cptpooface
03-13-2007, 06:55 PM
Lately I have started to have severe breakthrough almost every day. It can last from two to three hours, or it can last all day. I am on 60mg of MS Contin, which seems to work really randomly, sometimes it will help a lot, but sometimes it doesn't help much at all. I was on Oxycontin but it started to give me euphoria so I got off of them as quickly as possible. I think the Oxycontin would keep the breakthrough pain away, but I don't want to have those side effects. So I have been talking to my doctor and he gave me 20mg of MS-IR (Instant release morphine). I have tried MS-IR before (last spring) but at a much lower dose, and it wasn't effective. I was hoping that with this higher dose I would get relief, but when I take them it feels like I never took anything at all.
I was wondering if maybe the instant release morphine doesn't work because I am taking MS Contin, and I have developed a big resistance to the morphine. Since I started taking MS Contin, developing a resistance has been a huge problem. I don't like upping the dosage and neither does my doctor. This was the reason I tried Oxycontin, my doctor said that since they are different I wouldn't have a resistance to Oxycontin. He was right and the Oxycontin worked great, but the side effects caused me to stop taking them.
I have a doctors appointment tomorrow, and I need to get some information so I can discuss this intelligently with my doctor. If I take morphine for both long lasting and breakthrough pain will the medication be less effective? That is what I think the problem is, and I think if I take morphine for long lasting pain, and something different for breakthrough it will work muc better. What do you think? Would it be better to take the MS Contin and switch to a different breakthrough medication? I also would like to know what effective breakthrough meds anyone has taken. I don't really know the names of any breakthrough meds, and I don't know what the primary medication in each one is. The primary medication in MS-IR is morphine, the primary medication in Oxycontin is oxycodone (I think). I know that sometimes it can take a long time to get the dosage and medication right. So I would really like it if some people could tell me what has worked really well for them.
I really appreciate all the help I have gotten on this forum. I also appreciate any input on this thread. Thank you very much for any help you can give me.
I was wondering if maybe the instant release morphine doesn't work because I am taking MS Contin, and I have developed a big resistance to the morphine. Since I started taking MS Contin, developing a resistance has been a huge problem. I don't like upping the dosage and neither does my doctor. This was the reason I tried Oxycontin, my doctor said that since they are different I wouldn't have a resistance to Oxycontin. He was right and the Oxycontin worked great, but the side effects caused me to stop taking them.
I have a doctors appointment tomorrow, and I need to get some information so I can discuss this intelligently with my doctor. If I take morphine for both long lasting and breakthrough pain will the medication be less effective? That is what I think the problem is, and I think if I take morphine for long lasting pain, and something different for breakthrough it will work muc better. What do you think? Would it be better to take the MS Contin and switch to a different breakthrough medication? I also would like to know what effective breakthrough meds anyone has taken. I don't really know the names of any breakthrough meds, and I don't know what the primary medication in each one is. The primary medication in MS-IR is morphine, the primary medication in Oxycontin is oxycodone (I think). I know that sometimes it can take a long time to get the dosage and medication right. So I would really like it if some people could tell me what has worked really well for them.
I really appreciate all the help I have gotten on this forum. I also appreciate any input on this thread. Thank you very much for any help you can give me.
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BrittleBones
03-13-2007, 10:32 PM
Hi CPT! I'm experiencing the same sort of problem that you are having. I've been on Methadone, 120 mgs. a day, for my long acting pain medication and on oxycodone, 30 mgs., 4 tablets a day for breakthrough pain. I've been on this combination for quite some time and recently have been experiencing a big increase in the amount of "break through" pain. The oxycodone is not really effective anymore and I'm really not too keen on asking for an increase in the Methadone. I'm scheduled to see a new pain management doctor this Friday. He is taking the place of my long term doc who just left the practice late last month. I'm hoping that he'll be willing to let me try a different "break through" med. At one time I was taking Dilaudid for my break through pain and it was very effective. I needed to take at least 8mg. of Dilaudid to get relief, but it was a good med for me. After awhile it stopped working as well. The other medication that was a great bt med for me was Actiq "lollipops" or lozenges. If you are not familiar with that drug, it comtains the same medication that's in the Duragesic patch (Fentanyl). Unlike the patch which allows the medicine to be administered through the skin over a three to five day period, the Actiq is a very quick (but short) acting way to get the med into the bloodstream for rapid results. I'm going to see if he's willing to let me try that again. So all in all, I would suggest the Dilaudid first as an option for you. Have you ever tried that before? Good luck. I hope you find something that can give you quicker relief. All the best - KathyMac
TraveltoSL
03-13-2007, 10:47 PM
Hey KathyMac,
Maybe I am totally not getting what other people are on so if you could help with your plan then maybe I can understand better since I just quoted something and may be wrong....
Are you saying that you are on Oxycontin...pure Oxycodone without Tylenol....the one's that last from 8-12 hours.....for B/T pain....4 times a day?
Or are you actually saying another name for Percocet....30mgs total a day...which equals 4 tablets a day???? I am totally confused.....
I didn't know that Oxycontin was used for B/T pain since I am on 20mg, every 8 hours (since it doesn't last the 12 hours it first was made for) and then Percocet 7.5/325, 1-2 every 4-6 hours...but no more than 8 in a 24hr period......only take them when needed actually....
So, when I just posted above, I want to make sure I am saying the right thing....
Not saying that people aren't on two forms of long acting medicines....Just haven't heard Oxycontin used for B/T since it is a time released medicine and not fast acting like Percocet or other B/T's....
This way, we can all be on the same page for those new to the board and asking about medicine.....So for me....I always call Oxycontin....Oxycontin or Oxycodone......this way people know it's the straight Oxycodone with nothing added....then Percocet....I say the name brand or call it Oxycodone WITH Tylenol....and usually has the Oxycodone mg....like 7.5 and then the Tylenol listed with the / and then the mgs....like 325.....
So, if you could respond to explain this to me it would be very helpful so if I'm saying the wrong thing I can shut my trap....HAHAHA.....
Blessings,
Ingrid
Maybe I am totally not getting what other people are on so if you could help with your plan then maybe I can understand better since I just quoted something and may be wrong....
Are you saying that you are on Oxycontin...pure Oxycodone without Tylenol....the one's that last from 8-12 hours.....for B/T pain....4 times a day?
Or are you actually saying another name for Percocet....30mgs total a day...which equals 4 tablets a day???? I am totally confused.....
I didn't know that Oxycontin was used for B/T pain since I am on 20mg, every 8 hours (since it doesn't last the 12 hours it first was made for) and then Percocet 7.5/325, 1-2 every 4-6 hours...but no more than 8 in a 24hr period......only take them when needed actually....
So, when I just posted above, I want to make sure I am saying the right thing....
Not saying that people aren't on two forms of long acting medicines....Just haven't heard Oxycontin used for B/T since it is a time released medicine and not fast acting like Percocet or other B/T's....
This way, we can all be on the same page for those new to the board and asking about medicine.....So for me....I always call Oxycontin....Oxycontin or Oxycodone......this way people know it's the straight Oxycodone with nothing added....then Percocet....I say the name brand or call it Oxycodone WITH Tylenol....and usually has the Oxycodone mg....like 7.5 and then the Tylenol listed with the / and then the mgs....like 325.....
So, if you could respond to explain this to me it would be very helpful so if I'm saying the wrong thing I can shut my trap....HAHAHA.....
Blessings,
Ingrid
cpapp31
03-14-2007, 12:33 AM
Hi Ingrid!
Sorry to butt in on your post to Kathy. There is a breakthrough med called OxyIR, it releases oxycodone fast and does not have any tylenol in it.
Also, I wanted to agree with Kathy about the Dilaudid for breakthrough pain. I am on the Duragesic Patch for my chronic pain and use Dilaudid for breakthrough pain. It really helps with my pain.
Take care,
Cpapp31
Sorry to butt in on your post to Kathy. There is a breakthrough med called OxyIR, it releases oxycodone fast and does not have any tylenol in it.
Also, I wanted to agree with Kathy about the Dilaudid for breakthrough pain. I am on the Duragesic Patch for my chronic pain and use Dilaudid for breakthrough pain. It really helps with my pain.
Take care,
Cpapp31
TraveltoSL
03-14-2007, 12:50 AM
OHHHHH....that's right...Thank you:):) Maybe for people like me, could we try to use the brand name with the generic or info in parenthesis so everyone can learn the medicines as well??? Just a thought....Thanks for "butting" in...:):)
Kathy, is that what you are talking about when you say Oxycodone for your B/T?....
CTPoo...(i laugh at that screen name every time...!)LOL....Anyway, maybe you can ask for that but if you had bad reactions to the Oxycontin, it is the same medicine so maybe switching to something new all together would help....
Maybe on one quick post, we would be allowed to describe where we all came up with our screen names....it would be fun!!! But don't know if Mods would be ok since it's off topic....But just one little post???? Please??? Mods????(Tee Hee)....with all these pain we need some fun once in awhile....
Blessings,
Ingrid
Kathy, is that what you are talking about when you say Oxycodone for your B/T?....
CTPoo...(i laugh at that screen name every time...!)LOL....Anyway, maybe you can ask for that but if you had bad reactions to the Oxycontin, it is the same medicine so maybe switching to something new all together would help....
Maybe on one quick post, we would be allowed to describe where we all came up with our screen names....it would be fun!!! But don't know if Mods would be ok since it's off topic....But just one little post???? Please??? Mods????(Tee Hee)....with all these pain we need some fun once in awhile....
Blessings,
Ingrid
cptpooface
03-14-2007, 03:20 AM
To clear up any confusion, yes I was on oxycontin last spring, I did get some crazy side effects, such as euphoria, cold and hot flashes and tremors, so I quickly went off it and went back on the MS Contin. I think when I went back onto the MS Contin I went to 45 mg three times daily, the last time I tried oxycontin (just a month or two ago) I came back to the MS Contin at 60mg three times daily, so I spent quite a while on 45mg three times daily. My doctor is just a GP and I think he likes to stick with certain meds that he knows a lot about, so for long acting meds its either MS Contin or Oxycontin, I don't think he is really well versed in these narcotic pain killers, that is why I went back on the Oxycontin, because it was worth another try to see if that would stop the tolerance problem. The reason my doctor is now willing to prescribe breakthrough meds is because it seems like my condition has gotten much worse in the last two or three months, also I go to see a surgeon at the end of the month after waiting more than a year (thanks to the canadian medical system) when I see him a decision will be made as to what will be done, and the surgeon will be much more confident in his diagnoses as I have had a ton of tests done and tried a lot of different things. I think my doctor feels it is okay to go on BT's for a month so I don't have to suffer more, and he doesn't have to commit to prescribing them long term. I guess I will discuss this with him and mention the percocet, oxyIR Dilauded and Actiq. Thanks everyone for helping me out.
BrittleBones
03-14-2007, 10:42 AM
Goodmorning...ok, let me try and describe my med schedule and the medications that I use.
First of all, Percocet and Percodan are name brands for drugs that contain Oxycodone plus tylenol, or Oxycodone plus aspirin. To my knowledge they are both fast acting (immediate release) drugs that can be dosed every 4-6 hours.
Oxycontin is the brand name for the same drug as above, Oxycodone, and differs only in its time release formula. Oxycontin has a covering on the pill that allows the body to get some of the oxycodone into the system right away and the remainder of the oxycodone to be released at various intervals. It is considered a long acting pain med dosed about every 12 hours. The way I tell them apart (if I forget) is by looking at the name. Oxycontin really stands for oxycodone-continuous or Oxycontin. This naming rule is also good for the drug MSContin. The MS stands for morphine sulfate and the Contin stands for continuous release.
Oxycodone is the just the generic name given to oxycodone. It's like saying, "Give me an aspirin (oxycodone) or give me a Bayer aspirin (OxyIR) - they are both aspirin any way you look at it, right? When I get my prescription filled each month it is written as: Oxycodone 30mg. This pill is just plain immediate release oxycodone with no special covering to make it release the medicine slowly.
I hope that I haven't miss-spoken on any of these drugs. It is just my interpretation of what the terms mean. It can be very confusing and this is how I try to remember all the names.
So to answer your question: I take Methadone, 10mg tablets: I take 40 mgs. in the a.m., 40 mgs at lunchtime, and 40 mgs. before bed. If I need pain relief for breakthrough pain I use the generic oxycodone 30mg. and I am allowed 4 tablets a day if I need it. So you can see that I don't take 2 long-acting drugs. Does this help? KathyMac P.S. - I still think Dilaudid is a good drug to try for the breakthrough pain. Bye for now!
First of all, Percocet and Percodan are name brands for drugs that contain Oxycodone plus tylenol, or Oxycodone plus aspirin. To my knowledge they are both fast acting (immediate release) drugs that can be dosed every 4-6 hours.
Oxycontin is the brand name for the same drug as above, Oxycodone, and differs only in its time release formula. Oxycontin has a covering on the pill that allows the body to get some of the oxycodone into the system right away and the remainder of the oxycodone to be released at various intervals. It is considered a long acting pain med dosed about every 12 hours. The way I tell them apart (if I forget) is by looking at the name. Oxycontin really stands for oxycodone-continuous or Oxycontin. This naming rule is also good for the drug MSContin. The MS stands for morphine sulfate and the Contin stands for continuous release.
Oxycodone is the just the generic name given to oxycodone. It's like saying, "Give me an aspirin (oxycodone) or give me a Bayer aspirin (OxyIR) - they are both aspirin any way you look at it, right? When I get my prescription filled each month it is written as: Oxycodone 30mg. This pill is just plain immediate release oxycodone with no special covering to make it release the medicine slowly.
I hope that I haven't miss-spoken on any of these drugs. It is just my interpretation of what the terms mean. It can be very confusing and this is how I try to remember all the names.
So to answer your question: I take Methadone, 10mg tablets: I take 40 mgs. in the a.m., 40 mgs at lunchtime, and 40 mgs. before bed. If I need pain relief for breakthrough pain I use the generic oxycodone 30mg. and I am allowed 4 tablets a day if I need it. So you can see that I don't take 2 long-acting drugs. Does this help? KathyMac P.S. - I still think Dilaudid is a good drug to try for the breakthrough pain. Bye for now!
TraveltoSL
03-14-2007, 11:55 AM
Hi there,
Thanks for explaining things CTPoo....it helps understand a bit better what has been going on....i hope your surgeon can find out what's specifically wrong and if needed, may be able to repair it which would be great:)
As you can see from my other posts, I am a firm beliver in total body/mind pain mgmt. that includes many other things besides opiates...
Did you say that you are also being treated for your depression and anxiety? What medicine do they have you on for that? I know for me, that counseling is a HUGE part of helping me deal with the chronic pain along with the Cymbalta I take.....
So, I hope that you can get some better results with different types of medicine and maybe something that doesn't contain Oxycodone since that doesn't seem to work well with you...
KathyMac....thanks so much for detailing your plan as I think you are on (from what CPap describes), the OxyIR (brand name)(Oxycodone) for your B/T which is the straight Oxycodone...but in the short acting form....and yes....it does get very confusing....LOL.....
Just wanted to distinguish to others that are new somehow the difference between the long acting and short acting...
I actually take the generic form of Oxycontin...which is straight Oxycodone...the extended release.....Just to make it more confusing...HAHAHA....
CTPoo....have I totally confused you now???? I think the best advice is to tell your Dr. you are just not getting full coverage for your pain....plain and simple...and then see where he goes from there.....
Blessings,
Ingrid
Thanks for explaining things CTPoo....it helps understand a bit better what has been going on....i hope your surgeon can find out what's specifically wrong and if needed, may be able to repair it which would be great:)
As you can see from my other posts, I am a firm beliver in total body/mind pain mgmt. that includes many other things besides opiates...
Did you say that you are also being treated for your depression and anxiety? What medicine do they have you on for that? I know for me, that counseling is a HUGE part of helping me deal with the chronic pain along with the Cymbalta I take.....
So, I hope that you can get some better results with different types of medicine and maybe something that doesn't contain Oxycodone since that doesn't seem to work well with you...
KathyMac....thanks so much for detailing your plan as I think you are on (from what CPap describes), the OxyIR (brand name)(Oxycodone) for your B/T which is the straight Oxycodone...but in the short acting form....and yes....it does get very confusing....LOL.....
Just wanted to distinguish to others that are new somehow the difference between the long acting and short acting...
I actually take the generic form of Oxycontin...which is straight Oxycodone...the extended release.....Just to make it more confusing...HAHAHA....
CTPoo....have I totally confused you now???? I think the best advice is to tell your Dr. you are just not getting full coverage for your pain....plain and simple...and then see where he goes from there.....
Blessings,
Ingrid
cptpooface
03-15-2007, 10:53 PM
Okay, I went to my doctors appointment, on wednesday we talked about breakthrough meds, I told him a lot about what everyone in this thread said. I was really surprised because my doctor was extremely supportive and it looks like he is willing to work on breakthrough meds. What I mean is that we will keep trying different breakthrough meds until we find the right drug and the right dosage. The reason I am surprised is because he has been totally against any of the fast acting meds. Because I have depression he was always worried I was told that the fast acting meds do more to your mood than the long lasting meds do. The fast acting meds can make your mood swing really bad, from a really good mood to a really bad mood, I guess they are just more dangerous for me because anything that tips the scales towards a bad mood can cause a lot of problems.
I think one of the reasons he has decided to start a breakthrough plan is because over the last year, since I started taking narcotic pain killers, I have proved that I can be trusted with the responsability that comes with taking narcotic drugs. I have never needed an early refill or had any other problems like that, so I think (and hope) that he now fully trusts me.
He decided to give me the Dilaudid and see if that works. He said he was starting me out on a smaller dose just to see how effective it is. He gave me the 2mg pills, and I think they are generic because they just say hydromorphone. I had a really bad day today, for many different reasons, and this caused breakthrough about three hours ago. I used the Dilaudid like I was supposed to, I took it at the first sign of pain. It didn't cause any drowsiness or other side effects, but it also didn't releave any of the breakthrough pain. I'm not sure about the dosage, but I think it is probably a rather small dose, but I could be wrong. So any help or information about the dosages of Dilaudid would be really appreciated. I will probably be taking one a day, some days I might not have any breakthrough pain, so I won't have to take one, but most days I do have breakthrough pain.
I also saw on the prescription bottle that I can take two at a time if I need to, so next time I have bad breakthrough I will try two and see what that does. If I take two I would be taking 4mg, for some drugs that would be a very small increase, but for others it could be a big increase. I don't know much about Hydromorphone, so if anyone has any info please share it. I am just kind of reading through this post and for some reason I think it sounds kind of bossy or arrogant or something, so I am sorry if I am coming across as bossy and arrogant. I am also always worried that I sound desperate for drugs, thats why I hate going to the doctor and talking to him about this stuff. I always wonder if he thinks I am being dishonest with him, and abusing the drugs he prescribes. So I hope I don't sound like an abuser on this forum either.
Thanks for all the help everybody, I will wait for some more posts, and research everything I can on Hydromorphone. And hopefully it will work for me, but if it doesn't I am going to need some more suggestions. Thanks again everyone, this is extremely helpful.
I think one of the reasons he has decided to start a breakthrough plan is because over the last year, since I started taking narcotic pain killers, I have proved that I can be trusted with the responsability that comes with taking narcotic drugs. I have never needed an early refill or had any other problems like that, so I think (and hope) that he now fully trusts me.
He decided to give me the Dilaudid and see if that works. He said he was starting me out on a smaller dose just to see how effective it is. He gave me the 2mg pills, and I think they are generic because they just say hydromorphone. I had a really bad day today, for many different reasons, and this caused breakthrough about three hours ago. I used the Dilaudid like I was supposed to, I took it at the first sign of pain. It didn't cause any drowsiness or other side effects, but it also didn't releave any of the breakthrough pain. I'm not sure about the dosage, but I think it is probably a rather small dose, but I could be wrong. So any help or information about the dosages of Dilaudid would be really appreciated. I will probably be taking one a day, some days I might not have any breakthrough pain, so I won't have to take one, but most days I do have breakthrough pain.
I also saw on the prescription bottle that I can take two at a time if I need to, so next time I have bad breakthrough I will try two and see what that does. If I take two I would be taking 4mg, for some drugs that would be a very small increase, but for others it could be a big increase. I don't know much about Hydromorphone, so if anyone has any info please share it. I am just kind of reading through this post and for some reason I think it sounds kind of bossy or arrogant or something, so I am sorry if I am coming across as bossy and arrogant. I am also always worried that I sound desperate for drugs, thats why I hate going to the doctor and talking to him about this stuff. I always wonder if he thinks I am being dishonest with him, and abusing the drugs he prescribes. So I hope I don't sound like an abuser on this forum either.
Thanks for all the help everybody, I will wait for some more posts, and research everything I can on Hydromorphone. And hopefully it will work for me, but if it doesn't I am going to need some more suggestions. Thanks again everyone, this is extremely helpful.
mudbone
03-16-2007, 09:17 PM
New med called OPANA both IR and ER. I did not get euphoria on it, just a bit tired. I was on 10mg ER. So maybe try the intant releif.. Just my $.02
Mudbone..:blob_fire
Mudbone..:blob_fire
TraveltoSL
03-16-2007, 09:22 PM
Can you tell me what is in that? I tried to look it up but don't know what Oxymorphone is...is it Oxycodone and morphine in the same tablet? I've heard about it before and just curious....
I, personally can't take morphine products....get too sick and on Oxycontin as well as Percocet...so just was wondering....Thanks!
Blessings,
Ingrid
I, personally can't take morphine products....get too sick and on Oxycontin as well as Percocet...so just was wondering....Thanks!
Blessings,
Ingrid
rayefaye
03-16-2007, 09:52 PM
It is a powerful semi-symthetic opioid analgesic that is derived from thebaine and is approximately 6-8 times more potent than morphine.