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Do obese people need more pain meds?

reptilesrreptiles Posts: 15
edited 06/11/2012 - 7:25 AM in Pain Medications

I was wondering if anyone knows of any references that support the position that obese patients taking oral opioids for chronic pain -- require an increase in dose or frequency.

Surely one wouldn't expect a 300 lb. individual to get the same pain relief as a 150 lb. person since the drug serum levels will never be equal.



  • Why would you want to know that answer?a person weight has no barring on the dosage of the pain medicine they take...if you have a question like that ask your doctor....
  • Why would you want to know that answer?a person weight has no barring on the dosage of the pain medicine they take...if you have a question like that ask your doctor....
    Well, I have several doctors and there appears to be different opinions on the matter. In my case I gained 80 pounds after being immobile, eating poorly, and on Lyrica for 3 years.

    I also remember when I worked at a zoo, in the 1980's the vet and I would spend a great deal of time placing 160 motrins into a rhino's food (he had a bad knee.)

    I suspect there is a correlation between body weight and oral opioids, too.

    Thanks for your interest.
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  • It's not the weight of the rhino that makes it require 160 motrins; it's the metabolic rate and excretion mechanism for the drug.

    My 130lb dog is on valium; he gets 120mg every 3 hours as needed. I'm quite a lot larger than my dog and when I'm on valium, I only get 5-10mg every 4-6 hours.

  • A lot of the medications that we take for back and back related problems, we used at work. I worked in mental heath. What we had to do at work was check blood pressure, weight and height every 2 weeks, because the weight could fluctuate either way rapidly. We had to make sure that they were taking the right dose for there weight, height and blood pressure.for example amitryptiyline and citolopram 20mg taken by a 300lb person and a 150lb person would not work the same, it would work on one but not the other.

  • an obese person would require more medications than a "normal" size person, it would make no sense to me. My bottle of Tylenol says nothing about the increase of dosage for those who weigh X amount of pounds? Age yes, weight no. A rational doctor is going to tell you to lose weight. BTDT for my knees. Lose weight and your knees won't bother you at all, and if they still do THEN we will address the dosage of medication. 130# dog taking 12 10mg. Valium? I'll have to call my vet and think on that one.
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  • there are many factors involved in determaning the dosage for a medication.

    age, weight, species, tolerances...ect--the list is almost as enless as the list of meds out there--if you have a question reguarding the dosage of a med that you are taking, your best bet is to talk to your doctor about it!
  • A relative of mine is obese and the doctor said he had to double his intake of medication and even OTC because the normal dosage wouldn't work for him. That's all I know about this issue.
  • The valium dosage for dogs is based on weight. Our orders are 2-3mgs per kg every 3 hours until Tonka's seizures stop, then .5mg per kg every hour as maintenance until we get him to the vet's office. Can you imagine the dose for a 300 pound human based on weight? 8}

    I can tell you from experience, when you take a 125mg valium prescription to the pharmacy to get it filled, they ALWAYS call the doctor and confirm it's not a mistake or an altered prescription. That dose just freaks them out. =))
  • Alot of medications that are given are by the person's weight. It's different for pain medications as every person has a different threshold for pain. Quite a job for the GP or Pain Management Dr.
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • I've never researched this topic indepth, but it seems to me that the obesity itself wouldn't be the problem with dosing the medications. Instead, it seems to me that the dosing difficulties would come from the high correlation between obesity and a variety of disease process that impact heart, liver, and kidney functions.

    Even if specific diseases aren't present, the higher percentage of body fat changes many basic hormonal responses within the body, which impacts the overall metabolic rate. For example, when women hit a certain percentage of body fat, they stop having menstrual periods. It's not their weight, per se, but rather the percentage of fat to lean muscle mass.

    Since pain medications are absorbed and then metabolized into other chemical compounds that act on the various receptors in our brains, if the liver, kidneys, circulation, and other metabolic processes aren't functioning normally as a result of obesity, then it stands to reason that dosing could be come a problem. But again, it's not obesity causing the problem directly, so it would certainly vary based on the individuals overall condition, rather than a simple weight issue.

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