Painintheback
07-29-2002, 05:11 PM
I'm currently being treated for chronic pain in my back (result of ruptured disc's) and I'm curious as to how people supplement time release medication with Break Thru meds. They have my on Duragesic 75 mcg. every 48 hrs. and have provided Norco 10/325 for break thru pain. They told me to use the Norco for when I really have that break thru type pain, other then that they did not really elaborate as to timing.
Curious as to if people use this every day once a day or twice a day or once a week etc.... ?
The way my back feels I could use it every day, the Duragesic patch seems to help fairly well but there are times in the day where the pain just gets so bad. Seems like I could take the Norco everyday. Just curious for some feedback. If I'm off my rocker then write me off as a looney. Just feel the pain management group haven't been as helpful as I'd like them to be and at this point and after reading all the horror stories here about losing help I just don't want to screw up anything with my pain management team.
Thanks
Curious as to if people use this every day once a day or twice a day or once a week etc.... ?
The way my back feels I could use it every day, the Duragesic patch seems to help fairly well but there are times in the day where the pain just gets so bad. Seems like I could take the Norco everyday. Just curious for some feedback. If I'm off my rocker then write me off as a looney. Just feel the pain management group haven't been as helpful as I'd like them to be and at this point and after reading all the horror stories here about losing help I just don't want to screw up anything with my pain management team.
Thanks
Sponsor
davidc66
07-29-2002, 08:53 PM
Hey Pain, I use BT meds every day. I take 600mgs of kadian a day and with a 24 hour med it's not like I can adjust the schedule to give me the added relief I need in the evening. So I use them every night. I also need something occasionally in the day time if I'm going to be doing an activity which will be hard to manage.
I would think the quantity given and the way it's written should be your guide. If it' written take 1 tablet every 6-8 hours for BT pain and he gives you 60, I would say that is your month "30 day" supply, It's 2 a day sometimes 3 sometimes one as long as it last you a month. What were the instructions on the bottle or does it just say use as needed? It should still have a days supply calculated on the pharmacy bag.
For ins. purposes they tell you how long it should last, so they can deny early refills.LOL More info would help but isn't a substitute for being clear with your doc.
By the way, I'm given 90 pills a month and it's written take one pill every 6-8 hours as needed for pain. The ins says this is a 30 day supply but the pharmacist has a little control. You could say that reads up to 4 a day then it's less than a 30 day supply, but the pharmacist actually calculates that and should be on your paperwork.
It's something worth keeping an eye on so the pharmacist isn't turning a 20 day supply into a 30 on you. IT could cost you some money if the pharmacist isn't calculating DS correctly. This can happen easily especially with smaller scripts.
For example a script for 24 Norco. It's written take one pill every 4-6 hours. It's up to the pharmacist to decide whether that's 4 pills a day or 6 pills. My pharmacist looks out for me but I have met pharmacist that say your sleeping 8 hours a day and 4 a day is appropriate. So that script is a 6 day supply in one pharmacist eyes and and a 4 day in anthers. My wife is in the Biz.LOL
If you show up 4 days later looking for a refill you may be told ins won't pay until the next day or even the 6th day depending on the ins and the pharmacist. Pharmacists have the ability to override, and push scripts through in some cases. Sorry didn't mean to turn this into a pharmacy topic.
My pharmacist knows me and how my doc works and realizes that my scripts are 30 day supplies. So there is no misunderstanding there. I figure as long as I have something at the end of the month I'm doing OK. LOL Good luck and welcome, David
I would think the quantity given and the way it's written should be your guide. If it' written take 1 tablet every 6-8 hours for BT pain and he gives you 60, I would say that is your month "30 day" supply, It's 2 a day sometimes 3 sometimes one as long as it last you a month. What were the instructions on the bottle or does it just say use as needed? It should still have a days supply calculated on the pharmacy bag.
For ins. purposes they tell you how long it should last, so they can deny early refills.LOL More info would help but isn't a substitute for being clear with your doc.
By the way, I'm given 90 pills a month and it's written take one pill every 6-8 hours as needed for pain. The ins says this is a 30 day supply but the pharmacist has a little control. You could say that reads up to 4 a day then it's less than a 30 day supply, but the pharmacist actually calculates that and should be on your paperwork.
It's something worth keeping an eye on so the pharmacist isn't turning a 20 day supply into a 30 on you. IT could cost you some money if the pharmacist isn't calculating DS correctly. This can happen easily especially with smaller scripts.
For example a script for 24 Norco. It's written take one pill every 4-6 hours. It's up to the pharmacist to decide whether that's 4 pills a day or 6 pills. My pharmacist looks out for me but I have met pharmacist that say your sleeping 8 hours a day and 4 a day is appropriate. So that script is a 6 day supply in one pharmacist eyes and and a 4 day in anthers. My wife is in the Biz.LOL
If you show up 4 days later looking for a refill you may be told ins won't pay until the next day or even the 6th day depending on the ins and the pharmacist. Pharmacists have the ability to override, and push scripts through in some cases. Sorry didn't mean to turn this into a pharmacy topic.
My pharmacist knows me and how my doc works and realizes that my scripts are 30 day supplies. So there is no misunderstanding there. I figure as long as I have something at the end of the month I'm doing OK. LOL Good luck and welcome, David
jane2
07-29-2002, 11:03 PM
I see what you are saying David. The doctor can write 4 times a day and the pharmacists has some leeway to interpert. My doctor puts down the full # of pills.
You are not crazy, many people take b/t every day. In fact it is part of their regime. I think there are good reasons to do this. Like the patch is bumpy or you have a daily pain surge. Or you need more but don't want to go up to the next patch size. David often says that mixing opiates is helpful.
I do wonder if so many are on so much b/t medication because their docs won't up their base dose. For me, the whole idea of long-acting medication was to get away from the ups and downs and additives of the short-acting b/t drugs. I would rather have enough base medication for most days and use b/t for emergencies. But that is me and I get rebound headaches from the short-acting stuff. Plus I find I get tolerant to it fast.
My perference aside, it is extremely common to be on it all the time. It is reasonble to bring it up. You sound nervous about how your doctor will react if you need a refill at the end of the month. Regardless of what that wrote on the bottle, they said use it for really bad pain. In which case they may not be expecting you to ask for refill at the end of the month.
I hear the fear in your words. I remember being nervous about asking for my monthly refills. Generally, I would say if they wrote it for a month, then you can use it. Perhaps it would be safer to let this guy know before you move to every day.
Sounds like they have under-estimated what you need on a normal day. So perhaps he will up your patch or say just take the Narco. Would that you did not have to panic about having the converstation.
Good luck. It is normal to prescribe b/t drugs for every day. I can't tell if this guy will be cool, but you are not asking for anything unusual.
You are not crazy, many people take b/t every day. In fact it is part of their regime. I think there are good reasons to do this. Like the patch is bumpy or you have a daily pain surge. Or you need more but don't want to go up to the next patch size. David often says that mixing opiates is helpful.
I do wonder if so many are on so much b/t medication because their docs won't up their base dose. For me, the whole idea of long-acting medication was to get away from the ups and downs and additives of the short-acting b/t drugs. I would rather have enough base medication for most days and use b/t for emergencies. But that is me and I get rebound headaches from the short-acting stuff. Plus I find I get tolerant to it fast.
My perference aside, it is extremely common to be on it all the time. It is reasonble to bring it up. You sound nervous about how your doctor will react if you need a refill at the end of the month. Regardless of what that wrote on the bottle, they said use it for really bad pain. In which case they may not be expecting you to ask for refill at the end of the month.
I hear the fear in your words. I remember being nervous about asking for my monthly refills. Generally, I would say if they wrote it for a month, then you can use it. Perhaps it would be safer to let this guy know before you move to every day.
Sounds like they have under-estimated what you need on a normal day. So perhaps he will up your patch or say just take the Narco. Would that you did not have to panic about having the converstation.
Good luck. It is normal to prescribe b/t drugs for every day. I can't tell if this guy will be cool, but you are not asking for anything unusual.
Painintheback
07-30-2002, 12:53 PM
Thanks David and Jane, your thoughts are well received. And yes Jane your sense of fear in my post is accurate. I am a tab bit afraid to say anything to the pain mgt doc as I do not want to upset the apple cart. For the first time in along time I'm getting real treatment that is providing some level of effectiveness. I do not want to lose what I have. SO I really appreciate the help you and David have given.
The other thing that really bothers me is my stomach does not seem to handle Norco or the Vicoprofen well anymore. I get nauseous when I take them. The patch doesn't seem to bother me at all, no sickness, not sleepy or drowsy, not light headed and no constipation. Should I tell them this fact and ask for a medication that does not have the aspirin, acetaminophen or ibuprofen in them. Not sure what this would be as I'm not very experienced with the medication used for BT.
Thanks again for your help and any additional help you can provide.
The other thing that really bothers me is my stomach does not seem to handle Norco or the Vicoprofen well anymore. I get nauseous when I take them. The patch doesn't seem to bother me at all, no sickness, not sleepy or drowsy, not light headed and no constipation. Should I tell them this fact and ask for a medication that does not have the aspirin, acetaminophen or ibuprofen in them. Not sure what this would be as I'm not very experienced with the medication used for BT.
Thanks again for your help and any additional help you can provide.
fibrose
07-31-2002, 07:17 AM
i have a lot of b/t pain too. i have arthritis in my back.i am on a pain contol regime of ultram 2 x day and as needed. i also take vioxx for the arthritis daily. then i have vicoden or darvocet for the b/t pain. i use my b/t meds at least daily and sometimes twice.i usually get 30 pills at a time. and i too try to make it stretch for 30 days but have had to have refills in 20 days. my pharmacist is really good at passing stuff thru my insurance for me too. my dr. knows that i need the pain control and work with me very well. so take a chance and at least use it 1 time a day..good luck
FREDO
07-31-2002, 07:12 PM
Hi, I am on a base dose of 80mg Oxy TID [3x's daily] and given 180 B/T meds a month, The only instructions read "Take up to six times daily". Well, I have been taking ALL the meds every month for at least six months, so no mystery on how my doc wants me to take, or that he would rather I take these six tabs when I need them the most, than raise my base dose right now. Why - who knows? Some docs are just that way..
Common sense also needs to play a part in taking your BT meds....like I have no printed restrictions, so technically I could take two or three BT meds at a time, if I felt I needed them......BUT! Common sense tells me that I should only take a max of one grain of tylenol at a time as it won't help anymore higher than that dose, and may cause liver damage....
So, my BT meds are Endocet - 10/650 [10mg Oxycodone/650mg tylenol] so I know I could harm myself if I took two Endocet's at once=1300mgs of tylenol..
Common sense, and the PDR, also tells me I cannot take more than 4000mgs tylenol per day without risking liver damage - so NO WAY should I ever take more than the six Endocet's allowed per day, as 6 x 650 = 3900mgs
I guess I'm saying it would be to your advantage to learn about the meds you are taking, and do further research on your own....as within the CP community, it is well known that more than 4000mgs/day tylenol can harm you.....but in the "Normal" world, how many people know that? See what I meen?
One more thing...I know you are worried about "screwing up a good thing" but, if your base meds, plus BT meds arn't cutting 50% of your pain, you have a limited time frame that your doc will increase the meds to achieve this. Usually need to tell them within a week that you need more meds. Usually, if you wait to long, they will think bad thoughts about you, and not approve any increases.
Hope something above helps,
:wave:
------------------
FREDO
Common sense also needs to play a part in taking your BT meds....like I have no printed restrictions, so technically I could take two or three BT meds at a time, if I felt I needed them......BUT! Common sense tells me that I should only take a max of one grain of tylenol at a time as it won't help anymore higher than that dose, and may cause liver damage....
So, my BT meds are Endocet - 10/650 [10mg Oxycodone/650mg tylenol] so I know I could harm myself if I took two Endocet's at once=1300mgs of tylenol..
Common sense, and the PDR, also tells me I cannot take more than 4000mgs tylenol per day without risking liver damage - so NO WAY should I ever take more than the six Endocet's allowed per day, as 6 x 650 = 3900mgs
I guess I'm saying it would be to your advantage to learn about the meds you are taking, and do further research on your own....as within the CP community, it is well known that more than 4000mgs/day tylenol can harm you.....but in the "Normal" world, how many people know that? See what I meen?
One more thing...I know you are worried about "screwing up a good thing" but, if your base meds, plus BT meds arn't cutting 50% of your pain, you have a limited time frame that your doc will increase the meds to achieve this. Usually need to tell them within a week that you need more meds. Usually, if you wait to long, they will think bad thoughts about you, and not approve any increases.
Hope something above helps,
:wave:
------------------
FREDO
Lori.19
08-05-2002, 07:43 PM
Hi all. I just found this site about 20 minutes ago. I need some advice and you people seem very kind and know your stuff. My husband's doctor has him wearing 2 Duragesic 25mg patches and swaping the older one for a new one everyday. In the doctor's mind that equals a 35mg patch, but my druggist says he's a dope and it's still 50mg a day. For B/T pain he gets 180 percoset 7.5/325 pills per month. The percs aren't helping anynore and he wants to go to the 10/325's. I found a new thing online from the makers of the patch. It's for B/T pain and it's a lollipop. When the pain spikes, you suck on the pop which has the same stuff in it as the patch. The site is WWW.ACTIQ.COM (http://WWW.ACTIQ.COM) His doc says it's too new and won't give it to him yet. My question is ...is there anything else out there better than the perc he is already on besides the 10mg? Years ago when he first got hurt he was taking a half of a 5mg/500 and getting relief. Now he's popping 2 7.5's at a time sometimes taking 10 in a day with no relief.
If anyone has any ideas, please let me know! I would appreciate it!
If anyone has any ideas, please let me know! I would appreciate it!
ANiceGirl
08-05-2002, 10:43 PM
There is Oxy IR which is percocet minus the tylenol. You can take as many of those as needed to get relief without worrying about the tylenol. Good luck.
davidc66
08-06-2002, 02:09 PM
Hi Lori, Yes your doc is a nut.LOL He's wearing 2 25's that means he's wearing 50, You don't need a math whiz to figure that out.The patches last 48-72 hours so he's got a constant 50mic's on board.
Having breakthrough pain is nothing abnormal. There are many drugs that don't contain tylenol besides the percecet. Nice girl mention OxyIR "instant release" I'm pretty sure it only comes in 5's but there may be a 10mg available.There is a plain generic 5mg oxycodone tablet available. There is another med called Roxicodone that comes in 15mg and 30mg with no apap. You also have Oxyfast, a liquid version of oxycodone without apap.There is also a generic liquid called Oxydose. With the liquid you have a metered dropper each ML contains 20mgs of oxycodone. You could also use instant release morphine or Dilaudid.
I think the best thing to do is at your next apt discuss your BT pain and your concerns about tylenol intake.
Fentanyl is a very potent drug and the use of Actiq for non cancer pain is not FDA aproved or recomended by the manufacturer. I do know several folks with non malignant CP using Aqtiq but I have also seen where patients prescriptions were refused at the pharmacy because it's not aproved for non cancer pain. I've also seen ins. co's deny paying for this "cancer" med.
We all know many drugs are used for off label purposes but this drug can be scrutinized a little harder at every stage because of the potency, It's roughly 900 times stronger than morphine mg to mg.That's why it's measured in Micro grams. The doc,the pharmacist and the ins carrier can all balk at the "use for cancer only" statement in the prescribing info.
Personally I think you do better using a different BT med from the base med. You cover a broader range of receptors that way. JMO. Good luck, David
Having breakthrough pain is nothing abnormal. There are many drugs that don't contain tylenol besides the percecet. Nice girl mention OxyIR "instant release" I'm pretty sure it only comes in 5's but there may be a 10mg available.There is a plain generic 5mg oxycodone tablet available. There is another med called Roxicodone that comes in 15mg and 30mg with no apap. You also have Oxyfast, a liquid version of oxycodone without apap.There is also a generic liquid called Oxydose. With the liquid you have a metered dropper each ML contains 20mgs of oxycodone. You could also use instant release morphine or Dilaudid.
I think the best thing to do is at your next apt discuss your BT pain and your concerns about tylenol intake.
Fentanyl is a very potent drug and the use of Actiq for non cancer pain is not FDA aproved or recomended by the manufacturer. I do know several folks with non malignant CP using Aqtiq but I have also seen where patients prescriptions were refused at the pharmacy because it's not aproved for non cancer pain. I've also seen ins. co's deny paying for this "cancer" med.
We all know many drugs are used for off label purposes but this drug can be scrutinized a little harder at every stage because of the potency, It's roughly 900 times stronger than morphine mg to mg.That's why it's measured in Micro grams. The doc,the pharmacist and the ins carrier can all balk at the "use for cancer only" statement in the prescribing info.
Personally I think you do better using a different BT med from the base med. You cover a broader range of receptors that way. JMO. Good luck, David
Lori.19
08-06-2002, 05:54 PM
Hi,
thanks for your help. I was't concerned with a pill without tylenol until I read the above post about tylenol. What I am looking for is a pill that is stronger than 10mg percoset and works faster. He was taking oxycodone and it did nothing. I think he has tried everything out there to be tried. We have talked to his doc and he said that the B/T pain is to be expected and he has to learn to deal with it. Well, when the pain is so bad he passes out, I think he needs stronger meds. Please don't stop offering suggestions!
thanks for your help. I was't concerned with a pill without tylenol until I read the above post about tylenol. What I am looking for is a pill that is stronger than 10mg percoset and works faster. He was taking oxycodone and it did nothing. I think he has tried everything out there to be tried. We have talked to his doc and he said that the B/T pain is to be expected and he has to learn to deal with it. Well, when the pain is so bad he passes out, I think he needs stronger meds. Please don't stop offering suggestions!
davidc66
08-06-2002, 10:00 PM
Hey Lori, The liquid versions of morphine and the liquid oxy called Oxyfast Really give you a broad range of dosing ability. Because it's liquid form it does work a little more rapidly than normal pills. I have heard Aqtiq is very quick and may be suited for the type of flares going on.
All you can do is talk to the doc. My second choice would be one of the liquid products. BT meds, as far as strength goes are usually in line with the base dose. A percentage or fraction of a daily dose. People on high base doses need higher strength BT meds to make a difference and vice versa.People on lower doses can still get relief from some of the meds with apap. But 10 percs a day really sugests he's way undermedicated plus he's pushing the tylenol limit.
If the doc is trying to wean him off the patch what is the next step? In your docs eyes He's not on a high dose of the patch and that would probably limit the strength needed of the BT med in your docs eyes.
It really doesn't sound like his pain is being managed well at all.I guess more info would help.
What are the goals of this PM doc as far as the patch? Is He switching base meds or is this a post op situation where the doc is trying to DC the meds?
Between the Aqtiq and the liquid pure opiates you have the strongest of all the pain meds. There is no dose restriction with liquid oxy/morph. Some folks may use 120mgs of oxyfast for BT pain several times a day. Everyones tolerance is different. Keep plugging away untill you find the right combination of meds to restore some of his life. Take care, David
All you can do is talk to the doc. My second choice would be one of the liquid products. BT meds, as far as strength goes are usually in line with the base dose. A percentage or fraction of a daily dose. People on high base doses need higher strength BT meds to make a difference and vice versa.People on lower doses can still get relief from some of the meds with apap. But 10 percs a day really sugests he's way undermedicated plus he's pushing the tylenol limit.
If the doc is trying to wean him off the patch what is the next step? In your docs eyes He's not on a high dose of the patch and that would probably limit the strength needed of the BT med in your docs eyes.
It really doesn't sound like his pain is being managed well at all.I guess more info would help.
What are the goals of this PM doc as far as the patch? Is He switching base meds or is this a post op situation where the doc is trying to DC the meds?
Between the Aqtiq and the liquid pure opiates you have the strongest of all the pain meds. There is no dose restriction with liquid oxy/morph. Some folks may use 120mgs of oxyfast for BT pain several times a day. Everyones tolerance is different. Keep plugging away untill you find the right combination of meds to restore some of his life. Take care, David
Lori.19
08-07-2002, 12:57 AM
Oh David, you are a doll! You really gave me some good advice to take to the doc on Aug 29. Alittle background might help. Six years ago Ken was unloading a truck when he wrenched his lower back. He had bulging disks. By the time they removed them 3 months later, the disks had done damage to the sciatic nerve. Over the next 4 years he had 17 sympathic root blocks that helped him to lead an almost pain free life. But then it hit the fan. Since it was work related, the workers compensation insurence decided that they weren't going to pay for anymore injections. He started going downhill real fast from there. All he had was Percoset for about 9 months when they let him have a final injection which only lasted him a month. Then they sent him to a couple of their doctors. Then finally they sent him to Kessler Rehab for PT. The PT damn near killed him, and that's when the doc put him on the 25 Duragesic with 5/325 percoset chasers. That worked for about 3 months when the pain got worse and he went to the 2 25 patches and this weird way of using them. Plus he upped him to the 7.5 percs. This month when we go there I am going to see if he can give him that liquid stuff you talked about, but Ken thinks he's just going to go to the 50 patch. Which makes no sense since he's doing 50 now. I am also going to ask him about the pure perc that doesn't have the tylenol in it. What else do you think I should ask him about? He already shot down my idea about the lollipop. The doc knows Ken is getting worse. Scar tissue is growing all over the sciatic nerve, damaging it further. He said Ken will probably end up in a wheelchair in a year.
fallllea
08-17-2002, 07:51 AM
Hey guys-Several years ago I used a drug called Numorphine.Dose for dose it was about 10 x stronger than morphine.Do they still use this ?It was not a common drug and usually had to be ordered by the hospital or pharmacy.It was an excellent pain-killer.It was available only by injection or a supossitory(which was great if nausea was present)Has anyone heard or this or know if they still make it?Randy
davidc66
08-17-2002, 01:39 PM
Hi Lori, Is Ken using any of the anti seizure meds like Neurontin to help with nerve pain, Does he have burning leg pain? If so, this class of meds works very well for some folks that have PN or radiculopothy or other types of nerve pain. Hang in there and prove this doc wrong about the wheelchair.
When titrating a new med a month is really too long to wait to make adjustments, You are unable to tell if it's just tolerance or the dose was never correct in the first place. I would ask the doc at the next apt how long should you give the new dose. With Duragesic you pretty much know by the second patch if it's the right dose. If he simply goes to 50ugh you know he hasn't mmade a change. Titration shouldn't take more than a month and then you fine toon things.
If the doc thinks pain will put him in the chair then tell the doc your paying him to keep the pain controlled so he won't end up in a chair. Ask what is taking so long to get the meds right and perhaps he will speed things up.
I've seen to many docs give up on a drug or a patient because they aren't comfy prescribing whats neccesary.
Just because the highest strength patch is 100ugh doesn't mean that is the maximum dose for Duragesic. I've met several people using 4 100's at a time that are still able to work.
An agressive doc could really mean the difference between being bed ridden and able to function and participate in life. If you feel this doc is too conservative don't waste time on him and start looking for a more agressive doc. The more time he's bed ridden or sedentary the more muscle mass and strength he loses so waiting a month between apts isn't helping and the doc needs to be told. Especially since the doc is predicting a wheelchair in the next year.
Pain can be managed, some folks need very high doses and some docs just won't go there. If this doc has some imaginary number where he cuts people off he's not sounding like a keeper.
It's important that you go to the apts too so the doc has confidence he's not overmedicated and knows he has your support. Take care, David
When titrating a new med a month is really too long to wait to make adjustments, You are unable to tell if it's just tolerance or the dose was never correct in the first place. I would ask the doc at the next apt how long should you give the new dose. With Duragesic you pretty much know by the second patch if it's the right dose. If he simply goes to 50ugh you know he hasn't mmade a change. Titration shouldn't take more than a month and then you fine toon things.
If the doc thinks pain will put him in the chair then tell the doc your paying him to keep the pain controlled so he won't end up in a chair. Ask what is taking so long to get the meds right and perhaps he will speed things up.
I've seen to many docs give up on a drug or a patient because they aren't comfy prescribing whats neccesary.
Just because the highest strength patch is 100ugh doesn't mean that is the maximum dose for Duragesic. I've met several people using 4 100's at a time that are still able to work.
An agressive doc could really mean the difference between being bed ridden and able to function and participate in life. If you feel this doc is too conservative don't waste time on him and start looking for a more agressive doc. The more time he's bed ridden or sedentary the more muscle mass and strength he loses so waiting a month between apts isn't helping and the doc needs to be told. Especially since the doc is predicting a wheelchair in the next year.
Pain can be managed, some folks need very high doses and some docs just won't go there. If this doc has some imaginary number where he cuts people off he's not sounding like a keeper.
It's important that you go to the apts too so the doc has confidence he's not overmedicated and knows he has your support. Take care, David
Lori.19
08-22-2002, 07:29 PM
Hi David,
Thanks for your reply. Ken ran out of Percoset a few days ago and it's been hell. We don't go to the doc until the 29th. I know this is wrong, but to get through until we see the doc, Ken isn't removing the patch when he puts a new one on every other day.He's leaving the older patch on so now he is wearing 3 at all times. One patch is 3 days old, the other is 2 days old and then the new one. I remove the oldest and switch it for a new one every day. Even with doing this the pain is intense since he has no BT meds to take. I spoke to my pharmasist,Bruce, who is also a personal friend, and he suggests asking the doc for MScontin 15 mg every 4 hours for BT and keeping the 7.5 perc and still doing the switching patches every other day. Bruce knows this is nuts with the patch but that's what the doc wants. My How does this sound to you? We can't get other opinions or switch doctors since this doc is the best and most respected in our area and no one questions him on what he prescribes. It's also a workmans comp case. My hubby just wants to rent a gun and buy a bullet.
Thanks for all your help.
Lori
Oh, he don't have the burning leg pain but he has sharp knife like pains running from the small of his back down to his toes and in his hip. He was on Neurontin, Celebrex and Zanaflex, also oxycodone, roxicet, endocet, and a whole bunch of other stuff that I can't remember.
[This message has been edited by Lori.19 (edited 08-22-2002).]
Thanks for your reply. Ken ran out of Percoset a few days ago and it's been hell. We don't go to the doc until the 29th. I know this is wrong, but to get through until we see the doc, Ken isn't removing the patch when he puts a new one on every other day.He's leaving the older patch on so now he is wearing 3 at all times. One patch is 3 days old, the other is 2 days old and then the new one. I remove the oldest and switch it for a new one every day. Even with doing this the pain is intense since he has no BT meds to take. I spoke to my pharmasist,Bruce, who is also a personal friend, and he suggests asking the doc for MScontin 15 mg every 4 hours for BT and keeping the 7.5 perc and still doing the switching patches every other day. Bruce knows this is nuts with the patch but that's what the doc wants. My How does this sound to you? We can't get other opinions or switch doctors since this doc is the best and most respected in our area and no one questions him on what he prescribes. It's also a workmans comp case. My hubby just wants to rent a gun and buy a bullet.
Thanks for all your help.
Lori
Oh, he don't have the burning leg pain but he has sharp knife like pains running from the small of his back down to his toes and in his hip. He was on Neurontin, Celebrex and Zanaflex, also oxycodone, roxicet, endocet, and a whole bunch of other stuff that I can't remember.
[This message has been edited by Lori.19 (edited 08-22-2002).]
fallllea
08-24-2002, 03:50 AM
If anyone knows if numorphone is still made,This is an excellent drug.In response to another reply I am curious.I am also given the oxy 80 mg 3 x a day and percocet 10/325 x 4 a day.It does not seem to help much with the percocet 10/325What would be better to go along with the oxycontin.It just seems like a different narcotic for breakthru would be better then adding 10 mg of the same drug every 6 hours.This doesn't have much effect especialy wnen I am receiving 80mg of the same drug every 8 hours anyway.Any comment's?Thank's randy
Director
08-24-2002, 10:30 AM
Hey Randy,
I was on Oxycontin until just recently. I had gotten up to 160 mg.s four times a day, with break through meds too. The doctor decided maybe it was getting too high and a change was in order. The BT meds he prescirbed were Roxicodone 30 mg. every four hours as needed. With this you're getting the same medication that's in the Oxy, but it's three times as strong. If your doctor is comfortable with that, I think that's the way to go. You can also get Oxycodone for BT in 5, 15 and the 30 mg. strengths.
By the way, thanks for your help and info you oprovided to me in the e-mails pertaining to Hydrocodone 15/80 and having it compounded and then ordered by mail from a pharmacy. I see my doctor this coming week and I'm going to see what he thinks. Right now I'm taking eight 10/325 Hydros a day, but after being on the Oxy for over a year, it just isn't cutting it. Maybe upping the dose, but without all that APAP will help some. The one you gave me was in Florida, but I think if I do it, I'll try to find one closer (Washington State) to cut down on the order/delivery time. Thanks again.
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Director
I was on Oxycontin until just recently. I had gotten up to 160 mg.s four times a day, with break through meds too. The doctor decided maybe it was getting too high and a change was in order. The BT meds he prescirbed were Roxicodone 30 mg. every four hours as needed. With this you're getting the same medication that's in the Oxy, but it's three times as strong. If your doctor is comfortable with that, I think that's the way to go. You can also get Oxycodone for BT in 5, 15 and the 30 mg. strengths.
By the way, thanks for your help and info you oprovided to me in the e-mails pertaining to Hydrocodone 15/80 and having it compounded and then ordered by mail from a pharmacy. I see my doctor this coming week and I'm going to see what he thinks. Right now I'm taking eight 10/325 Hydros a day, but after being on the Oxy for over a year, it just isn't cutting it. Maybe upping the dose, but without all that APAP will help some. The one you gave me was in Florida, but I think if I do it, I'll try to find one closer (Washington State) to cut down on the order/delivery time. Thanks again.
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Director
ckelly
08-31-2002, 09:25 PM
I use Duragesic 50's and change every 48 hrs instead of 72. I also have oxycodone 5mg for break through pain. I have 90 for oxycodone for 30 days.
Geiniel
11-26-2002, 02:29 PM
Hi all,
I too deal with chronic pain on a daily basis.. A suggestion for all of you who are concerned about your Break Thru meds with Additives.. Get them in a liquid form with NO additive.. Morphine and Oxycodone are available in liquid form and are FASTER acting thus lowering the amounts you may need to take in the long run.. The faster you get on top of your pain the better!!
I am a retired RN.. I take 40mg of Oxycontin , 1 in the am and 2 at night, plus I am also prescribed up to 4.5 cc of 20mg/ml pure oxycodone liquid per day (90mg).. Also as a note as for cost.. Oxyfast by Purdue is the most expensive, next lower I have found is by a manufacturer named Mallinckrodt (available at Walmart), and lower than that even made by Ethex is Oxydose (this also has a far more pleasant BERRY flavor).. these are all 20mg/ml of Oxycodone (NO tylenol just pure pain med)..
Also be aware for those of you who have little or no prescription insurance coverage that PCS ($7.95/mo)helps a ton, and if your income is really low like mine (SSDI) I get most of my medication FREE from Purdue once a month. (They even pay the shipping costs and you get approved for a Year of medication at a time) You must apply for this thru your doctor. If you need assistance I would be happy to help you.. my email is gabriella@ragingbull.com..
Hugs,
Geiniel/Ruth
I too deal with chronic pain on a daily basis.. A suggestion for all of you who are concerned about your Break Thru meds with Additives.. Get them in a liquid form with NO additive.. Morphine and Oxycodone are available in liquid form and are FASTER acting thus lowering the amounts you may need to take in the long run.. The faster you get on top of your pain the better!!
I am a retired RN.. I take 40mg of Oxycontin , 1 in the am and 2 at night, plus I am also prescribed up to 4.5 cc of 20mg/ml pure oxycodone liquid per day (90mg).. Also as a note as for cost.. Oxyfast by Purdue is the most expensive, next lower I have found is by a manufacturer named Mallinckrodt (available at Walmart), and lower than that even made by Ethex is Oxydose (this also has a far more pleasant BERRY flavor).. these are all 20mg/ml of Oxycodone (NO tylenol just pure pain med)..
Also be aware for those of you who have little or no prescription insurance coverage that PCS ($7.95/mo)helps a ton, and if your income is really low like mine (SSDI) I get most of my medication FREE from Purdue once a month. (They even pay the shipping costs and you get approved for a Year of medication at a time) You must apply for this thru your doctor. If you need assistance I would be happy to help you.. my email is gabriella@ragingbull.com..
Hugs,
Geiniel/Ruth
davidc66
11-26-2002, 03:29 PM
Hey Genie, I saw your post about Purdue's assistance program, I was wondering if they supply the BT med, OxyFast or OxyIR with their base med of OxyContin or MSContin, I guess that may be a bit much to ask for.LOL I have heard they supply SenekotS to some of their patients on OxyContin. Take care, David
chriztene
11-26-2002, 04:34 PM
I sure could use some assistance with senocot-S?? I have only a 9.00 co-pay, but I have to buy the laxitave and it gets expensive every month!! I asked the dr. if he could prescribe me an rx for constipation and he suggested buying just a stool softner to take along with the senocot.
Christine
Christine