual pharmacy bottle and the note on hospital letterhead from my doctor. What we also found out is the dosage of tylenol versus hydrocodone was bit different in each country than what you would get here in the states. My advice as those of other posters is to get whatever pain meds you need HERE!! and while I have personally checked to see if my pain meds are allowed in France and Germany..rules and laws change so whatever you decided to get from your doctor.. I would suggest that you double check that they are legal to bring in. I hope you feel better soon. If you find relief from a heating pad..I would suggest you pack one.