twisten
07-26-2004, 08:41 PM
Anyone else have this problem with mscontin? Mine got so bad that the doc changed my meds today. I'm a bit more stable now so we are going to try to lower my meds and see if the pain becomes really intense again or not. I think maybe she may have lowered me to much off the start today though. Shore what is your take of these dosages? I was on MScontin 30 mg. a.m and 60 mg. p.m. I had oxyir 10mg for breakthrough and could take up to 3 of them a day if I really needed to. She has now put me on oxycontin 20 mg twice a day and dilaudid 2 mg twice a day. Is the conversion close on the oxyir I had been on to the dilaudid she has me on now? We are hoping to get me to the lowest dose possible but I don't want to do it to fast and go through withdrawal. Anyone's opinions on this would be much appreciated.
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twisten
07-27-2004, 07:25 PM
Does anyone know if these conversions are right??
Shoreline
07-27-2004, 10:30 PM
Hey Twist, the charts are just guides and shouldn't replace patient reporting. From what I have experienced, Oxy is stronger than morphine, so a decrease there is expected, As far as replacing 10 mgs of Oxy IR with 2mg dilaudid, It's acurate on the charts , but the best charts will do is hopefully keep you from experiencing withdrawal, and defintely to prevenmt patient overdose.
The twitch is caused by the M6g metabolite, Been there, done that and read plenty about it. It can be treated with the same meds for restless leg syndrom, The antiparkinsons meds.I didn't tolerate miripex or requip well and My doc had me try high doses of niacin and eventually we found Klonopin worked well and has a long half life to prevent any withdrawal effect between doses.
The one thing about dlaudid, Although it's a great IV pain med and perfectly suited for PCA. Orally, it has a shorter half life than oxy and generally lasts 30-60 minutes less.
But 2mg may seeem like an increase to you and you may think wonder drug and cheap.
Funny thing happened to me trying to fill my BT meds, Dilaudid, 4mg. My great pharmacy at sams where everything is 1/3 the price didn't have any. It comes tomorrow, So I figure I go to the next on my list, Walgreens, The same genric dilaudid made by Mekllenkrodt was 56 bucks at Walgreens and 26 bucks at Sam's, Walgreens to my dismay says they don't price match. No way, so I go to Eckerds, all on different corners of the intersection. I ask eckerds what the price was, 76 bucks for the same med, same dose, same manufacturer. But they do match price. I have paid attn to the signs hanging in front of the pharmacy, I pulled out my tab I keep in my wallett from my last fill of dilaudid, they confirmed it and I got the 76 dollar dilaudid at Eckerds for 26 and change. 1/3 their normal price
Buyer beware, you friendly neighbohod pharmacist is 10 times worse then the idea most people have of the ordinary car salesman trying to make a living when the client thinks the salesman is trying to get you when all the time, the sales manager and finance office are figuring out a way to transfer the profit to the back end "financing" where the salesman makes squat and the dealerships makes a killing. 40-5o bucks a car on most promo deals. I was in that buisness for 4 years and there isn't much more than 10% profit on the price of any new car, used is a different story and financing is where most get bent. Rebates change things but folks that think a 16 K car can be bought for 11 or 12, Unless there is a 5k rebate I showed em the door or snapped them into reality. Take 10% off MSRP and your getting it for dealer cost. All the add on ademedums are just added profit to negotiate back down to the 10% profit made on MSRP. That's the truth of new cars.Higher end with extra luxury may be 12-15 % but usually have the big rebates, Sorry to ramble off. It just made me sick knowing what this stuff cost and what the big chains want you to pay.Walkgreens and eckerds will seell it 100% or 200% higher than the store across the street and smile.
But when the pharmacist smiles to poor old widowed Ms Johnson, and plays concerned healthcare worker, He knows exactly what his company is doing, particulary because the get a bonus on pushing generics where the profit margins reach the 1000's. She pays 3 times the amount in cash, out of her social security check for the exact same med she can get by walking across the street. But my pharmacist is nice and will look out for me. PLEASE. The KY is there on the counter for a reason.
Take it easy, Dave
The twitch is caused by the M6g metabolite, Been there, done that and read plenty about it. It can be treated with the same meds for restless leg syndrom, The antiparkinsons meds.I didn't tolerate miripex or requip well and My doc had me try high doses of niacin and eventually we found Klonopin worked well and has a long half life to prevent any withdrawal effect between doses.
The one thing about dlaudid, Although it's a great IV pain med and perfectly suited for PCA. Orally, it has a shorter half life than oxy and generally lasts 30-60 minutes less.
But 2mg may seeem like an increase to you and you may think wonder drug and cheap.
Funny thing happened to me trying to fill my BT meds, Dilaudid, 4mg. My great pharmacy at sams where everything is 1/3 the price didn't have any. It comes tomorrow, So I figure I go to the next on my list, Walgreens, The same genric dilaudid made by Mekllenkrodt was 56 bucks at Walgreens and 26 bucks at Sam's, Walgreens to my dismay says they don't price match. No way, so I go to Eckerds, all on different corners of the intersection. I ask eckerds what the price was, 76 bucks for the same med, same dose, same manufacturer. But they do match price. I have paid attn to the signs hanging in front of the pharmacy, I pulled out my tab I keep in my wallett from my last fill of dilaudid, they confirmed it and I got the 76 dollar dilaudid at Eckerds for 26 and change. 1/3 their normal price
Buyer beware, you friendly neighbohod pharmacist is 10 times worse then the idea most people have of the ordinary car salesman trying to make a living when the client thinks the salesman is trying to get you when all the time, the sales manager and finance office are figuring out a way to transfer the profit to the back end "financing" where the salesman makes squat and the dealerships makes a killing. 40-5o bucks a car on most promo deals. I was in that buisness for 4 years and there isn't much more than 10% profit on the price of any new car, used is a different story and financing is where most get bent. Rebates change things but folks that think a 16 K car can be bought for 11 or 12, Unless there is a 5k rebate I showed em the door or snapped them into reality. Take 10% off MSRP and your getting it for dealer cost. All the add on ademedums are just added profit to negotiate back down to the 10% profit made on MSRP. That's the truth of new cars.Higher end with extra luxury may be 12-15 % but usually have the big rebates, Sorry to ramble off. It just made me sick knowing what this stuff cost and what the big chains want you to pay.Walkgreens and eckerds will seell it 100% or 200% higher than the store across the street and smile.
But when the pharmacist smiles to poor old widowed Ms Johnson, and plays concerned healthcare worker, He knows exactly what his company is doing, particulary because the get a bonus on pushing generics where the profit margins reach the 1000's. She pays 3 times the amount in cash, out of her social security check for the exact same med she can get by walking across the street. But my pharmacist is nice and will look out for me. PLEASE. The KY is there on the counter for a reason.
Take it easy, Dave
Kissa
07-27-2004, 10:56 PM
On the daytime news a while ago they did a report on the cost of medications at various pharmacies. Walgreens by far is the highest in area where I live, according to them they are charging people for convienance because many are open 24/7. We do not have an Eckards here that I know of. The cheapest was Costco, you do not need a membership to fill your medications there at all. CVS was in the top of over priced and our grocery store Giant Eagle was actually the next to the lowest price, unfortunately they will not fill anything stronger than vicodin so I go someplace else for my MS contin, generic price for 28 pills 30 mg (2 weeks) was $7.00 for my copay (80/20) not sure how that compares to others.
I generally do not use mom and pop places because they can not get the discount that the bigger chains can, they buy in bigger bulk and therefor the meds are cheaper to fill for the most part and often they have very limited business hours.
It does pay immensely to look around for your medications. Most pharmacies are pretty up front if you tell them what you are looking for and give you a fairly accurate price before any insurance plays into it. My husband used to get his antacids filled at CVS and his copay was some $40 a month, I decided to swap pharmacies because CVS really screwed up and filled a med that could of potentially killed me (severe allergy) and went to our nearest Giant Eagle to fill his antacids, a full month supply for the exact same product name brand was only $15. I will never go to CVS again unless I get a med I can not fill else where.
I generally do not use mom and pop places because they can not get the discount that the bigger chains can, they buy in bigger bulk and therefor the meds are cheaper to fill for the most part and often they have very limited business hours.
It does pay immensely to look around for your medications. Most pharmacies are pretty up front if you tell them what you are looking for and give you a fairly accurate price before any insurance plays into it. My husband used to get his antacids filled at CVS and his copay was some $40 a month, I decided to swap pharmacies because CVS really screwed up and filled a med that could of potentially killed me (severe allergy) and went to our nearest Giant Eagle to fill his antacids, a full month supply for the exact same product name brand was only $15. I will never go to CVS again unless I get a med I can not fill else where.
twisten
07-28-2004, 02:46 AM
My husband and I both have insurance so they cover most of my med costs including dilaudid and oxycontin. Boy am I thankful for that. Because I didn't have to pay anything I never noticed the cost on the receipt. I've already shredded it but I will look next time. I know 1 of them was around $85. and the other $15. but can't remember which. Pain wise I'm having trouble adjusting to these new ones. I just can't seem to be able to get on top of it. I don't think she'll raise my oxycontin but I was supposed to tell her if the dilaudid wasn't helping much and she said she would approve me to take more so I guess I'll phone her in a few days. I want to give it a couple more days (if I can stand it) before I call just in case things improve. Thanks for the help I really appreciate it.
Shoreline
07-28-2004, 12:23 PM
Hey Twist, The conversion from MSC to OxyC really is a little low, But often docs start low hoping your response will be better to the new med. The conversion I generally use for oxy to MSC or vice versa is 1.5:1 meaning 90 mgs of MSC should be replaced with 60 mgs of OxyC, a 1/3 decrease in base med would likely be felt if not throw someone into withdrawal.
An interesting thing about dilaudid is that the new 8 mg strength, even generic is more than twice what 2 4mg pills would cost.
I had Sam's print me a copy of my cash price. 200 4mg pills was 38 bucks where 100
8mg pills was 96 bucks. Pay twice as much for the convenience of only taking one pill, It's not that convenient.
I found the same thing with the 10 mg percocet, you can buy twice as many 5mg percocet than you can 10 mg percocet for about half the price. Even cheaper is buying generic 5mg Roxicodone, or simply 5mg oxycodone tablets which only cost about 35 cents a piece where I paid close to 90 bucks for 40 generic 10 mg percocet, 2 bucks a piece verses 70 cents for 10mgs of plain oxycodone. Add a plain old tylenol if it helps that much.
My doc actually put the printout in my file as they are trying to limit their BT meds to 60 a month, which is tough for patients that need stronger and cheap BT meds. I need 2 4mg dilaudid at a time to make a dent or 2 30mg MSIR at a time. Both those meds are the cheaper of the higher strength BT meds. 30 mg Roxi, Oxyfast or OxyDose would cost 3-4 times the price of generic dilaudid or generic MSIR In equal strength doses.
Sams is the same way, you don't need a membership to use their pharmacy. Prices are pretty comparable at their sister stores Walmart. The reason for this is that the true Pharmacies are in buisness to sell meds and make the bulk of their money in the pharmacy, the front end, sundries are just there to pick up while waiting for high priced meds.
Where Sams, costco and even stores like Kmart or Walmart offer pharmacy services as a convenience or added benefit of shopping in their store and don't depend on the huge profits in the pharmacy to keep the doors open. Rite aid, Eckerds, CVS and true drug stores are in the buisness of selling prescription drugs and OTC meds. The buying clubs make their money on big ticket items, TV's, tires, clothing, etc. The only time I step foot into a drug store is out of sheer necessity
An interesting thing about dilaudid is that the new 8 mg strength, even generic is more than twice what 2 4mg pills would cost.
I had Sam's print me a copy of my cash price. 200 4mg pills was 38 bucks where 100
8mg pills was 96 bucks. Pay twice as much for the convenience of only taking one pill, It's not that convenient.
I found the same thing with the 10 mg percocet, you can buy twice as many 5mg percocet than you can 10 mg percocet for about half the price. Even cheaper is buying generic 5mg Roxicodone, or simply 5mg oxycodone tablets which only cost about 35 cents a piece where I paid close to 90 bucks for 40 generic 10 mg percocet, 2 bucks a piece verses 70 cents for 10mgs of plain oxycodone. Add a plain old tylenol if it helps that much.
My doc actually put the printout in my file as they are trying to limit their BT meds to 60 a month, which is tough for patients that need stronger and cheap BT meds. I need 2 4mg dilaudid at a time to make a dent or 2 30mg MSIR at a time. Both those meds are the cheaper of the higher strength BT meds. 30 mg Roxi, Oxyfast or OxyDose would cost 3-4 times the price of generic dilaudid or generic MSIR In equal strength doses.
Sams is the same way, you don't need a membership to use their pharmacy. Prices are pretty comparable at their sister stores Walmart. The reason for this is that the true Pharmacies are in buisness to sell meds and make the bulk of their money in the pharmacy, the front end, sundries are just there to pick up while waiting for high priced meds.
Where Sams, costco and even stores like Kmart or Walmart offer pharmacy services as a convenience or added benefit of shopping in their store and don't depend on the huge profits in the pharmacy to keep the doors open. Rite aid, Eckerds, CVS and true drug stores are in the buisness of selling prescription drugs and OTC meds. The buying clubs make their money on big ticket items, TV's, tires, clothing, etc. The only time I step foot into a drug store is out of sheer necessity
twisten
07-28-2004, 12:57 PM
Thanks Shoreline. I thought maybe it was too low as my pain has increased a lot. Thank goodness I'm not dealing with withdrawal though (at least I don't think so). I hardly slept last night so I'll give things one more day and if they don't improve I'll have to call my doc tomorrow. I didn't realize the higher the mg on meds the more expensive. You would think they would all be the same price. I guess, like you said, we pay the cost of convenience.
vamp36
07-28-2004, 05:02 PM
I have a question on the twitching. I have the twitching every time I am laying down for a nap or to go to sleep at night. Thats the only time I get it. Is this from the MSC & Dilaudid as well?