gailbelle
06-11-2004, 12:49 AM
I was put on a new pain medicine today called Anvinza. I had been on 120 mg. oxycontin. (2 ) 40mg in morning and (1) 40 mg in evening; however after a year of being on this I felt as though it wasn't working. Today was my monthly visit. I have advanced DDD, Scolosis, Spinal Stenosis, fibro, lupus and so many things I feel like a hypo; but this is how it is. I also take zanaflex when needed, Bextra, neurontin 300 mg at bedtime. The dosage of the Anvizna is 60 mg., once daily. My dr advised to try this for this next month and we would go from there. My next appt is July 9. Tomorrow will be my first day.
Your input would be appreciated.
Thank you and God bless us all!
gailbelle
Your input would be appreciated.
Thank you and God bless us all!
gailbelle
Sponsor
lindao1
06-11-2004, 12:57 PM
Hi!
I also went from 120mgs of Oxy to Avinza and unfortunately, the Avinza did nothing for my pain. I stayed on it for a couple of weeks (in agony) and so my dr. put me back on the Oxy. Sorry it wasn't a success for me.
I have heard some people do get good relief from it. I had high hopes for it myself especially since it was a 24 hour dosing. But it just didn't control my pain in the least. Maybe you will have better luck with it. Take care, Linda :D
I also went from 120mgs of Oxy to Avinza and unfortunately, the Avinza did nothing for my pain. I stayed on it for a couple of weeks (in agony) and so my dr. put me back on the Oxy. Sorry it wasn't a success for me.
I have heard some people do get good relief from it. I had high hopes for it myself especially since it was a 24 hour dosing. But it just didn't control my pain in the least. Maybe you will have better luck with it. Take care, Linda :D
Shoreline
06-11-2004, 04:53 PM
Hi Gail, Unfortunately I don't think docs understand how the 24 hour meds work. A 60 mg Avinza spread over 24 hours would be roughly the same as taking 10 mgs of regular morphine every 4 hours.
60mgs of MSContin 3 times a day would sustain the same serum level as if you took 30 mgs of morphine every 4 hours which would be equivelent to your present dose of oxy. All you can do is call the doc if you are still hurting and using excessive BT meds to make up the difference.
I think Avinza and Kadian could be very efective meds when dosed properly. 60 mgs of avinza doesn't sustain 60 mgs in your system, It's spread out over 24 hours unlike OxyContin or MSContin that sustains half the mg strength for 8-12 hours.
Unfortunately docs often start low when tritrating any new med. However I have seen people get better releif from a different drug at a significantly lower dose, so I don't want to predict it's going to be too weak.
Morphine has a different mechanism of action, causes more euphoria which is part of the anelgesic process. That false sense of feeling well when your not is part of why morphine works. If your doc is willing to titrate the dose properly you may find excellent relief but it's hard to predict. Equianelgesic charts are just guides, Most conversion from Oxy to morphine are 1:1 or 1:1.5 meaning you need 50% more morphine than oxy.
When the patients pain spikes, or they experience some withdrawal it's natural to want to go back to the old med before Avinza or Kadian is really given a chance to work at the right dose. Most people also find morphine very sedating at the initiation of therapy, but you have to ride that out and it does go away. You just have to suck it up during the titration process. I'm sure my pump setting will be 3 times what the original dose was, I can't speed it up, but I do have weekly apts untill I'm comfy. If you know your doc will respond when you say you hurt and make adjustments it's probably worth sticking it out to give it a fair trial.
Personally I don't think the doc would be giving Avinza a fair chance untill you at least reach a 1:1 ratio from oxy to morphine and then fine tune it. Titration is never fun, they always start low with meds you haven't been exposed to and this is just the life of a CPer. If you give it 3-4 days and let the doc know how your feeling that's plenty of time to know if 60mgs is enough.
Good luck,and let us know how you do. Take care, dave
60mgs of MSContin 3 times a day would sustain the same serum level as if you took 30 mgs of morphine every 4 hours which would be equivelent to your present dose of oxy. All you can do is call the doc if you are still hurting and using excessive BT meds to make up the difference.
I think Avinza and Kadian could be very efective meds when dosed properly. 60 mgs of avinza doesn't sustain 60 mgs in your system, It's spread out over 24 hours unlike OxyContin or MSContin that sustains half the mg strength for 8-12 hours.
Unfortunately docs often start low when tritrating any new med. However I have seen people get better releif from a different drug at a significantly lower dose, so I don't want to predict it's going to be too weak.
Morphine has a different mechanism of action, causes more euphoria which is part of the anelgesic process. That false sense of feeling well when your not is part of why morphine works. If your doc is willing to titrate the dose properly you may find excellent relief but it's hard to predict. Equianelgesic charts are just guides, Most conversion from Oxy to morphine are 1:1 or 1:1.5 meaning you need 50% more morphine than oxy.
When the patients pain spikes, or they experience some withdrawal it's natural to want to go back to the old med before Avinza or Kadian is really given a chance to work at the right dose. Most people also find morphine very sedating at the initiation of therapy, but you have to ride that out and it does go away. You just have to suck it up during the titration process. I'm sure my pump setting will be 3 times what the original dose was, I can't speed it up, but I do have weekly apts untill I'm comfy. If you know your doc will respond when you say you hurt and make adjustments it's probably worth sticking it out to give it a fair trial.
Personally I don't think the doc would be giving Avinza a fair chance untill you at least reach a 1:1 ratio from oxy to morphine and then fine tune it. Titration is never fun, they always start low with meds you haven't been exposed to and this is just the life of a CPer. If you give it 3-4 days and let the doc know how your feeling that's plenty of time to know if 60mgs is enough.
Good luck,and let us know how you do. Take care, dave
gailbelle
06-12-2004, 07:53 PM
Shoreline I keep loosing my replies. Just as I am to finish it, it dissapears.
The Anviza did not work, my dr gave me a $2.00 coupon for 10 only. I am asking your permission to print your last reply to give to my dr. She is very appreciative when I do the research. She upped my med to 1 80mg in morining and 1 80 mg oxy in evening with 2 15mg roxicodone for bt. Can I use the Anviza also for bt. I don't just want to flush them. We cpers can have some really bad days that go beyond a 10.
Again, thank you both and have a blessed day.
gail
The Anviza did not work, my dr gave me a $2.00 coupon for 10 only. I am asking your permission to print your last reply to give to my dr. She is very appreciative when I do the research. She upped my med to 1 80mg in morining and 1 80 mg oxy in evening with 2 15mg roxicodone for bt. Can I use the Anviza also for bt. I don't just want to flush them. We cpers can have some really bad days that go beyond a 10.
Again, thank you both and have a blessed day.
gail
gailbelle
06-12-2004, 07:53 PM
I lost 3 replies and this last one posted twice
gailbelle
06-12-2004, 07:54 PM
Shoreline I keep loosing my replies. Just as I am to finish it, it dissapears.
The Anviza did not work, my dr gave me a $2.00 coupon for 10 only. I am asking your permission to print your last reply to give to my dr. She is very appreciative when I do the research. She upped my med to 1 80mg in morining and 1 80 mg oxy in evening with 2 15mg roxicodone for bt. Can I use the Anviza also for bt. I don't just want to flush them. We cpers can have some really bad days that go beyond a 10.
Again, thank you both and have a blessed day.
gail
The Anviza did not work, my dr gave me a $2.00 coupon for 10 only. I am asking your permission to print your last reply to give to my dr. She is very appreciative when I do the research. She upped my med to 1 80mg in morining and 1 80 mg oxy in evening with 2 15mg roxicodone for bt. Can I use the Anviza also for bt. I don't just want to flush them. We cpers can have some really bad days that go beyond a 10.
Again, thank you both and have a blessed day.
gail
rlcowboy
06-13-2004, 12:34 AM
Hey Gailbelle, I was on 40mg oxy myself for about a year and it got to the point where it was not working very well so my PM doctor put me on Methadone and I have to say, I wish I had been on it the whole time cause it really works well for me and I do not have to take very much at all, plus you can take this med for years without having to increase the dosage. Ask your Doctor what he or she thinks about it.
gailbelle
06-13-2004, 03:46 PM
Hi rlcowboy, the fall of 2002, I was in a pain clinic and was put on 40 mgs of Methadone for 1 month. Something about it didn't go well with me. I had several bad experiences. Mainly falling going down stairs. Especially going out the back door of our home with only 3 cinder block steps; but with jeans on I got a nasty deep knee cut and a L shape cut through the knee of the jeans. Another time pulling cornbread from the oven and several burns. I felt as though my senses were off to the touch.
As far as the pain clinic...way to costly and too many patients to feel like I could get to know my pm dr like I needed to.
As I stated before, my dr now is only a family practioner; but very concerned and gives me lots of her time. Thanks and I truely do believe in God! gail
As far as the pain clinic...way to costly and too many patients to feel like I could get to know my pm dr like I needed to.
As I stated before, my dr now is only a family practioner; but very concerned and gives me lots of her time. Thanks and I truely do believe in God! gail
Shoreline
06-13-2004, 05:42 PM
Hi Gail, Your more than welcome to print my reply and corect any spelling errors.LOL
I wouldn't through them away, But you have to realize as far as using it for BT, It will half a slight initial release that is part of it's design and that may bring down your level of pain but it's going to continue to release small amounts of morphine over the next 24 hours.
Good luck, Dave
I wouldn't through them away, But you have to realize as far as using it for BT, It will half a slight initial release that is part of it's design and that may bring down your level of pain but it's going to continue to release small amounts of morphine over the next 24 hours.
Good luck, Dave
idohair000
02-25-2008, 10:57 PM
hello. im completely new here and cannot for the life of me figure out how to start my own thread :) anyway, since my question is very related to this i will start here and then if someone could give me a clue on how to not do this on someone elses thread id be grateful.
i have been on Norco 10/325 for over a year now. I have fibromyalgia, arthritis so CP. this med is wonderful but i am/have always been weird about taking narcotics period. i have tried EVERYTHING under norco, ie ultram, darvocet HA, darvon, etc.. and nothing works like it. Im living in a VERY stressful situation which exacerbates my condition greatly so doc put me on ultram for breakthru pain (allergic reaction) my goal was to completely go OFF of the norco and let the ultram take over. NOPE. so now he wants to put me on Avinza. I am scared to death. One of the pluses of the norco is that it not only takes the pain away entirely, but it makes me feel energetic not sleepy. i have read some postings here regarding this and i want to know how in the heck to i tell my doctor i want to stay on the vicodin because it makes me feel happy??? how stupid and drug addict like does that sound? OMG. but its the truth. i have not EVER taken any more than prescribed with the exception of when i had a tooth pulled and then upped my dose to 15 mg 4 x a day for a day. i have been very honest with my doc and i do not feel that changing me to morphine is going to be beneficial. i am bipolar 2, so depression is an issue with me. if i am sedated i will only go down hill. i want a way to explain this to him without sounded like i am a vicodin FREAK. i know this goes on a lot but i am not one to do this kind of thing due to being very leary of ANY new medication. in fact it took me 3 weeks to start taking Cymbalta because i read the side effects and was sure i would go into a coma! lol seriously any help would be great with this situation. and has anyone ever switched from norco to avinza and had a serious let down?
thanks just scared.:confused:
i have been on Norco 10/325 for over a year now. I have fibromyalgia, arthritis so CP. this med is wonderful but i am/have always been weird about taking narcotics period. i have tried EVERYTHING under norco, ie ultram, darvocet HA, darvon, etc.. and nothing works like it. Im living in a VERY stressful situation which exacerbates my condition greatly so doc put me on ultram for breakthru pain (allergic reaction) my goal was to completely go OFF of the norco and let the ultram take over. NOPE. so now he wants to put me on Avinza. I am scared to death. One of the pluses of the norco is that it not only takes the pain away entirely, but it makes me feel energetic not sleepy. i have read some postings here regarding this and i want to know how in the heck to i tell my doctor i want to stay on the vicodin because it makes me feel happy??? how stupid and drug addict like does that sound? OMG. but its the truth. i have not EVER taken any more than prescribed with the exception of when i had a tooth pulled and then upped my dose to 15 mg 4 x a day for a day. i have been very honest with my doc and i do not feel that changing me to morphine is going to be beneficial. i am bipolar 2, so depression is an issue with me. if i am sedated i will only go down hill. i want a way to explain this to him without sounded like i am a vicodin FREAK. i know this goes on a lot but i am not one to do this kind of thing due to being very leary of ANY new medication. in fact it took me 3 weeks to start taking Cymbalta because i read the side effects and was sure i would go into a coma! lol seriously any help would be great with this situation. and has anyone ever switched from norco to avinza and had a serious let down?
thanks just scared.:confused:
SpinalMalady
02-26-2008, 12:41 AM
gailbell:
It's a shame your doc only gave you 10 days, and a coupon for $2.00. When my doctor switched me over from Fentynal to Avinza he gave me a "Co-Pay Savings Card" for the Avinza. It can be used WITH insurance, as well as is good for UP to $50 per month for 6 months. I would guess he got it from a Pharmacy Rep. My #30 30mg Avinza ended up being FREE! Maybe you could ask your doc about that Co-Pay card, and see if he can get some from his rep. It may be worth it to try it again. I don't know if I could have said that Avinza was working after 10 days or not. Heck, we're still working it out, and when I see him next week, we'll be looking at the dosage again. But it I do understand what you mean, it IS expensive, and there is no generic for it, and one HAS to have SOMETHING to give some measure of pain control during the time when the doc and you are working out the kinks. I guess that's why he gave me the MSIR too.
I did have to dose every 12 hours for 3 days (per the doctors orders) after going through a pretty rough spot, and then it seems to have evened out. I still have quite a bit of BT pain, but I was having that on the Fentynal as well. He did say at our last appointment that he thought he would probably go to 60mgs at the next appointment. For right now I am also given MSIR 15mg, and am only taking 1 per day, and sometimes can get by with a half per day.
When I initially started taking the Avinza, I had SO much pain, then got rear ended the VERY NEXT DAY!! I'm not sure if the pain escalation was from that, or was some mild withdrawl from the Fentynal, as I had to completly stop taking it for at least 18 hours prior to starting the Avinza. I waited 24 hours, just to be safe. Some of you may remember that I had some problems with the "stigma" attached to taking Morphine, but I seem to be better, and hopefully, as Shoreline (Dave) suggested, at this next appointment we will be able to tweak the dosage to where I won't even have to take the MSIR. At least that's my goal.
I did have some extreme fatigue with the 12 hour dosing those two or three days, and thank goodness it was over a weekend. There is no way I would have been able to work and drive, etc. I'm going to talk with my doc about my concerns regarding the fatigue with an increased dosage. I still HAVE to be able to put in 4 more years into the system before I can retire. My doc and I are working to do what we can to meet that goal of keeping me employable, and hopefully, I will be able to make it.
I wish you luck gailbell in finding something that works for you. I just wanted to suggest that maybe your doc could talk to the Avinza rep about one of those Co-pay cards, (let's face it Free is good, and FREE for 6 months is BETTER.. LOL) and perhaps you could try it again, maybe along with something like MSIR or even Oxycodone (percocet) or Hydrocodone for BT.
Feel better soon!
It's a shame your doc only gave you 10 days, and a coupon for $2.00. When my doctor switched me over from Fentynal to Avinza he gave me a "Co-Pay Savings Card" for the Avinza. It can be used WITH insurance, as well as is good for UP to $50 per month for 6 months. I would guess he got it from a Pharmacy Rep. My #30 30mg Avinza ended up being FREE! Maybe you could ask your doc about that Co-Pay card, and see if he can get some from his rep. It may be worth it to try it again. I don't know if I could have said that Avinza was working after 10 days or not. Heck, we're still working it out, and when I see him next week, we'll be looking at the dosage again. But it I do understand what you mean, it IS expensive, and there is no generic for it, and one HAS to have SOMETHING to give some measure of pain control during the time when the doc and you are working out the kinks. I guess that's why he gave me the MSIR too.
I did have to dose every 12 hours for 3 days (per the doctors orders) after going through a pretty rough spot, and then it seems to have evened out. I still have quite a bit of BT pain, but I was having that on the Fentynal as well. He did say at our last appointment that he thought he would probably go to 60mgs at the next appointment. For right now I am also given MSIR 15mg, and am only taking 1 per day, and sometimes can get by with a half per day.
When I initially started taking the Avinza, I had SO much pain, then got rear ended the VERY NEXT DAY!! I'm not sure if the pain escalation was from that, or was some mild withdrawl from the Fentynal, as I had to completly stop taking it for at least 18 hours prior to starting the Avinza. I waited 24 hours, just to be safe. Some of you may remember that I had some problems with the "stigma" attached to taking Morphine, but I seem to be better, and hopefully, as Shoreline (Dave) suggested, at this next appointment we will be able to tweak the dosage to where I won't even have to take the MSIR. At least that's my goal.
I did have some extreme fatigue with the 12 hour dosing those two or three days, and thank goodness it was over a weekend. There is no way I would have been able to work and drive, etc. I'm going to talk with my doc about my concerns regarding the fatigue with an increased dosage. I still HAVE to be able to put in 4 more years into the system before I can retire. My doc and I are working to do what we can to meet that goal of keeping me employable, and hopefully, I will be able to make it.
I wish you luck gailbell in finding something that works for you. I just wanted to suggest that maybe your doc could talk to the Avinza rep about one of those Co-pay cards, (let's face it Free is good, and FREE for 6 months is BETTER.. LOL) and perhaps you could try it again, maybe along with something like MSIR or even Oxycodone (percocet) or Hydrocodone for BT.
Feel better soon!