shore i need some advice on meds - Pain Management Message Board

TATS · 06-11-2004, 12:37 PM

hey shore man glad to read you and pump are doing well.i'm going to my pm doc on mon.and need some advice?i'm taking 90mg.morphine E.R.daily and roxi 30mg.up to 4 times as needed for b.t.pain.i dont have insurance so i'm limited by expense.the doc wanted me on oxi-cot but i dont have 600 plus.my problem is hepC.i tried methadone 120mg daily but it made my liver spike.i need somthing cheap but yet strong?is dulidid a drug that would fall into this catogory?does it work oraly or is it lost when done that way?is the liver the main organ that does all the work besides the brain?also ;i have addisons disease this means my heart runs slow i.e.morphine literature stess's to be carful when addministered with addisons.shore its taken me awhile to post (personal problems) so if you could think this over and drop me a line i would be thankful.

Shoreline · 06-11-2004, 01:09 PM

Hi Tats, Although I would prefer Dilaudid PCA "IV' over any other med for post op pain, when delivered orally it's not nearly as effective, It's half life is shorter than morphine and duration was limeted to bearly 3 hours regardless of doseage.

Roxicodone is mighty expensive especially if you take 4 a day. Short acting morphine is just as cheap as generic Dilauadid, I get 100 30mg generic MSIR for 27 bucks at Sams club with the Peoples prescription plan. But you loose the benefit of using multiple opiates to cover a broader range of receptors. That 7 bucks a month does pay for itself over and over. The PPP is managed by Advanced PCS which is the largest prescription drug insurance co in the country, so the discounts are real. It dropped my meth from 90 bucks to 60 bucks.

If you tolerate the LA morphine, using MSIR "generic" for BT would seem to make sense but I need to take a look at the contraindications and research addisons a bit.
I'll get back to ya though, Take care, Dave

Levodromoran may be another alternative but I need to check that too.

Shoreline · 06-11-2004, 01:15 PM

Hi Tats, Although I would prefer Dilaudid PCA "IV' over any other med for post op pain, when delivered orally it's not nearly as effective, It's half life is shorter than morphine and duration was limited to barely 3 hours regardless of doseage. But you may find you resppond better to oral Hydromorph than I. I would need to check it with addisons too.

Roxicodone is mighty expensive especially if you take 4 a day. Short acting morphine is just as cheap as generic Dilauadid, I get 100 30mg generic MSIR for 27 bucks at Sams club with the Peoples prescription plan. But you loose the benefit of using multiple opiates to cover a broader range of receptors. Oxy works particularly well on visceral pain.

That 7 bucks a month does pay for itself over and over. The PPP is managed by Advanced PCS which is the largest prescription drug insurance co in the country, so the discounts are real. It dropped my meth from 90 bucks to 60 bucks.

It may also help to know what your pain generator is, Visceral, Somatic or Neuro

If you tolerate the LA morphine, using MSIR "generic" for BT would seem to make sense but I need to take a look at the contraindications and research addisons a bit.
I'll get back to ya though, Take care, Dave

Levodromoran may be another alternative but I need to check that too.

TATS · 06-12-2004, 11:14 AM

hi shore ,this is a drag i wrote you this morning and thanked you for getting back to me so soon .then i pressed submit reply and poof it disapears?i dont see it any where? so i'll send this short note and see where it goes?

Shoreline · 06-12-2004, 11:26 AM

Hey Tats, I'm online now if you can answerabout your pain generator, I kept loosing posts yesterday too and now I see I have duplicated the one that made it. I'm not sure what the glitch is , But if you can tell me about your pain that would be great.

Although I have only had the pump for 10 days it's making a difference, My head is so much cleaer, It's amazing what .1 mgs delivered IT every hour can do, It's not metabolized by your liver and if any exxcess is, the doseage would be so low I couldn't imagine it causing any liver problem. You may want to start researching the pump. The synchromed 11 is now beingtest marketed, thay make a thinner pump and one the same size withat holds enough meds for up to 6 months.

It took 3 years of research and 2 seperate trials to convjnce me this was the right thing to do. I'm not sugesting you jump to a pump without great consideration. But IT meds are basically 300 times stronger than oral meds, The refills are coverd by medicare, which is my only insurance, so I'll be saving the money spent on meth and hopefully save money on BT meds.They can even put baclofin for spasm or spasticity into the pump along with numbing agents.

Personally I would love to go back to Roxi for BT but I can't fork out 150-200 bucks a month for 100 30mg pills.
I'll be doing some checking on addisons and come back at take a look at your response. Take care, Dave