Norco vs oxycodone - Pain Management Message Board

******** · 11-06-2004, 05:52 AM

I finally go into see a pain doc here in Boston about 2 weeks ago. I had to go out of Virginia to do it (I live in VA) I have been up here about 2 weeks for treatment for my severe TMJ. Anyways had a medication question. I was on Norco 10.325 4times a day. It was not working well enough. I think the cold up here in Boston is not helping my pain at all. He switched me to oxycodone 5mg 5 times a day. What is the conversion of these 2 meds. Am I getting better pain relief or just different drug since the Norco was no longer cutting it??

Amy

Shoreline · 11-06-2004, 09:10 AM

Hey Amy, Only you can decide if your getting better relief from the oxycodone. You can't let a conversion chart decide that for you. Some people respond better to one drug versus another.

The standard conversion from hydro to oxy is 10mgs of hydrocosone would be equal to 7.5-8.0 mgs of oxycodone. So on some chart it may apear your getting less opiate, but charts are just ballpark guides and shouldn't replace patient reporting. The increase in valium would certanly make any opiate more potent, along with increasing the side effects of both untill you become accomadated to the valium and the oxy side effects.

Oxy can cause anxiety but in theory the valium would reduce anxiety although it doesn't work on the part of the brain that's causing the anxiety, which is another factor. Valium can also cause memory loss, and depression. I think valium is a grat muscle relazer when nothing else works but I've seen people cry within an hour of a single dose from the feelings of depression it can cause. Any med can cause a wide variety of symptoms and it's just a matter of trial and error and your individul response.

An antihystamine like Visteril would work on anxiety, itching and nausea from opiates and potentiate the effectiveness, but not give you the relief of a potent muscle relaxer like valium to help with the clenchng and grinding. Some people just respond beter to another opiate particularly when you become tolerant to the first. They can then get by with less than some chart may say. Most charts are different from one another anyway.

I don't believe in the idea of cross tolerance which is the idea of your tolerant to 10 mgs of hydro you would be equally tolerant to 7.5mgs of oxy. Hydrocodone breaks down into hydromorphone as on of it's metabolites and Oxycodone breaks down into oxymorphone, so there is a differnce in the way someone would respond although a chart may say X is = to Y.
Talk to your doc about your dose and schedule.
Are you going to have to stay in boston to continue treatment?
Good luck, Dave

******** · 11-06-2004, 12:52 PM

Thanks Dave

The oxycodone seems to be working ok. Not 100% pain relief, but I have given up on the notion that I will ever have 100% pain relief. I do take the valium (5mg) 4 times a day. He gave me some Soma to try out too. I took it last night instead of the valium and found it really knocked me on my buttocks. I have found the valium to be by far the most effective muscle relaxer out of all that I have tried. I don't get depressed at all from it. On top of it all I am now coming down with a head cold which is not helping the pressure in my ear at all.
I am staying up here as long as I need to. My MRI and Cat scan were so-so. There is a big chunk missing out of one of my jaw bones and they are not sure what the cause of it is. I had a bone scan done but have not gotten the results back yet. The pain doc I am seeing is also a periodontist. He works very closely with the surgeon I am seeing here. I have the utmost confidence in them. They have done some other testing and believe that alot of my pain in neuropathic in nature. Which from what I have been told is not fixable, but only can be managed with medications. If the missing chunk of bone turns out to be necrosis, I will probably have to have joint replacement. They are trying arthrocentethis first. I don't hold out much hope for that working as I have had that done 3 times already without any success. But I trust these guys and am willing to try it again. It is certainly less invasive than joint replacement.
So I am here for the long hall. I had to take my son out of school and my husband is back in Virginia working. Fortunately I have my parents and mother in law and lots of other family in the area to help me out. Wish me luck, I am going to need it.

Amy