Is oxycontin the best there is? - Pain Management Message Board

StMishl · 03-16-2005, 12:26 PM

Hi. I usually post on the back board. I have a question re: oxycontin.
I currently take 20 mg at 6:00 am/6:00 pm and 10mg at noon (My surgeon is my perscribing doctor still, had a TLIF fusion 12/13/04, which is not fusing, and I have a "possible" lose screw which is pressing on a nerve...) I am still in pain around the 6-7 "pain level" even in the "middle" of the dose - I feel like this is making my pain tolerable, but in no way is it controlled. Is this the best I can expect from such a powerful med or can I ask for more relief? I don't want to be unconcious, but ??

Originally (pre-op) I was taking 10mg am/10mg pm and he bumped it to 20/20 post op, and then added the 1 mid-day about 6 weeks ago. I am not getting the same relief that I previously was.. although I very much notice that they DO help (ie if I miss a dose I am in absolute agony - unable to function). I don't know if my pain is getting worse or if I am building tolerance to the meds. Either way, although I like the way the LA meds work (I have Rheumatoid Arthritis & osteoporis = many broken bones in past, so have experience with narcotic pain meds) and DON'T want to return the short acting meds (pre-oxycontin I was on roxicet), I am concerned that I may need to increase my dose and do not want to get into a cycle of increasing the dose regularly. I am allergic to the adhesive on the patches (tried them... I am also allergic to bandaids- they cause raised burning welts within minutes) and demerol.

Does anyone have a suggestion for a long acting (preferably) med that will not require as frequent bumps in dose? I think my doctor thinks this stuff should work for everyone, and it just isn't... It appears my back is more screwed up then previously expected (the fusion appears to be failing), and I seem to be in this for the long road. Additionally, oxycontin is causing extreme constipation (I realize this is a side effect of most narcotics, but is there one w/ less of this effect??). My doctor seems willing to listen to suggestions, but is of the mindset that if a little oxycontin isn't working lets try some more... I read about all the other meds available on here and just wonder if there isn't a better choice for me. I did see a PM doctor pre-op (who did the ESI -which made things worse) and assume at sometime in the near future I will be returning to his care... but would like to have my "basic" med under control first. My relationship w/ my surgeon is good- he does listen to me, and I think if I ask him about a specific med he will let me try. But then how do I change from 1 to another? Luckily I do have pretty good insurance...

I really appreciate any advice...and thank you in advance

Michelle

scotty12 · 03-16-2005, 12:34 PM

Michelle,
20 mg really isnt much for someone whos been on meds say a year or more.although the oxy is 20mg it only sustains 10mg in your bloodstream,or atleast thats what it is supposed to do.

so if you were taking 2(10mg)oxycodone short acting per dose then it actually is a step down from that.

whatever the dose of oxycontin pill is equal to 1/2 the actual amount when comparing it to roxicet or roxicodone.

if you were taking 20 mg of roxicet then an equivilent dose of oxycontin would be 40MG

scott

SheSparkles · 03-16-2005, 01:44 PM

Hi,
Since you have insurance, why not try some of the long acting morphines? Kadian, Avinza, MSContin, or Palladone, LA hydromorphone (Dilaudid)? Lots of people really like Methadone. There is a new generic fentanyl patch made in a different way by Mylan, you might think about that. Different adhesives.
OK my brain is now mush.
SS

Streetcar · 03-16-2005, 01:59 PM

Hi Michelle,

Welcome to the PM board. Considering what you've been through and with what you're going thru with the screw, I wouldn't be concerned about needing a regular doseage increase. It might take several adjustments to get you where you need to be comfort wise. You (right along with most of us CPers) probably also need a short acting med for breakthru pain even after they get your base med right and especially until they get the base right.

You ask if Oxycontin is the best there is. That all depends on the individual. What works best for me might not do anything for you and what works great for you might only give me marginal relief. There are several LA morphine products available. But any time you change med types, it's a long (usually painful) process getting the doseage correct. If you change meds the dr is going to want to start you off on a conservative doseage to be on the safe side and then work the doseage up slowly till you reach the agreed level of comfort. Plus with a change in med type, you also have a whole new set of side effects to deal with that you may or may not be able to handle.

StMishl · 03-16-2005, 05:21 PM

Thank you all for the reply. If I go in and suggest that perhaps I would like to try a different long acting med (instead of the oxycontin) should I expect that he will say "sure okay" or not? Are the LA morphines similar to the oxy - in that I mean is my pain "bad enough" for them? Is there a relativity between oxycontin is = to the LA morphine? In the hospital the morphine seemed to do a much better job of pain relief then the oxycontin does (but that was in an IV). Is it really just hit and miss? How long should I have to be at each dose before realizing it works or not? Getting BT pain meds seems to be a problem, as I can't seem to get anything consistantly other then the oxycontin (I think that he feels it was a big deal to up the oxycontin, so I shouldn't need anything for BT).

Thanks.

Michelle