madhatter
06-22-2004, 04:57 AM
I always hear-if the lortab 10 isn't strong enough,then go to oxycotin-oxycodone. My question is,why not make a stronger dose of hydrocodone? I heard if you went to a compound pharmacy,they can do that,but theres not many of them around.
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thomason
06-22-2004, 12:16 PM
I'd also like to know that. I barely get by taking the 10's, and am not sure I want to start taking the oxys. I'd like to know if there is another step between the 10's and the oxys because that is about where I am at right now.
tyler7
06-22-2004, 07:24 PM
Well yea, there is a step in between. First off, I assume when you say "going to oxys", and the other things you said, that you were referring to OxyContin, the long-acting med. You didn't want to have to go all the way to that if Lortab (hydro) 10's didn't get the job done. Well, you can take just regular short-acting oxycodone, in any of its many forms, depending on what your doc wants for you (Percocet, Percodan, OxyIR, Roxicodone - all brand names of oxycodone). The mgs per pill go from 5mg to (I believe) 30mg, and tylenol content can be as little as 325mg.
Does this help at all? This what you were talking about? I hope so, but maybe I've misunderstood and got it wrong. Good luck all the same.
Does this help at all? This what you were talking about? I hope so, but maybe I've misunderstood and got it wrong. Good luck all the same.
Shoreline
06-22-2004, 07:57 PM
The only reason to not go to oxycodone is that it'sa class 111 med and Oxy is a class 11. A compounding pharmacy can create anystrength Hydro compound you want, But why pay the enormous expense of having a pill compounded for you.
Hydro is 75% as strong as Oxy, Oxy is simply 25% stronger, Hydro is equal to morphine 1:1, What would be the advantage of using high strength compounded Hydro. I know a lady that had hydro compounded into long acting Hydro by adding Dextromathorphan, 100mgs of hydro and however many mgs of dex to increase the duration and add NMDA blocking ability.She took 3 100mg hydro capsules per day. No apap. If your alergic to oxy you would likely be alergic to hydro, they are both in thes ame class of Keto synthetic opiates.
Comeing off 300 mgs of Hydro really wouldn't be any easier than coming off 300 mgs of morphine or 200mgs of oxy. I don't see the gain other than the ability to presently fly under the dea radar. In a year or two that won't even be an advatage because hydro is so abused because it's not controlled the way class 11 meds are.
One 10/325 norco is equal in strength to a 7.5/325 percocet. I don't get it? What's the advantage. You are taking an opiate equal in strength to morphine, so abuse, dependence and withdrawal will be equally unpleaseant. Soon prescribing guidelines will equally tough. Are we talking about pain management or just prefering the way hydro makes you feel, apposed to oxy products or morphine products.
I would take a 10 mg perc over a norco any day although the Perc is more expensive even in generic, But when you start compounding meds, it becomes the most expensive version of that med you can get, you don't have the quality control, you don't have a Chemist/ pharmaceutical liason with the FDA to ensure QC or even potency. Just curious as to what people think the advantage would be? There is a a web site that sells a 15mg hydro with 35 mgs of apap. or there was, I'm not sure they are still around as most of the internet sources a simply a roll of the dice and adding your name to a database of a less then legitimate way to obtain pain meds.
I met a guy on the net that was buying the 15/35's from the net and was going through withdraswal from over 300 mgs of hydro a day, withdrawal is withdrawal, hydro isn't any easier, it has all the same side effects of oxy, If oxy makes you itch a high dose of hydro causes the same hystamine repsponse but that will deminish as you become acomadated.
If your internet source is outside the country how do you even know your not getting caplets filled with sugar, No FDA, NO QC, No gaurentee and the posibility of prosecution buying controlled meds from less than legitamate sources.
Within the next couple years Hydro will be a class 11 med too, It's the most abused prescription narcotic there is. Once it bocomes a class 11, The same rules and regs will be enforced, your use will be tracjked, your doc will be cmore closely watched, I'm just curious why someone would want to spend 3 times the price of pharmacuetical med?
I can certainly imagine why smeone would want a pure hydro capsule with no filling agents but bather than guesing why someone wants to spend more money on weaker meds, I'll just wait for an answer?
Dave
Hydro is 75% as strong as Oxy, Oxy is simply 25% stronger, Hydro is equal to morphine 1:1, What would be the advantage of using high strength compounded Hydro. I know a lady that had hydro compounded into long acting Hydro by adding Dextromathorphan, 100mgs of hydro and however many mgs of dex to increase the duration and add NMDA blocking ability.She took 3 100mg hydro capsules per day. No apap. If your alergic to oxy you would likely be alergic to hydro, they are both in thes ame class of Keto synthetic opiates.
Comeing off 300 mgs of Hydro really wouldn't be any easier than coming off 300 mgs of morphine or 200mgs of oxy. I don't see the gain other than the ability to presently fly under the dea radar. In a year or two that won't even be an advatage because hydro is so abused because it's not controlled the way class 11 meds are.
One 10/325 norco is equal in strength to a 7.5/325 percocet. I don't get it? What's the advantage. You are taking an opiate equal in strength to morphine, so abuse, dependence and withdrawal will be equally unpleaseant. Soon prescribing guidelines will equally tough. Are we talking about pain management or just prefering the way hydro makes you feel, apposed to oxy products or morphine products.
I would take a 10 mg perc over a norco any day although the Perc is more expensive even in generic, But when you start compounding meds, it becomes the most expensive version of that med you can get, you don't have the quality control, you don't have a Chemist/ pharmaceutical liason with the FDA to ensure QC or even potency. Just curious as to what people think the advantage would be? There is a a web site that sells a 15mg hydro with 35 mgs of apap. or there was, I'm not sure they are still around as most of the internet sources a simply a roll of the dice and adding your name to a database of a less then legitimate way to obtain pain meds.
I met a guy on the net that was buying the 15/35's from the net and was going through withdraswal from over 300 mgs of hydro a day, withdrawal is withdrawal, hydro isn't any easier, it has all the same side effects of oxy, If oxy makes you itch a high dose of hydro causes the same hystamine repsponse but that will deminish as you become acomadated.
If your internet source is outside the country how do you even know your not getting caplets filled with sugar, No FDA, NO QC, No gaurentee and the posibility of prosecution buying controlled meds from less than legitamate sources.
Within the next couple years Hydro will be a class 11 med too, It's the most abused prescription narcotic there is. Once it bocomes a class 11, The same rules and regs will be enforced, your use will be tracjked, your doc will be cmore closely watched, I'm just curious why someone would want to spend 3 times the price of pharmacuetical med?
I can certainly imagine why smeone would want a pure hydro capsule with no filling agents but bather than guesing why someone wants to spend more money on weaker meds, I'll just wait for an answer?
Dave
thomason
06-23-2004, 01:51 AM
I wouldn't refuse to be treated with oxycodone, just seems that theres a stigma attached to it and the things I've heard about pharmacies just refusing to fill them.
I didn't realize that flying under the radar was something people try to do by using the hydro.
I'd like to whatever (oxy or hydro) at the minimum amount required to treat my pain level. I don't necessarily like that my tolerance levels seem to go up so much initially, that if I need to come off of it, the harder it will be with the higher doses.
I guess there is a point when you have to jump up to the oxys, and even though you might get some attitude from pharmacies, thats just part of having to deal with CP.
I didn't realize that flying under the radar was something people try to do by using the hydro.
I'd like to whatever (oxy or hydro) at the minimum amount required to treat my pain level. I don't necessarily like that my tolerance levels seem to go up so much initially, that if I need to come off of it, the harder it will be with the higher doses.
I guess there is a point when you have to jump up to the oxys, and even though you might get some attitude from pharmacies, thats just part of having to deal with CP.
NeedANewJaw
06-23-2004, 02:44 PM
I took compounded hydro for quite a while and it worked well for me...but i was using it for BT meds.
When you take out the apap, it makes the hydro a sched II drug.
Its not as expensive as you would think tho...i got 90 a month and it was $109.
let me know if you have more questions.
When you take out the apap, it makes the hydro a sched II drug.
Its not as expensive as you would think tho...i got 90 a month and it was $109.
let me know if you have more questions.
madhatter
06-23-2004, 06:29 PM
I guess what i meant to say was why not have a time release hydrocodone?All oxycotin is , is a time release percocet.[but stronger]without all the tylonol or asprin.
NeedANewJaw
06-23-2004, 06:35 PM
Hatter....i have heard people's opinion on that very question several times but for some odd reason, NONE come to mind!! i will think and get back to ya if any come to mind. :confused:
You CAN get compounded hydro into time released meds in addition to instant release (the ones i took). Again its not that expensive...in fact compared to oxy and some others its ALOT cheaper if you have to pay for your meds. Some insurances will reimburse you for what you spend on the compounded meds, mine did.
It would be nice for those of us that respond to hydro better than oxy products to have a SR hydro.
You CAN get compounded hydro into time released meds in addition to instant release (the ones i took). Again its not that expensive...in fact compared to oxy and some others its ALOT cheaper if you have to pay for your meds. Some insurances will reimburse you for what you spend on the compounded meds, mine did.
It would be nice for those of us that respond to hydro better than oxy products to have a SR hydro.
Shoreline
06-24-2004, 07:34 PM
Hey Need a new jaw, What strength of Hydro did you have compounded, did they add dex to make it LA, If it becomes a class 11 without the apap, it just comes down to what med works best. $109 for 90 of anything these days isn't a bad price, I jus paid 85 bucks for percocet 10/325 generic by endo. Hydro does break down a little different than oxy but it's still the same classs of opiate. I would think we would catch less crud from a compounding pharmacist when he knows a little more about our condition and why his specialized services are needed.
Thanks for the heads up, Perhaps compounding may work for me since I can't find a BT that's afordable any stronger than MSIR generic 30mg, Dilaudid has a short half life and has a shorter duration than oxy or morphine, it works much better IV but You get the raised eyebrow with dilaudid too because of the IV abuse.
Thanks for the info, Dave
Thanks for the heads up, Perhaps compounding may work for me since I can't find a BT that's afordable any stronger than MSIR generic 30mg, Dilaudid has a short half life and has a shorter duration than oxy or morphine, it works much better IV but You get the raised eyebrow with dilaudid too because of the IV abuse.
Thanks for the info, Dave
NeedANewJaw
06-24-2004, 11:42 PM
glad i could help you with some info, friend :p thats not the norm ;)
The pharmacist was VERY nice and also very helpful. I got into the habit of calling a few days before my script was due so he always made sure to have them ready for me. He also would let my doc fax a script, then he would fill it...as long as i had the written script to bring in. And he also let me fill it and take it with a "regular" script and my doc followed up with sending him a green script (how our sched II meds are done here). He was just a great resource in general. I was getting 20 mgs of hydro, pure nothing added. Although I would have liked to try adding the dex if i ever had to get them again. He did make the first script sustaned release for me since it didnt specify instant. Those didnt work well at all...although im sure at a higher dosage it would have. I was on the patch at the time so i wanted the instant ones for BT meds. My doc was willing to let me try them since we both felt there was a good chance I was getting rebound headaches from the norco i had taken for several years. Not to mention liver issues from all that apap. And i did notice a decrease in my head pain while on them.
I know you know this already shore, but since i switched to using the 30 mg roxicodone....and declared it the BEST hands down BT med...ive never used another :D but the pure hydro came close!
Just out of curiousity...do you know what 90 generic roxi's run? I agree the $109 i paid wasnt near as expensive as I thought it would be. And they gave me a claim form to send in to my insurance. I had problems with them but that wasnt the pharmacy's fault.
All and all it was a good experience and one that I try to tell whenever someone asks about hydro without the apap. Im trying to get that word out!! :wave:
take care my friend
waiting to hear back for ya...let me know if you didnt get my last coorespondence.
The pharmacist was VERY nice and also very helpful. I got into the habit of calling a few days before my script was due so he always made sure to have them ready for me. He also would let my doc fax a script, then he would fill it...as long as i had the written script to bring in. And he also let me fill it and take it with a "regular" script and my doc followed up with sending him a green script (how our sched II meds are done here). He was just a great resource in general. I was getting 20 mgs of hydro, pure nothing added. Although I would have liked to try adding the dex if i ever had to get them again. He did make the first script sustaned release for me since it didnt specify instant. Those didnt work well at all...although im sure at a higher dosage it would have. I was on the patch at the time so i wanted the instant ones for BT meds. My doc was willing to let me try them since we both felt there was a good chance I was getting rebound headaches from the norco i had taken for several years. Not to mention liver issues from all that apap. And i did notice a decrease in my head pain while on them.
I know you know this already shore, but since i switched to using the 30 mg roxicodone....and declared it the BEST hands down BT med...ive never used another :D but the pure hydro came close!
Just out of curiousity...do you know what 90 generic roxi's run? I agree the $109 i paid wasnt near as expensive as I thought it would be. And they gave me a claim form to send in to my insurance. I had problems with them but that wasnt the pharmacy's fault.
All and all it was a good experience and one that I try to tell whenever someone asks about hydro without the apap. Im trying to get that word out!! :wave:
take care my friend
waiting to hear back for ya...let me know if you didnt get my last coorespondence.
Shoreline
06-25-2004, 01:00 PM
Hey NANJ, I would also say the 30mg roxi was the best BT med I ever used, It has a longer half life and duration than morphine and Dilaudid. Howevr it's still name brand only and last I priced a 100 30mg roxi would run about 175 bucks. A little to steep right now.
Thanks for the info, I will call a compounding paharmacy and ask what they can do as far as creaitng something similar to the roxi, they can't make a pure 30 mg due to patent infringement, they have to justify the need to compound because an alternative is not available, But compounding a 25 or a 35 would not infringe on the patent of Roxi. So we'll see. I'm actually surprised by how little BT meds I'm needing now, smaller doses work better and aren't needed as often. Thanks for the info.
As far as the article about FBSS, The whole psych screening thing was a bit bothersome, Not every comp patient is looking to get sliced open to further their case for secondary gain. Including the psych components to all this does change things but I don't believe to the extent they are suggesting, It's a easy way to expalin an unsuccesful or unhappy patient, All 3 of my surgeries failed, proven by the next surgery and then diagnostics, No bone where it was suppoesed to be, But every doc treated my like an addict for the 2 years following each surgery and proclaimed their surgery based of Xrays a success, that really don't tell you if bone is alive or just sitting there. The way my fusion was done last time was with ground up cadavor and my own from the iliac crest, they added an enzyme to the paste and slapped it in like morter posteriorly and with each Xray there was less and less grafted bone seen, he explained it away as excess that would be reabsorbed, well it was all reabsorbed, It just took several years of me telling docs something was wrong and him telling me it was in my head to actually learn the truth.It takes a couple years for all the bone to be reabsorbed or to be displacec. Calling a a fusion a success at the 2 week post op check based n Xrays is smply a plecebo to put positive thoughts in your head. What doc is going to say it failed within 2 weeks, the bone is still there, the hardware prevents movement so it's called a success
The closest they can come to telling if a Fusion is alive and thriving is bone scan, however bone scan will show activity, hot spots, where there is growth going on or where there is deterioation, or where plateletes have been layed down, It's not copnclusive in any way, no way to tell the diff..
My fusions were all confirmed solid by the surgeons after their procedure by Xrays which don't tell you squat about bone being alive or not. You can see donor bone but it's much lighter than normal solid bone, any sight of bone was declared succesfull. Up untill the next surgery when all the donar bone was flaked out like dried fish.
That article also basically didn't mention any aspect of patient reporting, It talked of docs expertise and the type of procedure whether it's proven and excepted but nowhere was patient reporting considered other than during titration of opiates.
Thanks for the info, Dave
Thanks for the info, I will call a compounding paharmacy and ask what they can do as far as creaitng something similar to the roxi, they can't make a pure 30 mg due to patent infringement, they have to justify the need to compound because an alternative is not available, But compounding a 25 or a 35 would not infringe on the patent of Roxi. So we'll see. I'm actually surprised by how little BT meds I'm needing now, smaller doses work better and aren't needed as often. Thanks for the info.
As far as the article about FBSS, The whole psych screening thing was a bit bothersome, Not every comp patient is looking to get sliced open to further their case for secondary gain. Including the psych components to all this does change things but I don't believe to the extent they are suggesting, It's a easy way to expalin an unsuccesful or unhappy patient, All 3 of my surgeries failed, proven by the next surgery and then diagnostics, No bone where it was suppoesed to be, But every doc treated my like an addict for the 2 years following each surgery and proclaimed their surgery based of Xrays a success, that really don't tell you if bone is alive or just sitting there. The way my fusion was done last time was with ground up cadavor and my own from the iliac crest, they added an enzyme to the paste and slapped it in like morter posteriorly and with each Xray there was less and less grafted bone seen, he explained it away as excess that would be reabsorbed, well it was all reabsorbed, It just took several years of me telling docs something was wrong and him telling me it was in my head to actually learn the truth.It takes a couple years for all the bone to be reabsorbed or to be displacec. Calling a a fusion a success at the 2 week post op check based n Xrays is smply a plecebo to put positive thoughts in your head. What doc is going to say it failed within 2 weeks, the bone is still there, the hardware prevents movement so it's called a success
The closest they can come to telling if a Fusion is alive and thriving is bone scan, however bone scan will show activity, hot spots, where there is growth going on or where there is deterioation, or where plateletes have been layed down, It's not copnclusive in any way, no way to tell the diff..
My fusions were all confirmed solid by the surgeons after their procedure by Xrays which don't tell you squat about bone being alive or not. You can see donor bone but it's much lighter than normal solid bone, any sight of bone was declared succesfull. Up untill the next surgery when all the donar bone was flaked out like dried fish.
That article also basically didn't mention any aspect of patient reporting, It talked of docs expertise and the type of procedure whether it's proven and excepted but nowhere was patient reporting considered other than during titration of opiates.
Thanks for the info, Dave
NeedANewJaw
06-25-2004, 01:07 PM
Maybe you should write an article and send it in. something from the patients point of view! you have such a way with words and are able to explain things in a way that the average lay person can understand.
Im serious here! :p
I was under the impression there was a generic roxi. Reason being is that the first 6 months or so I was prescribe the 30 mg roxi, my copay was $30 which it is for name brands. Then one month my doc wrote "roxicodone oxycodone" on the script, instead of just roxicodone. And when they rang it up it was only $7, which is what a generic costs. I asked them about it and they said my doc wrote it for the generic. Odd huh? The pills looked exactly the same and worked the same too. Now the next month I had my doc go back to just writing roxicodone, and I got the generic again.
This last month they were out of the brand name so gave me the generic again.
Perhaps this is something new??? i could ask when I go get my next refill which is early next week.
let me know what you think!
Im serious here! :p
I was under the impression there was a generic roxi. Reason being is that the first 6 months or so I was prescribe the 30 mg roxi, my copay was $30 which it is for name brands. Then one month my doc wrote "roxicodone oxycodone" on the script, instead of just roxicodone. And when they rang it up it was only $7, which is what a generic costs. I asked them about it and they said my doc wrote it for the generic. Odd huh? The pills looked exactly the same and worked the same too. Now the next month I had my doc go back to just writing roxicodone, and I got the generic again.
This last month they were out of the brand name so gave me the generic again.
Perhaps this is something new??? i could ask when I go get my next refill which is early next week.
let me know what you think!
sgibson
06-25-2004, 01:36 PM
Hey Shoreline,
I use a generic roxicodone. It's liquid, I don't know if that makes a difference or not. It's made by Mallinckrodt. I have used the name brand Roxicodone when the pharmacy didn't have the generic. It comes in 5mg/5ml. I take 20mg or 4tsp per dose. I'm not real sure about whether it's just the 30mg pill you were talking about or not, but I wanted to let you know if you didn't mind liquid the roxi is available in generic. I get 3 500ml bottles at a time and at one mom and pop pharmacy (the one I use) it's 149.00, at the other pharmacy I have used when main one is out, the same thing is 85.00 I know it's a big difference but since I have drug coverage, it doesn't really matter to me. The pharm I use is only 2 blocks from my house. The other pharm is near my docs office so it's too far to drive unless there are extenuating circumstances. The Wal-mart near my house didn't carry it and wouldn't order it either. I don't know if maybe your wal-mart might carry it because you live in a larger town. The mom and pop pharm I use didn't carry it until I started getting it. He orders it just for me. He has done this for other scripts for me also. If I can be of any help just let me know.
God Bless
Sherry :wave:
I use a generic roxicodone. It's liquid, I don't know if that makes a difference or not. It's made by Mallinckrodt. I have used the name brand Roxicodone when the pharmacy didn't have the generic. It comes in 5mg/5ml. I take 20mg or 4tsp per dose. I'm not real sure about whether it's just the 30mg pill you were talking about or not, but I wanted to let you know if you didn't mind liquid the roxi is available in generic. I get 3 500ml bottles at a time and at one mom and pop pharmacy (the one I use) it's 149.00, at the other pharmacy I have used when main one is out, the same thing is 85.00 I know it's a big difference but since I have drug coverage, it doesn't really matter to me. The pharm I use is only 2 blocks from my house. The other pharm is near my docs office so it's too far to drive unless there are extenuating circumstances. The Wal-mart near my house didn't carry it and wouldn't order it either. I don't know if maybe your wal-mart might carry it because you live in a larger town. The mom and pop pharm I use didn't carry it until I started getting it. He orders it just for me. He has done this for other scripts for me also. If I can be of any help just let me know.
God Bless
Sherry :wave: