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Old 10-11-2007, 09:10 AM   #3
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Re: more questions Roxicodone 30mg or dilaudid (hydromorphone)

I've used both and althouigh Dialaudid would be med of choice for post op pain when delivered IV through a PCA, I wasn't at all impressed with it orally. There are some other meds like this too, that loose a great deal of their potency when you change the delivery method. Oxymorphone is 10 times more potent than morphine when delivered IV but when delivered orally it's only 3 times more potent. Some of the meds ae just poorly metabolized and loose a great deal of their bio abvailabilty for various reasons.

I actualy turned 2 weeks worth of dilaudid back into my doc to in order to switch back to oxy rather than wait two more weeks with poor pain relief. The 15 bucks it cost was nothig compared to having to do another two weeks on oral didlaudid. As far as pain relief, I don't know what you're shooting for, but complete relief is rarely possible once you reach the point of actualy needing these meds. I have a pump know after 3 failed fusions and a pump that relieves 50% of the pain is considered a success, coming to terms with that takes a little more time than a doc telling you it's functioning the way it's suposed to. Just because a larger dose is always available it doesn't mean it's the best thing for you. It's a trade, If I wanted to be sedated, have no motivation, pee through a cath and give up sex at 40, They could crank that sucker up and leave me in a coma, But that's not living either and I haven't seem them change the sign from pain management to pain obliteration. Doubling a dose over night isn't safe by any standard I have read. Unfortunately they don't make something in between 15 and 30. Ideally you doc would say get a pill splitter and try 1 and 1/2 before doubling your dose. If it works, why skip over it and take more meds and deal with more side effects than you have too. There is also a noticable difference between Mallinkrodts generic Roxicodonde and any other generic I have used. Mallinkrodts version sucks along with their versions of many of meds.

I use the 30's but split those all the time. If I don't feel like I need 30 mgs or have to be alert and function I can always take the other half an hour later if a half isn't working. BTW, Methadone would be even cheaper and makes more sense from a PM standpoint than trying to manage long term pain with short acting meds.

But that's JMO, Good luck, Dave