inpaininnv
01-14-2005, 08:02 PM
I know that it is name brand Palladone, but what exactly is this drug and how does it work. Also, how does it differ/compare to the other narcotic pain meds. When will it be available here in the U.S.? Thanks
Car
Car
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klh121560
01-14-2005, 08:21 PM
Hydromorphone is called in brand name by Dilaudid. Comes in injectible, intramuscular and oral methods. Oral comes in 2mg, 4mg, and 8mg.
It is a short acting opiod. Usually takes effect in about an hour and lasts maybe 2-3 hours. It is said to be a very potent opiod, but having been personnaly on it, I am not impressed. It is more used after surgery for pain relief in an IV method, and from what I have heard, it is very good. It loses alot in oral form (in my opinion).
Palladone is, or will be, the long acting version of hydromorphone. It will come in 12mg, 16mg, 24mg and 32mg. I spoke with the company medical representative, and he told me it is schedule to be released in late March 05'. However it will be in limited release in that their sales force will only be meeting with certain prescribing doctors. Mainly pain management docs and not GP's or other non pain docs.
I would certainly try hydromporhone first and see if it works and in what dose before considering palladone.
A few other things. Palladone will be marketed as a 24 hour medication that can be taken once a day, and as a 12 hour dosage if needed. The other thing I found is that there is a significant cost difference between hydromorphone and dilaudid. Hydro of course the generic being less expensive. But also in the size pill cost difference. The 8mg tabs were almost twice expensive as the 4mg. I would recommend to anyone taking it, get the 4mg tabs. The tabs are so small in any size that it is almost impossible to cut in half so you save nothing. The cost of the 4's are where it makes the difference.
As far as comparison, it is stronger than several other narcotics. But don't go by that, go by what works best for you and gives you the best pain relief. So many just go by others experiences and don't realize everyones body is different.
Hope that helps!
Peace,
Ken
It is a short acting opiod. Usually takes effect in about an hour and lasts maybe 2-3 hours. It is said to be a very potent opiod, but having been personnaly on it, I am not impressed. It is more used after surgery for pain relief in an IV method, and from what I have heard, it is very good. It loses alot in oral form (in my opinion).
Palladone is, or will be, the long acting version of hydromorphone. It will come in 12mg, 16mg, 24mg and 32mg. I spoke with the company medical representative, and he told me it is schedule to be released in late March 05'. However it will be in limited release in that their sales force will only be meeting with certain prescribing doctors. Mainly pain management docs and not GP's or other non pain docs.
I would certainly try hydromporhone first and see if it works and in what dose before considering palladone.
A few other things. Palladone will be marketed as a 24 hour medication that can be taken once a day, and as a 12 hour dosage if needed. The other thing I found is that there is a significant cost difference between hydromorphone and dilaudid. Hydro of course the generic being less expensive. But also in the size pill cost difference. The 8mg tabs were almost twice expensive as the 4mg. I would recommend to anyone taking it, get the 4mg tabs. The tabs are so small in any size that it is almost impossible to cut in half so you save nothing. The cost of the 4's are where it makes the difference.
As far as comparison, it is stronger than several other narcotics. But don't go by that, go by what works best for you and gives you the best pain relief. So many just go by others experiences and don't realize everyones body is different.
Hope that helps!
Peace,
Ken
Shoreline
01-14-2005, 08:39 PM
Ken's right about everything he said. The one advantage of Palladoneis the way it's delivery systemm is designed, the half life of Palladone, the 24 hour versionis 18 hours, short acting Dilaudid has a half life of about 2 hourts, not at all mpressive orally but great IV or in PCAafter surgery, becaue you have a continous supply that doesn't wear off.
Dilaudid is rated about 7 times stronger than morphine MG to mg. The 18 hour half life of of Pallodone shold take care of the short acting oral meds, he's absolutely right about the 4mg pills vs the 8's. It's not so conveinient I would pay more than twice as much.
Hydromorpohone is a synthetic opiate, in the same class of keto opiates as Hydrocodone, oxycodone, hydromorphone, oxymorphone, natyraly occuring opiates are mmorphine, codeine and heroin "diacetyl morphone. Heroi is is just the trade name Dimorphone is still sed in the UK and other countries, the US has banned it as a class 1 drug with no theraputic value due to horoin abuse.
The other class of opiates are the fenatnyls, suffentanyl, affentanyl and carfebntatanyl, other than plain fentanyl you won't get one of the other fent outside the surgery areana, although a suffenatnyl patch is in the works by endo, It's's the stronger mtablite that Fentanyl breaks down into, Fentanyls are very short acting and need a deliver system like the patch tha gve yo u a continous dose, It's IV half life is mere minutes, so you have to have continous dosing for the fents to be effective, Demerol is also in the same class as fentanyl but not used for long term treatment due to risk of seizure after prolonged use.
The last class of synthetic opiates are methadone, Darvon and levorphanol.
Take care, Dave
Dilaudid is rated about 7 times stronger than morphine MG to mg. The 18 hour half life of of Pallodone shold take care of the short acting oral meds, he's absolutely right about the 4mg pills vs the 8's. It's not so conveinient I would pay more than twice as much.
Hydromorpohone is a synthetic opiate, in the same class of keto opiates as Hydrocodone, oxycodone, hydromorphone, oxymorphone, natyraly occuring opiates are mmorphine, codeine and heroin "diacetyl morphone. Heroi is is just the trade name Dimorphone is still sed in the UK and other countries, the US has banned it as a class 1 drug with no theraputic value due to horoin abuse.
The other class of opiates are the fenatnyls, suffentanyl, affentanyl and carfebntatanyl, other than plain fentanyl you won't get one of the other fent outside the surgery areana, although a suffenatnyl patch is in the works by endo, It's's the stronger mtablite that Fentanyl breaks down into, Fentanyls are very short acting and need a deliver system like the patch tha gve yo u a continous dose, It's IV half life is mere minutes, so you have to have continous dosing for the fents to be effective, Demerol is also in the same class as fentanyl but not used for long term treatment due to risk of seizure after prolonged use.
The last class of synthetic opiates are methadone, Darvon and levorphanol.
Take care, Dave
twisten
01-14-2005, 10:43 PM
I've been on dilaudid in the past both IV form and oral, the IV form is definitely better than the oral. I found the oral only lasted a very short time for me, approximately 2 to 2 1/2 hours. There was a mix up in a hospital in the ER department in Alberta recently where a patient was supposed to receive morphine by iv but was given hydromorphone instead. The hospital caught it after the man had left. The family brought him back in right away but he overdosed and they couldn't save him. Most hospitals here now don't have it in the ER any longer because of this and they've also changed the packaging as it was quite similar to the morphine.
inpaininnv
01-15-2005, 12:14 AM
Thanks guys
Ya know what one thing I read that was interesting is it does not matter which med is stronger, it matters which meds works for you personally. Now see when I started pm I was kinda upset about being prescribed methadone because I had not really heard of that drug and did not know much about it. the only 2 drugs I had heard of where Oxycontin and ms contin. I finnally realized how hard this pm road has been after 2 years. All The med switches at dr's request. The withdrawls from med switches. The months and months of trying to get the dosage right.
I know I know that has nothing to do with what I posted but I am always keeping watch for a new drug that could maybe help me and keep a steady dose of meds in my system.
Car
Ya know what one thing I read that was interesting is it does not matter which med is stronger, it matters which meds works for you personally. Now see when I started pm I was kinda upset about being prescribed methadone because I had not really heard of that drug and did not know much about it. the only 2 drugs I had heard of where Oxycontin and ms contin. I finnally realized how hard this pm road has been after 2 years. All The med switches at dr's request. The withdrawls from med switches. The months and months of trying to get the dosage right.
I know I know that has nothing to do with what I posted but I am always keeping watch for a new drug that could maybe help me and keep a steady dose of meds in my system.
Car
Shoreline
01-15-2005, 10:25 AM
Your right car, the equianelgesic charts don't gaurentee that a patient will get better relief from a med that's 7 times stronger than another acording to a chart. Those charts are just guides to transfer a patient from one med to another and get them in the same ballpark, without causing an OD. JUst because a chart says Hydromorph is7 times stronger doesn't mean someone will get the same relief. as the "equal amount of morphine". Morphine is just the gold standard to whch other meds are compared. But morphine is an opiate where hydromorph is an opioid, ones synthetic and one can be extrated naturally from opium. However all meds are synthetically created now, They figured out how to synthsize the morpheine molucle and the codeine molocule in '79, so you don't even need opium or thybaine to create morphine any longer. They know what the molecular structure of morphine is and simply synthasize it. Now a days, all opiates/opioids are syntheticbut still bind to different receptors and create different patient response.
I would be more hopefull that duration wouldn't be such a huge factor with palladone, due to it's releasse system creating an 18 hour half life. Although it's claimed to be a true 24 hour med Purdues claims haven't always resulted in clinical efectiveness. Purdue still insist OxyContin lasts 12 hours and I can think of one person that succesfully used it every 12 hours but had plenty of OxyFast from the 8th to 12th hour. What would stink is if the doc doesn't believe in BT meds.
Some docs think a higher dose will make it last longer due to purdues campaign which just inflates the daily intake but stlill leaves the same gaps. A lower daily dose could be obtained and a smoother serum level if Purdue would just get of their 12 hour claim to fame and desire to sell their short acting meds to bridge the gap.
For example, IF 40mgs twice a day isn't working, some docs will go to 80 mgs twice a day, now that should work acordng to Purdue. NOT, You would likely do better with 40 mgs 3 times a day, get smoother coverage without the ups and downs, reduce the amount of everyday use of BT meds and your daily dose would be less. But purdue rides on that 12 hour claim and would rather see you using one of their BT meds like Oxy IR or oxyfast to cover the gaps.
There was even a class action suite that Purdue knew this but still sent out letters to every doc and every pharmacist saying anything other than BID scripts shuld not be written or filled. IF you recieve your meds thrugh Purdues patient asistance program, they won't except a script written for anything other than twice a day dosing.
The suite claimed that purdue knew their product didn't last in the majority of patients and their suggestion to use BT meds was a marketing ploy to enhance their short acting med sales in addition to to the billions they make on OxyC. Fortunately, all the Oxy patents have expired, OxyC, OxyIR and OxyFast, I don't really get the idea that liquid oxycodone should be somehow protectd by a patent but they got it, same with OxyIR, Oxycodone without apap isn't exactly a scientific breakthrough.
Their long fight with Endo's generic version was a bit of wanting your cake and eating it too, they attacked Endo claimng their products patent was being infringed on by the OxySR product, but in the next breath they claimed it wasn't the same r close enough to be granted a generic status and rating. So which is it, too close and infringing, or not close enough to be called a generic. Whatever argument would work I guess? They eventually lost, but did succesfully remove endo's product once from the market.
Endo earned the right for the first 180 days of generic exclusivity, but sold that right to Teva to produce the first generic, then waited 180 days where anyone could through their hat in the ring. After a patent expires, the FDA allows one company the first 180 days of exclusive generic marketing.The company that earnd the right for first production of generics can either produce or sell that right for the first 180 days.
I would guess endo did this to recoup legal expenses after a long battle with purdue. After that anyone can produce a LA version of Oxy without infringing on anyones rights.
I was surprised last week to see the roxanne generic for Roxicodone. It was their own product they sold to AAI pharma for AAI to seel the name brand the last year of the patent. Roxannes, generic has the same imprint code as the pill they had an exclusive patent on for 6 years and then sold the last year of patent exclusivity to AAI and then brought their product back to market as a generic. Same pill, same color, same size and shape and same imprint code as their original name brand Roxicodone.
When the parma industry has 3 lobbyist for every single congressman and senetor in washington, they pretty much get to make their own rules and benefit in as many ways possible their money can be spent.
Good luck and let us know if you get to try Palladone. It's always fun being the first. ;)
Dave
I would be more hopefull that duration wouldn't be such a huge factor with palladone, due to it's releasse system creating an 18 hour half life. Although it's claimed to be a true 24 hour med Purdues claims haven't always resulted in clinical efectiveness. Purdue still insist OxyContin lasts 12 hours and I can think of one person that succesfully used it every 12 hours but had plenty of OxyFast from the 8th to 12th hour. What would stink is if the doc doesn't believe in BT meds.
Some docs think a higher dose will make it last longer due to purdues campaign which just inflates the daily intake but stlill leaves the same gaps. A lower daily dose could be obtained and a smoother serum level if Purdue would just get of their 12 hour claim to fame and desire to sell their short acting meds to bridge the gap.
For example, IF 40mgs twice a day isn't working, some docs will go to 80 mgs twice a day, now that should work acordng to Purdue. NOT, You would likely do better with 40 mgs 3 times a day, get smoother coverage without the ups and downs, reduce the amount of everyday use of BT meds and your daily dose would be less. But purdue rides on that 12 hour claim and would rather see you using one of their BT meds like Oxy IR or oxyfast to cover the gaps.
There was even a class action suite that Purdue knew this but still sent out letters to every doc and every pharmacist saying anything other than BID scripts shuld not be written or filled. IF you recieve your meds thrugh Purdues patient asistance program, they won't except a script written for anything other than twice a day dosing.
The suite claimed that purdue knew their product didn't last in the majority of patients and their suggestion to use BT meds was a marketing ploy to enhance their short acting med sales in addition to to the billions they make on OxyC. Fortunately, all the Oxy patents have expired, OxyC, OxyIR and OxyFast, I don't really get the idea that liquid oxycodone should be somehow protectd by a patent but they got it, same with OxyIR, Oxycodone without apap isn't exactly a scientific breakthrough.
Their long fight with Endo's generic version was a bit of wanting your cake and eating it too, they attacked Endo claimng their products patent was being infringed on by the OxySR product, but in the next breath they claimed it wasn't the same r close enough to be granted a generic status and rating. So which is it, too close and infringing, or not close enough to be called a generic. Whatever argument would work I guess? They eventually lost, but did succesfully remove endo's product once from the market.
Endo earned the right for the first 180 days of generic exclusivity, but sold that right to Teva to produce the first generic, then waited 180 days where anyone could through their hat in the ring. After a patent expires, the FDA allows one company the first 180 days of exclusive generic marketing.The company that earnd the right for first production of generics can either produce or sell that right for the first 180 days.
I would guess endo did this to recoup legal expenses after a long battle with purdue. After that anyone can produce a LA version of Oxy without infringing on anyones rights.
I was surprised last week to see the roxanne generic for Roxicodone. It was their own product they sold to AAI pharma for AAI to seel the name brand the last year of the patent. Roxannes, generic has the same imprint code as the pill they had an exclusive patent on for 6 years and then sold the last year of patent exclusivity to AAI and then brought their product back to market as a generic. Same pill, same color, same size and shape and same imprint code as their original name brand Roxicodone.
When the parma industry has 3 lobbyist for every single congressman and senetor in washington, they pretty much get to make their own rules and benefit in as many ways possible their money can be spent.
Good luck and let us know if you get to try Palladone. It's always fun being the first. ;)
Dave
ruko4
01-16-2005, 08:22 PM
There is hydromorphone contin here in Canada which is a long acting dilaudid that comes in strengths up to 32mg, i think they are for every 12hrs?